Vialafil 675 mg Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Vialafil 675 mg against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Vialafil 675 mg is a dietary supplement by NewtonEverett with 12 active ingredients. Its ingredients are commonly taken for zinc deficiency, immune support, cold symptoms.Based on those ingredients, 1,628 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginkgo biloba leaf extract, Eleuthero Root Extract, Yohimbe Bark Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Vialafil 675 mg by NewtonEverett
Ask about any prescription or over-the-counter medication and we check it for interactions with Vialafil 675 mg by NewtonEverett — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Vialafil 675 mg by NewtonEverett
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Vialafil 675 mg contains 12 active ingredients. The largest components are herbal extracts traditionally associated with sexual health and vitality: yohimbe bark (containing yohimbine, an alpha-adrenergic stimulant), muira puama bark, catuaba bark, epimedium leaf (horny goat weed), ginkgo biloba leaf, cnidium monnieri seed, maca root, eleuthero root, and oat straw — plus micronutrients and amino acids including zinc and L-arginine hydrochloride.
Inactive ingredients include gelatin, titanium dioxide, FD&C Blue #1, magnesium stearate, and silicon dioxide.
Does it work?
Leans against
The evidence for most ingredients in this product is sparse. Zinc is effective for zinc deficiency and likely effective for Wilson disease, and possibly effective for acne and a few other conditions.
Oat straw is likely effective for high cholesterol and heart disease. Ginkgo is possibly effective for hearing loss, stroke, schizophrenia, PMS, dementia, and anxiety.
For the rest — maca, L-arginine, eleuthero, yohimbe, muira puama, catuaba, cnidium, epimedium, and xanthoparmelia — the evidence available to us rates as insufficient to say whether they work. None of these ingredients have established effectiveness for sexual function specifically in our data.
How safe is it?
Well-documented data
Zinc is generally well tolerated in doses below 40 mg daily for adults, though oral use can cause abdominal cramps, diarrhea, metallic taste, nausea, and vomiting in a dose-dependent way. High doses raise the risk of copper deficiency over time.
L-arginine is often well tolerated short-term but can lower blood pressure and isn't safe for everyone — use requires medical supervision. Yohimbe carries serious cautions: it can cause anxiety, agitation, tremors, hypertension, tachycardia, and in rare cases hypertensive crisis; it's considered possibly unsafe in pregnancy.
Eleuthero and ginkgo are generally well tolerated for short-term use, but ginkgo may increase bleeding risk, and both lack long-term safety data. Eleuthero is best avoided in pregnancy and lactation.
Maca, muira puama, catuaba, cnidium, epimedium, and xanthoparmelia all lack sufficient human safety data; pregnancy and lactation safety is not established for most of them.
Meds to double-check
Major interaction found
Check with your pharmacist if you take: MAOIs or other antidepressants (yohimbe carries Major risk with MAOIs); blood thinners or antiplatelet drugs like warfarin or aspirin (zinc, eleuthero, ginkgo, cnidium, and epimedium all documented); beta-blockers, especially talinolol (ginkgo); blood pressure medications including ACE inhibitors, ARBs, and other antihypertensives (L-arginine, yohimbe, epimedium); quinolone or tetracycline antibiotics, or cephalexin (zinc); diabetes medications or insulin (oat straw, eleuthero); or HIV medications like ritonavir and integrase inhibitors (zinc). If you take any of these, use the medication search tool below with your specific drugs before adding this supplement.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with graded evidence leaning against its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Vialafil is a multi-ingredient supplement with herbal and nutrient components. If you take any blood pressure medication, blood thinner, antidepressant (especially an MAOI or tricyclic), diabetes drug, antibiotic, or HIV medication, you need to check this product against your exact prescriptions before starting — the interactions are real and can affect how your drugs work.
