Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Vein Essentials Ingredients & Drug Interactions

by Adaptogen Research

Capsule Category: Other Combinations
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Vein Essentials is a dietary supplement by Adaptogen Research with 5 active ingredients. Its ingredients are commonly taken for hemorrhoids, varicose veins and poor circulation, leg swelling (venous insufficiency).Based on those ingredients, 1,603 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Citrus Bioflavonoid Complex, Hesperidin Methyl Chalcone, Gotu Kola extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Vein Essentials by Adaptogen Research

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

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 4 of its 9 active ingredients.
  • “Hesperidin Methyl Chalcone” is listed as a grouped ingredient — the label gives one combined amount (125 mg) without saying how much of each component you get.

Vein Essentials contains 9 active ingredients designed to support vein health. The main players are butcher's broom extract and horse chestnut extract — both are used to address chronic venous insufficiency — plus gotu kola extract, which is also used for venous insufficiency.

You'll also get citrus ingredients (grapefruit, orange, lemon, lime, tangerine) and hesperidin methyl chalcone, a flavonoid from citrus. The product is filled out with standard inactive ingredients: a vegetarian capsule, silicon dioxide, and magnesium stearate.

Does it work?

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

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

Why this rating?
  • The label markets this product for: Vein health and circulation support.
  • We looked for evidence on: Chronic venous insufficiency (CVI), Hemorrhoids, Leg swelling and heaviness, Poor circulation.
  • The strongest evidence on file: Butcher's Broom is rated "Possibly Effective" for Chronic venous insufficiency (CVI) (Natural Medicines).
  • Also on file: Gotu Kola is rated "Possibly Effective" for Venous insufficiency.
  • Also on file: Horse Chestnut is rated "Possibly Effective" for Chronic venous insufficiency (CVI).

Evidence varies by ingredient. Butcher's broom and horse chestnut both show possibly effective evidence for chronic venous insufficiency — that's the condition the product is named for.

Gotu kola also carries a possibly effective rating for venous insufficiency, plus possibly effective for burns. The citrus ingredients in this blend carry insufficient evidence ratings for the conditions that have been studied.

Overall, the foundation of this product — butcher's broom, horse chestnut, and gotu kola for vein health — has some clinical backing, but the citrus components have not been established as effective for any condition in our data.

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

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

Butcher's broom, horse chestnut, and gotu kola are generally well tolerated short-term in healthy adults, but long-term safety data is limited for all three. The most common side effects from butcher's broom are gastrointestinal: diarrhea, nausea, vomiting, heartburn, and indigestion.

Horse chestnut can cause dizziness, headache, itching, and stomach upset. Gotu kola may cause nausea and gastric irritation.

Grapefruit and citrus acids (in lemon and lime) can cause heartburn and gastrointestinal discomfort in some people, especially in larger amounts or when taken as juice. One clinical trial found that 37% of people taking lemon juice reported gastrointestinal symptoms compared to 8% on placebo.

During pregnancy, butcher's broom, horse chestnut, and gotu kola safety data advises against use. While these ingredients are foods, safety in pregnancy hasn't been established.

The citrus ingredients don't have pregnancy data on file — talk with your doctor or pharmacist about their use during pregnancy or breastfeeding. Gotu kola and horse chestnut should also be avoided while breastfeeding.

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 9 of the 9 matched ingredients can interact with medications — Quercetin, Butcher's Broom, Lemon, Lime, Gotu Kola, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,604 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.

Check before taking this product if you use heart rhythm medications (amiodarone), anticoagulants or blood thinners, sedatives or central nervous system depressants, the antifungal itraconazole, the blood pressure medications cyclosporine or celiprolol, buspirone for anxiety, dextromethorphan for cough, the anti-nausea medication scopolamine, or the cancer drugs etoposide — all carry Major or Moderate interactions with ingredients here. If you take blood pressure medications in the alpha-adrenergic class, check those too.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product is designed for people managing chronic vein issues, and butcher's broom and horse chestnut have some evidence behind them. But if you take any medications — especially heart rhythm drugs, blood thinners, sedatives, or antifungals — you'll want to check your specific list with the tool on this page first, because the grapefruit and other ingredients here can cause real interactions.

Talk to your pharmacist before starting if you're pregnant, breastfeeding, or have liver concerns.

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

Assessment coverage: 9 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 22, 2021.

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

At a glance

General information

Key facts about Vein Essentials, straight from the product label.

Brand Adaptogen Research
Barcode (UPC) 828054705043
Net contents 60 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD May 22, 2021
DSLD ID 247285
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Vein Essentials by Adaptogen Research, 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 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
60
UPC/BARCODE
828054705043
IngredientAmount% DV
Hesperidin Methyl Chalcone125 mg--
Butcher's Broom extract80 mg--
Orange0 NP--
Lemon0 NP--
Lime0 NP--
Tangerine0 NP--
Grapefruit0 NP--
Gotu Kola extract150 mg--
Horse Chestnut extract250 mg--
Citrus Bioflavonoid Complex125 mg--

Other ingredients: Vegetarian Capsule, Silicon Dioxide, Magnesium Stearate

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.
FDA Statement of Identity

Herbal Supplement

General Statements

Professional Use Only

Precautions

Report any adverse reactions to (302) 213-0030

Do not use of shrinkwrap is broken or missing.

Keep out of reach of children.

Suggested/Recommended/Usage/Directions

Suggested Use: As a dietary supplement, take 1 capsule, 1 to 2 times daily, or as directed by your health care practitioner.

Storage

Store in a cool, dry place (59 degrees F-85 degrees F) away from direct sunlight.

Formulation

Produced under a strict quality management system in compliance with Good Manufacturing Practices (GMPs) and third-party quality certifications.

Notice: Color, size or shape may appear different between lots.

See for yourself

Vein Essentials by Adaptogen Research label

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

What’s inside

The Ingredients in Vein Essentials by Adaptogen Research

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

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

Hesperidin Methyl Chalcone

Interacts with
702 drugs
125 mg per serving

Hesperidin is a flavonoid found in citrus fruits that is often combined with diosmin and used for vein and circulation problems like hemorrhoids and v...

Hesperidin Methyl Chalcone monograph & interactions

Butcher's Broom extract

Interacts with
158 drugs
80 mg per serving Form: Ruscogenins

Butcher's broom is a plant extract most often used for circulation problems in the legs, such as chronic venous insufficiency, where some evidence sug...

Butcher's Broom extract monograph & interactions

Gotu Kola extract

Interacts with
579 drugs
150 mg per serving Form: Asiaticosides

Gotu kola is a traditional Ayurvedic and Asian herb that people use for wound healing, circulation, skin problems, and as a calming or memory-supporti...

Gotu Kola extract monograph & interactions

Horse Chestnut extract

Interacts with
122 drugs
250 mg per serving Form: Aescin

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and h...

Horse Chestnut extract monograph & interactions

Citrus Bioflavonoid Complex

Interacts with
1,169 drugs
125 mg per serving Form: Total Bioflavonoids

Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early rese...

Citrus Bioflavonoid Complex monograph & interactions

Other (inactive) ingredients: Vegetarian Capsule, Silicon Dioxide, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Vein Essentials by Adaptogen Research Drug Interactions

Want to check YOUR meds against Vein Essentials?

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

Go to the checker
1,603Drugs
777 Major 826 Moderate

Each ingredient & the kinds of drugs it affects

For each ingredient in Vein Essentials 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.

Citrus Bioflavonoid Complex21 drug types · 1,169 drugs

Antidiabetes Drugs

Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.

Clinical research suggests that a combination of quercetin, myricetin, and chlorogenic acid reduce levels of fasting glucose in patients with type 2 diabetes, including those already taking antidiabetes agents. The effect of quercetin alone is unknown.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.

Quercetin can modestly decrease blood pressure in people with mild hypertension. Theoretically, it might have additive blood pressure lowering effects when used with antihypertensive drugs.

Likelihood Possible Evidence B
Cyclosporine (Neoral, Sandimmune)

Theoretically, concomitant use might increase the levels and adverse effects of cyclosporine.

A small study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine, possibly due to inhibition of p-glycoprotein or cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporin.

Likelihood Possible Evidence B
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.

In vitro research shows that quercetin inhibits CYP2C8. Inhibition of paclitaxel (Taxol) metabolism via CYP2C8 has been reported in vitro. However, a small study in humans found no effect of quercetin on rosiglitazone (Avandia), which is also a CYP2C8 substrate.

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

Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.

A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac, a CYP2C9 substrate, increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar), a substrate of CYP2C9. Furthermore, laboratory research shows that quercetin inhibits CYP2C9.

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

Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.

In vitro research show that quercetin inhibits CYP2D6. This effect has not been reported in humans.

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

Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
A small clinical study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine (Neoral, Sandimmune), a substrate of CYP3A4. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) and quetiapine (Seroquel), substrates of CYP3A4. Other laboratory research also shows that quercetin inhibits CYP3A4. However, one clinical study shows that quercetin can increase the metabolism of midazolam, a substrate of CYP3A4, and decrease serum concentrations of midazolam by about 24% in some healthy individuals, suggesting possible induction of CYP3A4.

Likelihood Possible Evidence D
Diclofenac (Voltaren, Others)

Theoretically, concomitant use might increase the levels and adverse effects of diclofenac.

A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. This is thought to be due to inhibition of CYP2C9 by quercetin.

Likelihood Probable Evidence B
Losartan (Cozaar)

Theoretically, concomitant use might increase the effects and adverse effects of losartan and decrease the effects of its active metabolite.

Animal research shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) while decreasing plasma levels of losartan's active metabolite. This metabolite, which is around 10-fold more potent than losartan, is the result of cytochrome P450 (CYP) 2C9- and CYP3A4-mediated transformation of losartan. Additionally, in vitro research shows that quercetin may inhibit P-glycoprotein-mediated efflux of losartan from the intestines, resulting in increased absorption of losartan. These results suggest that concomitant use of quercetin and losartan might increase systemic exposure to losartan while also decreasing plasma concentrations of losartan's active and more potent metabolite.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, concomitant use might decrease the levels and effects of midazolam.

A small clinical study in healthy volunteers shows that quercetin can increase the metabolism of midazolam, with a decrease in AUC of about 24%.

Likelihood Possible Evidence B
Mitoxantrone

Theoretically, quercetin might increase the effects and adverse effects of mitoxantrone.
In vitro research shows that quercetin increases the intracellular accumulation and cytotoxicity of mitoxantrone, possibly through inhibition of breast cancer resistance protein (BCRP), of which mitoxantrone is a substrate. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Organic Anion Transporter 1 (Oat1) Substrates

Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.

In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT1, with half-maximal inhibitory concentration (IC50) values less than 10 mcM. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Organic Anion Transporter 3 (Oat3) Substrates

Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.

In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT3, with half-maximal inhibitory concentration (IC50) values as low as 0.75 mcM. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.

In vitro evidence shows that quercetin can inhibit organic anion-transporting peptide (OATP) 1B1-mediated uptake of estrone-3-sulfate and pravastatin. Furthermore, clinical research in healthy males shows that intake of quercetin along with pravastatin increases the AUC of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.

There is preliminary evidence that quercetin inhibits the gastrointestinal P-glycoprotein efflux pump, which might increase the bioavailability and serum levels of drugs transported by the pump. A small study in healthy volunteers reported that pretreatment with quercetin increased bioavailability and plasma levels after a single dose of cyclosporine (Neoral, Sandimmune). Also, two small studies have shown that quercetin might decrease the absorption of talinolol, a substrate transported by the gastrointestinal P-glycoprotein efflux pump. However, in another small study, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase). The reason for these discrepancies is not entirely clear. Until more is known, use quercetin cautiously in combination with P-glycoprotein substrates.

Likelihood Possible Evidence B
Pravastatin (Pravachol)

Theoretically, concomitant use might increase the effects and adverse effects of pravastatin.
In vitro evidence shows that quercetin can inhibit OATP 1B1-mediated uptake of pravastatin. Also, preliminary clinical research in healthy males shows that intake of quercetin along with pravastatin increases the maximum concentration of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.

Likelihood Possible Evidence B
Prazosin (Minipress)

Theoretically, quercetin might increase the effects and adverse effects of prazosin.
In vitro research shows that quercetin inhibits the transcellular efflux of prazosin, possibly through inhibition of breast cancer resistance protein (BCRP), of which prazosin is a substrate. BCRP is an ATP-binding cassette efflux transporter in the intestines, kidneys, and liver. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Quetiapine (Seroquel)

Theoretically, concomitant use might increase the effects and adverse effects of quetiapine.
Animal research shows that pretreatment with quercetin can increase plasma levels of quetiapine and prolong its clearance, possibly due to inhibition of cytochrome P450 3A4 (CYP3A4) by quercetin. Additionally, the brain-to-plasma ratio of quetiapine concentrations increased, possibly due to inhibition of P-glycoprotein at the blood-brain barrier. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, concomitant use might inhibit the effects of quinolone antibiotics.
In vitro, quercetin binds to the DNA gyrase site on bacteria, which may interfere with the activity of quinolone antibiotics.

Likelihood Possible Evidence B
Sulfasalazine (Azulfidine)

Theoretically, quercetin might increase the effects and adverse effects of sulfasalazine.
Animal research shows that quercetin increases the maximum serum concentration (Cmax) and area under the curve (AUC) of sulfasalazine, possibly through inhibition of breast cancer resistance protein (BCRP), of which sulfasalazine is a substrate. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, quercetin may increase the risk of bleeding if used with warfarin.
Animal and in vitro studies show that quercetin might increase serum levels of warfarin. Quercetin and warfarin have the same human serum albumin (HSA) binding site, and in vitro research shows that quercetin has stronger affinity for the HSA binding site and can theoretically displace warfarin, causing higher serum levels of warfarin. Animal research shows that taking quercetin for 2 weeks before initiating warfarin increases the maximum serum level of warfarin by 30%, the half-life by 10%, and the overall exposure by 63% when compared with control. Concomitant administration of quercetin and warfarin, without quercetin pre-treatment, also increased these measures, but to a lesser degree. Researchers theorize that inhibition of CYP3A4 by quercetin may explain these effects. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Hesperidin Methyl Chalcone7 drug types · 702 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, hesperidin may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Animal research suggests that hesperetin, a bioflavonoid aglycone derivative of hesperidin, may have antiplatelet activity.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, taking hesperidin with antihypertensive drugs might increase the risk of hypotension.
Some clinical and animal research shows that hesperidin can decrease blood pressure. However, other clinical research shows that hesperidin does not affect blood pressure.

Likelihood Possible Evidence D
Celiprolol (Celicard)

Theoretically, hesperidin may decrease the levels and clinical effects of celiprolol.
Animal research shows that concomitant use of hesperidin may reduce the plasma area under the curve of celiprolol by up to 75%. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, concomitant use with CNS depressants may cause additive sedative effects.
Animal studies show that hesperidin has sedative effects, due to opioid receptor activity and can increase sedation when used with diazepam. This effect has not been reported in humans.

Likelihood Possible Evidence D
Diltiazem (Cardizem, Others)

Theoretically, hesperidin may increase the levels and clinical effects of diltiazem.
Animal research suggests that hesperidin may enhance the bioavailability of diltiazem, increasing the plasma area under the curve of diltiazem by up to 65.3%. This effect has not been reported in humans.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, hesperidin might inhibit P-glycoprotein-mediated drug efflux and potentially increase levels of drugs that are substrates of P-glycoprotein.
In vitro research shows that hesperidin can inhibit P-glycoprotein efflux. This effect has not been reported in humans.

Likelihood Possible Evidence D
Verapamil (Calan, Others)

Theoretically, hesperidin might increase the levels and clinical effects of verapamil.
Animal research suggests that hesperidin may enhance the bioavailability of verapamil, increasing the plasma area under the curve of verapamil by 96.8%. This effect has not been reported in humans

Likelihood Possible Evidence D

Gotu Kola extract2 drug types · 579 drugs

Cns Depressants

Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
In vitro research suggests that gotu kola may have sedative effects via binding of GABA receptors.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
There are at least four case reports of hepatotoxicity associated with the use of gotu kola. However, more information is needed to determine if gotu kola was the causative factor in these cases.

Likelihood Possible Evidence D

Butcher's Broom extract2 drug types · 158 drugs

Alpha-Adrenergic Agonists

Theoretically, butcher's broom might increase the effects and adverse effects of alpha-adrenergic agonists.
Animal and in vitro studies show that butcher's broom has alpha-adrenergic agonist effects.

Likelihood Possible Evidence D
Alpha-Adrenergic Antagonists

Theoretically, butcher's broom might reduce the effects of alpha-adrenergic antagonists.
Animal and in vitro studies show that butcher's broom has alpha-adrenergic agonist effects.

Likelihood Possible Evidence D

Horse Chestnut extract1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Horse chestnut may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Horse chestnut contains the constituent esculin which has been shown to have antithrombotic effects. Therefore, horse chestnut might have antiplatelet effects. This has not been shown in humans.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Vein Essentials, from the product label.

Adaptogen Research

See all Adaptogen Research products
Name
Adaptogen Research
Street Address
625 Barksdale Road, Suite 113
City
Newark
State
DE
ZipCode
19711
Phone Number
302-213-0030
Pharmacist Counseling Corner

Vein Essentials by Adaptogen Research: Common Questions

Does Vein Essentials by Adaptogen Research interact with any medications?
Yes. Based on its ingredients, Vein Essentials has a known interaction with 1,603 medications, including 777 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Vein Essentials contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this help with varicose veins or leg swelling?
Butcher's broom and horse chestnut both have possibly effective evidence for chronic venous insufficiency — that's the swelling and discomfort from blood pooling in your legs. Gotu kola also shows possibly effective for venous issues. These three ingredients form the backbone of the product, so there's some clinical backing here, though results vary by person.
Is it safe to take long-term?
These ingredients are generally well tolerated in the short term, but we don't have solid long-term safety data. If you're thinking of taking it daily for months, it's worth discussing with your pharmacist or doctor first, especially given the gotu kola concern about liver health in rare cases.
Can I take this if I'm on a blood thinner?
Not without checking first. Horse chestnut may increase bleeding risk with anticoagulants or antiplatelet drugs, and grapefruit can interact with several blood thinners. Run your exact medication through the checker on this page before starting.
What's the grapefruit doing in a vein supplement?
Grapefruit is included as a citrus bioflavonoid source — citrus flavonoids are sometimes used in vein health formulas. However, grapefruit is a potent drug interactor and can significantly raise or lower levels of many medications, so its presence here is a reason to check your drug list carefully.
What are the most common side effects?
Stomach upset — nausea, diarrhea, heartburn, indigestion — is the most common complaint across the herbal ingredients. Some people also report dizziness or headache. The citrus ingredients can add to heartburn risk if you're sensitive.
Can I take this while pregnant or breastfeeding?
The data advises against it during pregnancy (butcher's broom, horse chestnut, and gotu kola). While these are food-derived, their safety in pregnancy hasn't been established. Gotu kola and horse chestnut should be avoided while breastfeeding. Talk with your doctor or pharmacist for personalized guidance.

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

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

Vein Essentials label
Go deeper

The Full Monographs Behind Vein Essentials’s Ingredients

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

Herb & supplement monograph

Hesperidin

Interacts with 702 drugs

Hesperidin is a flavonoid found in citrus fruits that is often combined with diosmin and used for vein and circulation problems like hemorrhoids and varicose veins. Some evidence supports th...

Read the full Hesperidin monograph →
Herb & supplement monograph

Sweet Orange

Interacts with 246 drugs

Sweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and...

Read the full Sweet Orange monograph →
Herb & supplement monograph

Lemon

Interacts with 1 drug

Lemon is a common citrus fruit that is a good source of vitamin C and citric acid, and it is widely used in food, drinks, and home remedies. While it can support hydration and a healthy diet...

Read the full Lemon monograph →
Herb & supplement monograph

Lime

Interacts with 886 drugs

Lime is a common citrus fruit and a good natural source of vitamin C and plant antioxidants. As a food it is generally safe and enjoyed by most people, but evidence that lime treats any spec...

Read the full Lime monograph →
Herb & supplement monograph

Tangerine

Interacts with 643 drugs

Tangerine is a sweet citrus fruit that is a good source of vitamin C and other nutrients, and is widely enjoyed as food. While the peel and essential oil are used in traditional medicine and...

Read the full Tangerine monograph →
Herb & supplement monograph

Grapefruit

Interacts with 990 drugs

Grapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription...

Read the full Grapefruit monograph →
Herb & supplement monograph

Butcher's Broom

Interacts with 158 drugs

Butcher's broom is a plant extract most often used for circulation problems in the legs, such as chronic venous insufficiency, where some evidence suggests it may help reduce swelling and di...

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Herb & supplement monograph

Gotu Kola

Interacts with 579 drugs

Gotu kola is a traditional Ayurvedic and Asian herb that people use for wound healing, circulation, skin problems, and as a calming or memory-supporting herb. Some early studies suggest poss...

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Herb & supplement monograph

Horse Chestnut

Interacts with 122 drugs

Horse chestnut seed extract is most often used for chronic venous insufficiency, where standardized products may help reduce leg swelling, pain, and heaviness. Raw, unprocessed horse chestnu...

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Herb & supplement monograph

Quercetin

Interacts with 1,169 drugs

Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood...

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Sources

Sources & How We Checked

Vein Essentials'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 286 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.

Hesperidin 14 references
  1. Fernandez, S. P., Wasowski, C., Paladini, A. C., and Marder, M. Synergistic interaction between hesperidin, a natural flavonoid, and diazepam. Eur.J.Pharmacol. 4-11-2005;512(2-3):189-198. PubMed
  2. Jin, Y. R., Han, X. H., Zhang, Y. H., Lee, J. J., Lim, Y., Chung, J. H., and Yun, Y. P. Antiplatelet activity of hesperetin, a bioflavonoid, is mainly mediated by inhibition of PLC-gamma2 phosphorylation and cyclooxygenase-1 activity. Atherosclerosis 200
  3. Loscalzo, L. M., Wasowski, C., Paladini, A. C., and Marder, M. Opioid receptors are involved in the sedative and antinociceptive effects of hesperidin as well as in its potentiation with benzodiazepines. Eur.J.Pharmacol. 2-12-2008;580(3):306-313. PubMed
  4. Yamamoto, M., Suzuki, A., Jokura, H., Yamamoto, N., and Hase, T. Glucosyl hesperidin prevents endothelial dysfunction and oxidative stress in spontaneously hypertensive rats. Nutrition 2008;24(5):470-476. PubMed
  5. El-Readi, M. Z., Hamdan, D., Farrag, N., El-Shazly, A., and Wink, M. Inhibition of P-glycoprotein activity by limonin and other secondary metabolites from Citrus species in human colon and leukaemia cell lines. Eur.J.Pharmacol. 1-25-2010;626(2-3):139-145 PubMed
  6. Buckshee, K., Takkar, D., and Aggarwal, N. Micronized flavonoid therapy in internal hemorrhoids of pregnancy. Int J Gynaecol Obstet 1997;57(2):145-151. PubMed
  7. Uesawa, Y. and Mohri, K. Hesperidin in orange juice reduces the absorption of celiprolol in rats. Biopharm Drug Dispos. 2008;29(3):185-188. PubMed
  8. Cho, YA, Choi, DH, and Choi, JS. Effect of hesperidin on the oral pharmacokinetics of diltiazem and its main metabolite, desacetyldiltiazem, in rats. J Pharm Pharmacol. 2009;61(6):825-829. PubMed
  9. Piao, YJ and Choi, JS. Enhanced bioavailability of verapamil after oral administration with hesperidin in rats. Arch Pharm Res. 2008;31(4):518-522. PubMed
  10. Andersen KE. Hesperidin methyl chalcone?-?a new cosmetic contact allergen. Contact Dermatitis. 2015;72(6):402-4. PubMed
  11. Morand C, Dubray C, Milenkovic D, et al. Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers. Am J Clin Nutr 2011;93(1):73-80. PubMed
  12. Homayouni F, Haidari F, Hedayati M, Zakerkish M, Ahmadi K. Blood pressure lowering and anti-inflammatory effects of hesperidin in type 2 diabetes; a randomized double-blind controlled clinical trial. Phytother Res. 2018;32(6):1073-1079. PubMed
  13. Mohammadi M, Ramezani-Jolfaie N, Lorzadeh E, Khoshbakht Y, Salehi-Abargouei A. Hesperidin, a major flavonoid in orange juice, might not affect lipid profile and blood pressure: A systematic review and meta-analysis of randomized controlled clinical trials PubMed
  14. Valls RM, Pedret A, Calderón-Pérez L, et al. Effects of hesperidin in orange juice on blood and pulse pressures in mildly hypertensive individuals: a randomized controlled trial (Citrus study). Eur J Nutr. 2021;60(3):1277-1288. PubMed

See these in context on the Hesperidin monograph →

Butcher's Broom 8 references
  1. Beltramino R, Penenory A, Buceta AM. An open-label, randomized multicenter study comparing the efficacy and safety of Cyclo 3 Fort versus hydroxyethyl rutoside in chronic venous lymphatic insufficiency. Angiology 2000;51:535-44.. PubMed
  2. Redman DA. Ruscus aculeatus (butcher's broom) as a potential treatment for orthostatic hypotension, with a case report. J Altern Complement Med 2000;6:539-49..
  3. Landa, N., Aguirre, A., Goday, J., Raton, J. A., and Diaz-Perez, J. L. Allergic contact dermatitis from a vasoconstrictor cream. Contact Dermatitis 1990;22(5):290-291. PubMed
  4. Cluzan, R. V., Alliot, F., Ghabboun, S., and Pascot, M. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Lymphology 1996;29(1):29-35.
  5. Parrado F, Buzzi A. A study of the efficacy and tolerability of a preparation containing Ruscus aculeatus in the treatment of chronic venous insufficiency of the lower limbs. Clin Drug Invest 1999;18(4):255-61. DOI
  6. Sadarmin PP, Timperley J. An unusual case of Butcher's Broom precipitating diabetic ketoacidosis. J Emerg Med 2013;45(3):e63-e65. PubMed
  7. Ramirez-Hernandez M, Garcia-Selles J, Merida-Fernandez C, Martinez-Escribano JA. Allergic contact dermatitis to ruscogenins. Contact Dermatitis 2006;54(1):60. PubMed
  8. European Medicines Agency. Assessment report on Ruscus Aculeatus L rhizome. EMEA/HMPC/261939/2007. London, September 4, 2008. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_HMPC_assessment_report/2009/12/WC500018288.pdf. Acces

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Sweet Orange 17 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. FDA, CFSAN. FDA-approved potassium health claim notification for potassium containing foods. 2000. Available at: www.cfsan.fda.gov/~dms/hclm-k.html.
  3. Kurowska EM, Spence JD, Jordan J, et al. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr 2000;72:1095-100. PubMed
  4. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  5. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  6. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
  7. Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther 2004;75:184-90.
  8. Tian R, Koyabu N, Takanaga H, et al. Effects of grapefruit juice and orange juice on the intestinal efflux of P-glycoprotein substrates. Pharm Res 2002;19:802-9. PubMed
  9. Vanapalli SR, Chen Y, Ellingrod VL, et al. Orange juice decreases the oral bioavailability of ivermectin in health volunteers. Clin Pharmacol Ther 2003;73 (Abstract PDII-A-10):P94.
  10. Huang SM, Lesko LJ. Drug-drug, drug-dietary supplement, and drug-citrus fruit and other food interactions: what have we learned? J Clin Pharmacol 2004;44:559-69. PubMed
  11. Koitabashi Y, Kumai T, Matsumoto N, et al. Orange juice increased the bioavailability of pravastatin, 3-hydroxy-3-methylglutaryl CoA reductase inhibitor, in rats and healthy human subjects. Life Sci 2006;78:2852-9. PubMed
  12. Takanaga H, Ohnishi A, Yamada S, et al. Polymethoxylated flavones in orange juice are inhibitors of P-glycoprotein but not cytochrome P450 3A4. J Pharmacol Exp Ther 2000;293:230-6. DOI
  13. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  14. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  15. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  16. Kays MB, Overholser BR, Mueller BA, et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis. 2003;42(6):1253-9. PubMed
  17. Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI

See these in context on the Sweet Orange monograph →

Lemon 2 references
  1. Ruggenenti P, Caruso MR, Cortinovis M, et al. Fresh lemon juice supplementation for the prevention of recurrent stones in calcium oxalate nephrolithiasis: A pragmatic, prospective, randomised, open, blinded endpoint (PROBE) trial. EClinicalMedicine 2021;4 PubMed
  2. Umemura K, Katada Y, Nakagawa S, et al. Improved absorption of itraconazole tablet by co-administration with lemon beverages in a lung transplant recipient: A case report. J Infect Chemother 2022;28(8):1203-1207. PubMed

See these in context on the Lemon monograph →

Lime 20 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Roesyanto-Mahadi ID, Geursen-Reitsma AM, van Joost T, et al. Sensitization to fragrance materials in Indonesian cosmetics. Contact Dermatitis 1990;22:212-7. PubMed
  3. Naganuma M, Hirose S, Nakayama Y, et al. A study of the phototoxicity of lemon oil. Arch Dermatol Res 1985;278:31-6. . PubMed
  4. Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome P450 3A4 activity: comparison with grapefruit juice. Clin Pharmacol Ther 2003;73:529-37. PubMed
  5. Weber, I. C., Davis, C. P., and Greeson, D. M. Phytophotodermatitis: the other "lime" disease. J Emerg.Med 1999;17(2):235-237. PubMed
  6. Wagner, A. M., Wu, J. J., Hansen, R. C., Nigg, H. N., and Beiere, R. C. Bullous phytophotodermatitis associated with high natural concentrations of furanocoumarins in limes. Am.J Contact Dermat. 2002;13(1):10-14. PubMed
  7. Garcia, O. P., Diaz, M., Rosado, J. L., and Allen, L. H. Ascorbic acid from lime juice does not improve the iron status of iron-deficient women in rural Mexico. Am.J.Clin.Nutr. 2003;78(2):267-273. PubMed
  8. Coffman, K., Boyce, W. T., and Hansen, R. C. Phytophotodermatitis simulating child abuse. Am.J Dis.Child 1985;139(3):239-240. PubMed
  9. Adegoke SA, Oyelami OA, Olatunya OS, Adeyemi LA. Effects of lime juice on malaria parasite clearance. Phytother Res. 2011;25(10):1547-50. PubMed
  10. Adegoke SA, Shehu UA, Mohammed LO, Sanusi Y, Oyelami OA. Influence of lime juice on the severity of sickle cell anemia. J Altern Complement Med. 2013;19(6):588-92. PubMed
  11. Assarian Z, Nixon RL. Protein contact dermatitis caused by lime in a pastry chef. Contact Dermatitis. 2015;73(1):54-6. PubMed
  12. Bamise CT, Dinyain VE, Kolawole KA. Dental erosion due to lime consumption; review of literature and case report. East Afr J Public Health. 2009;6(2):141-3. PubMed
  13. Flugman SL. Mexican beer dermatitis: a unique variant of lime phytophotodermatitis attributable to contemporary beer-drinking practices. Arch Dermatol. 2010;146(10):1194-5. PubMed
  14. Galvañ-Pérez Del Pulgar JI, Linares-Barrios M, Galvañ-Pozo JI Jr. Acropigmentation of the dorsum of the hands from preparing mojitos: A lime-induced phytophotodermatosis. Actas Dermosifiliogr. 2016;107(3):253-5. DOI
  15. Hemmerling A, Potts M, Walsh J, Young-Holt B, Whaley K, Stefanski DA. Lime juice as a candidate microbicide? An open-label safety trial of 10% and 20% lime juice used vaginally. J Womens Health (Larchmt). 2007;16(7):1041-51. PubMed
  16. Mauck CK, Ballagh SA, Creinin MD, et al. Six-day randomized safety trial of intravaginal lime juice. J Acquir Immune Defic Syndr. 2008;49(3):243-50. PubMed
  17. Mioduszewski M, Beecker J. Phytophotodermatitis from making sangria: a phototoxic reaction to lime and lemon juice. CMAJ. 2015;187(10):756. PubMed
  18. Rungruanghiranya S, Ekpanyaskul C, Sakulisariyaporn C, Watcharanat P, Akkalakulawas K. Efficacy of fresh lime for smoking cessation. J Med Assoc Thai. 2012;95 Suppl 12:S76-82.
  19. Swerdlin A, Rainey D, Storrs FJ. Fragrance mix reactions and lime allergic contact dermatitis. Dermatitis. 2010;21(4):214-6. DOI
  20. Ademosun AO, Mohammed A, Oboh G, Ajeigbe OF. Influence of lemon (Citrus limon) and lime (Citrus aurantifolia) juices on the erectogenic properties of sildenafil in rats with L-NAME-induced erectile dysfunction. J Food Biochem 2022;46(2):e14074.

See these in context on the Lime monograph →

Tangerine 3 references
  1. Yuan, J. M., Wang, X. L., Xiang, Y. B., Gao, Y. T., Ross, R. K., and Yu, M. C. Preserved foods in relation to risk of nasopharyngeal carcinoma in Shanghai, China. Int J Cancer 2000;85(3):358-363. DOI
  2. Backman, J. T., Maenpaa, J., Belle, D. J., Wrighton, S. A., Kivisto, K. T., and Neuvonen, P. J. Lack of correlation between in vitro and in vivo studies on the effects of tangeretin and tangerine juice on midazolam hydroxylation. Clin Pharmacol Ther 2000; PubMed
  3. Vilaplana, J. and Romaguera, C. Contact dermatitis from the essential oil of tangerine in fragrance. Contact Dermatitis 2002;46(2):108. PubMed

See these in context on the Tangerine monograph →

Grapefruit 157 references
  1. Penzak SR, Gubbins PO, Gurley BJ, et al. Grapefruit juice decreases the systemic availability of itraconazole capsules in healthy volunteers. Ther Drug Monit 1999;21:304-9. PubMed
  2. Ioannides-Demos LL, Christophidis N, et al. Dosing implications of a clinical interaction between grapefruit juice and cyclosporine and metabolite concentrations in patients with autoimmune diseases. J Rheumatol 1997;24:49-54.
  3. Josefsson M, Zackrisson AL, Ahlner J. Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers. Eur J Clin Pharmacol 1996;51:189-93. PubMed
  4. Garg SK, Kumar N, Bhargava VK, Prabhakar SK. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther 1998;64:286-8. PubMed
  5. Weber A, Jager R, Borner A, et al. Can grapefruit juice influence ethinylestradiol bioavailability? Contraception 1996;53:41-7.
  6. Schubert W, Cullberg G, Edgar B, Hedner T. Inhibition of 17 beta-estradiol metabolism by grapefruit juice in ovariectomized women. Maturitas 1994;20:155-63.
  7. Kantola T, Kivisto KT, Neuvonen PJ, et al. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 1998 63:397-402. PubMed
  8. Bailey DG, Spence JD, Munoz C, Arnold JM. Interaction of citrus juices with felodipine and nifedipine. Lancet 1991;337:268-9. PubMed
  9. Bailey DG, Arnold JM, Strong HA, et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther 1993;54:589-94. PubMed
  10. Rau SE, Bend JR, Arnold MO, et al. Grapefruit juice-terfenadine single-dose interaction: magnitude, mechanism, and relevance. Clin Pharmacol Ther 1997 61:401-9. PubMed
  11. Offman EM, Freeman DJ, Dresser GK, et al. Cisapride interaction with grapefruit juice and red wine. Clin Pharmacol Ther 2000;67:110 (abstract PI-83).
  12. Bailey DG, Dresser GK, Kreeft JH, et al. Grapefruit juice-felodipine interaction: Effect of segments and an extract from unprocessed fruit. Clin Pharmacol Ther 2000;67:107 (abstract PI-71).
  13. Soldner A, Christians U, Susanto M, et al. Grapefruit juice activates P-glycoprotein-mediated drug transport. Pharm Res 1999;16:478-85. PubMed
  14. Zaidenstein R, Avni B, Dishi V, et al. Effect of grapefruit juice on the pharmacokinetics of losartan in healthy volunteers. Clin Pharmacol Ther 1998;65:(abstract PI-60). DOI
  15. Dresser GK, Bailey DG, Carruthers SG. Grapefruit juice-felodipine interaction in healthy seniors. Clin Pharmacol Ther 1998;65:(abstract PIII-63).
  16. Varis T, Kivisto KT, Neuvonen PJ. Grapefruit juice can increase the plasma concentration of methylprednisolone. Eur J Clin Pharmacol 2000;56:489-93.
  17. Gross AS, Goh YD, Addison RS, et al. Influence of grapefruit juice on cisapride pharmacokinetics. Clin Pharmacol Ther 1999;65:395-401. PubMed
  18. Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther 1999;66:118-27. DOI
  19. Ozdemir M, Aktan Y, Boydag BS. Interaction between grapefruit juice and diazepam in humans. Eur J Drug Metab Pharmacokinet 1998;23:55-9. PubMed
  20. Zaidenstein R, Dishi V, Gips M, et al. The effect of grapefruit juice on the pharmacokinetics of orally administered verapamil. Eur J Clin Pharmacol 1998;54:337-40. PubMed
  21. Lilja JJ, Kivisto KT, Backman JT, et al. Grapefruit juice substantially increases plasma concentrations of buspirone. Clin Pharmacol Ther 1998;64:655-60. PubMed
  22. Kupferschmidt HH, Fattinger KE, Ha HR, et al. Grapefruit juice enhances the bioavailability of the HIV protease inhibitor saquinavir in man. Br J Clin Pharmacol 1998;45:355-9. DOI
  23. Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Clin Pharmacol Ther 1998;64:477-83. PubMed
  24. Curhan GC, Willett WC, Speizer FE, Stamfer MJ. Beverage use and risk of kidney stones in women. Ann Intern Med 1998;128:534-40.
  25. Fuhr U. Drug Interactions with Grapefruit Juice. Drug Saf 1998;18:251-72. DOI
  26. Oesterheld J, Kallepalli BR. Grapefruit juice and clomipramine: shifting metabolitic ratios. J Clin Psychopharmacol 1997;17:62-3. PubMed
  27. van Agtmael MA, Gupta V, van der Wosten TH, et al. Grapefruit juice increases the bioavailability of artemether. Eur J Clin Pharmacol 1999;55:405-10. PubMed
  28. van Agtmael MA, Gupta V, van der Graaf CA, van Boxtel CJ. The effect of grapefruit juice on the time-dependent decline of artemether plasma levels in healthy subjects. Clin Pharmacol Ther 1999;66:408-14.
  29. Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol 1999;48:829-38. PubMed
  30. Takanaga H, Ohnishi A, Murakami H, et al. Relationship between time after intake of grapefruit juice and the effect on pharmacokinetics and pharmacodynamics of nisoldipine in healthy subjects. Clin Pharmacol Ther 2000:67:201-14. PubMed
  31. Takanaga H, Ohnishi A, Matsuo H, et al. Pharmacokinetic analysis of felodipine-grapefruit juice interaction based on an irreversible enzyme inhibition model. Br J Clin Pharmacol 2000;49:49-58. PubMed
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  33. Dresser GK, Bailey DG, Carruthers SG. Grapefruit juice-felodipine interaction in the elderly. Clin Pharmacol Ther 2000;68:28-34. PubMed
  34. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  35. Lilja JJ, Kivisto KT, Backman JT, Neuvonen PJ. Effect of grapefruit juice dose on grapefruit juice-triazolam interaction: repeated consumption prolongs triazolam half-life. Eur J Clin Pharmacol 2000;56:411-5. PubMed
  36. Erlund I, Meririnne E, Alfthan G, Aro A. Plasma kinetics and urinary excretion of the flavanones naringenin and hesperetin in humans after ingestion of orange juice and grapefruit juice. J Nutr 2001;131:235-41. PubMed
  37. Ho PC, Ghose K, Saville D, Wanwimolruk S. Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil enantiomers in healthy volunteers. Eur J Clin Pharmacol 2000;56:693-8. PubMed
  38. Uno T, Ohkubo T, Sugawara K, et al. Effects of grapefruit juice on the stereoselective disposition of nicardipine in humans: evidence for dominant presystemic elimination at the gut site. Eur J Clin Pharmacol 2000;56:643-9. PubMed
  39. Bailey DG, Dresser GK. Grapefruit juice-lovastatin interaction. Clin Pharmacol Ther 2000;67:690.
  40. Lilja JJ, Kivisto KT, Neuvonen PJ. Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin. Clin Pharmacol Ther 2000;68:384-90. PubMed
  41. Castro N, Jung H, Medina R, et al. Interaction between grapefruit juice and praziquantel in humans. Antimicrob Agents Chemother 2002;46:1614-6. PubMed
  42. Jetter A, Kinzig-Schippers M, Walchner-Bonjean M, et al. Effects of grapefruit juice on the pharmacokinetics of sildenafil. Clin Pharmacol Ther 2002;71:21-9. PubMed
  43. Ebert U, Oertel R, Kirch W. Influence of grapefruit juice on scopolamine pharmacokinetics and pharmacodynamics in healthy male and female subjects. Int J Clin Pharmacol Ther 2000;38:523-31. PubMed
  44. Fuhr U, Muller-Peltzer H, Kern R, et al. Effects of grapefruit juice and smoking on verapamil concentrations in steady state. Eur J Clin Pharmacol 2002;58:45-53. PubMed
  45. Kanazawa S, Ohkubo T, Sugawara K. The effects of grapefruit juice on the pharmacokinetics of erythromycin. Eur J Clin Pharmacol 2001;56:799-803. PubMed
  46. Reif S, Nicolson M, Bisset D, et al. Effect of grapefruit juice intake on etoposide bioavailability. Eur J Clin Pharmacol 2002;58:491-4.. PubMed
  47. Greenblatt DJ, von Moltke LL, Harmatz JS. Time course of recovery of cytochrome P450 3A function after single doses of grapefruit juice. Clin Pharmacol Ther 2003;74:121-29 . PubMed
  48. Gupta MC, Garg SK, Badyal D, et al. Effect of grapefruit juice on the pharmacokinetics of theophylline in healthy male volunteers. Methods Find Exp Clin Pharmacol 1999;21:679-82. PubMed
  49. Edwards DJ, Fitzsimmons ME, Schuetz EG, et al. 6',7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice: effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther 1999;65:237-44. PubMed
  50. Rogers JD, Zhao J, Liu L, et al. Grapefruit juice has minimal effects on plasma concentrations of lovastatin-derived 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Clin Pharmacol Ther 1999;66:358-66. PubMed
  51. Veronese ML, Gillen LP, Burke JP, et al. Exposure-dependent inhibition of intestinal and hepatic CYP3A4 in vivo by grapefruit juice. J Clin Pharmacol 2003;43:831-9. . PubMed
  52. Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome P450 3A4 activity: comparison with grapefruit juice. Clin Pharmacol Ther 2003;73:529-37 . PubMed
  53. Becquemont L, Verstuyft C, Kerb R, et al. Effect of grapefruit juice on digoxin pharmacokinetics in humans. Clin Pharmacol Ther 2001;70:311-6. DOI
  54. Dresser GK, Bailey DG, Leake BF, et al. Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther 2002;71:11-20. PubMed
  55. Parker RB, Yates CR, Soberman JE, Laizure SC. Effects of grapefruit juice on intestinal P-glycoprotein: evaluation using digoxin in humans. Pharmacotherapy 2003;23:979-87. PubMed
  56. Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Life Sci 2002;71:1149-60. PubMed
  57. Gaudineau C, Beckerman R, Welbourn S, Auclair K. Inhibition of human P450 enzymes by multiple constituents of the Ginkgo biloba extract. Biochem Biophys Res Comm 2004;318:1072–8. PubMed
  58. Sullivan DM, Ford MA, Boyden TW. Grapefruit juice and the response to warfarin. Am J Health-Syst Pharm 1998;55:1581-3. PubMed
  59. Fukazawa I, Uchida N, Uchida E, Yasuhara H. Effects of grapefruit juice on the pharmacokinetics of atorvastatin and pravastatin in Japanese. Br J Clin Pharmacol 2003;57:448-55.
  60. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  61. Zitron E, Scholz E, Owen RW, et al. QTc prolongation by grapefruit juice and its potential pharmacological basis: HERG channel blockade by flavonoids. Circulation 2005;835:835-8. PubMed
  62. Monroe KR, Murphy SP, Kolonel LN, Pike MC. Prospective study of grapefruit intake and risk of breast cancer in postmenopausal women: the Mutliethnic Cohort Study. Br J Cancer 2007;97:440-5.
  63. Farkas D, Oleson LE, Zhao Y, et al. Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice. J Clin Pharmacol 2007;47:286-94. PubMed
  64. Potential drug interactions with grapefruit. Pharmacist's Letter / Prescriber's Letter 2007;23(2):230204.
  65. Dresser GK, Kim RB, Bailey DG. Effect of grapefruit juice volume on the reduction of fexofenadine bioavailability: possible role of organic anion transporting polypeptides. Clin Pharmacol Ther 2005;77:170-7. PubMed
  66. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  67. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  68. Product information for Cordarone. Wyeth Pharmaceuticals, Inc. Philadelphia, PA 19101. September 2006.
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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.

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