Talk to your pharmacist or doctor, especially if you're pregnant, nursing, or have heart or blood pressure concerns.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 12 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 21, 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
General information
Key facts about Vialafil 675 mg, straight from the product label.
| Brand | NewtonEverett |
|---|---|
| Barcode (UPC) | 818423027920 |
| Net contents | 30 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | May 21, 2025 |
| DSLD ID | 330120 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult Male (18-50 Years) |
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 Vialafil 675 mg by NewtonEverett, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Zinc | 15 mg | 136% |
| Maca Root Extract | 0 NP | -- |
| L-Arginine Hydrochloride | 0 NP | -- |
| Eleuthero Root Extract | 0 NP | -- |
| Yohimbe Bark Extract | 0 NP | -- |
| Muira Puama Bark Extract | 0 NP | -- |
| Catuaba bark extract | 0 NP | -- |
| Cnidium monnieri Seed Extract | 0 NP | -- |
| Xanthomonnier Blend | 1350 mg | -- |
| Ginkgo biloba leaf extract | 0 NP | -- |
| Xanthoparmelia scabrosa Whole Plant Extract | 0 NP | -- |
| Oat Straw Whole Herb Extract | 0 NP | -- |
| Epimedium Leaf, Stem Extract | 0 NP | -- |
Other ingredients: Gelatin, Titanium Dioxide, FD&C Blue #1, Magnesium Stearate, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula
(Xanthomnnier) capsules 675 mg per capsule
Men's sexual performance supplement
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested use: As a dietary supplement, adults take 2 capsules daily preferably with a meal.
Precautions
Warning: If you are taking any medications, consult your doctor before use.
Discontinue use and consult your doctor if any adverse reactions occur.
Keep out of reach of the children.
Do not use if safety seal is broken.
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
Formulation
Non-GMO
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Vialafil 675 mg by NewtonEverett label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Vialafil 675 mg by NewtonEverett
These are the 12 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container15 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.
Zinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc monograph & interactionsXanthomonnier Blend
- › Maca Root Extract
- › L-Arginine Hydrochloride
- › Eleuthero Root Extract
- › Yohimbe Bark Extract
- › Muira Puama Bark Extract
- › Catuaba bark extract
- › Cnidium monnieri Seed Extract
- › Ginkgo biloba leaf extract
- › Xanthoparmelia scabrosa Whole Plant Extract
- › Oat Straw Whole Herb Extract
- › Epimedium Leaf, Stem Extract
Other (inactive) ingredients: Gelatin, Titanium Dioxide, FD&C Blue #1, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Vialafil 675 mg by NewtonEverett Drug Interactions
HelloPharmacist Interaction Report
Vialafil 675 mg by NewtonEverett contains multiple ingredients with documented interactions.
The most serious concern is yohimbe bark extract, which carries a Major-severity interaction with monoamine oxidase inhibitors (MAOIs) — a class of older antidepressants. Yohimbine, yohimbe's active constituent, has MAO-inhibiting properties itself, and combining them risks serious effects.
Read the full breakdown — every affected drug type, severity by severity
Several ingredients have Moderate-severity interactions with common medication types. Zinc reduces absorption of quinolone antibiotics (like ciprofloxacin), tetracyclines, and cephalexin, and can lower levels of the HIV drug ritonavir and integrase inhibitors — all requiring dosing separated by hours.
L-arginine may lower blood pressure additively with antihypertensive drugs, ACE inhibitors, and ARBs, and can theoretically raise bleeding risk with blood thinners. Eleuthero and ginkgo both interact with anticoagulants and antiplatelet drugs.
Ginkgo also carries a Major-severity interaction with talinolol (a beta-blocker), increasing its blood levels by 36% in clinical studies, and has documented cases of increased bleeding with warfarin.
Additionally, yohimbe may reduce antihypertensive effectiveness, ginkgo can decrease levels of simvastatin and alprazolam, and oat straw may add to blood-sugar-lowering effects of diabetes medications and insulin. Altogether, these interactions span 1,609 individual medications.
We could not check cnidium monnieri for complete interaction data beyond CNS depressants and anticoagulants. Muira puama, catuaba bark, and xanthoparmelia held no interaction data on file.
Use the medication checker on this page with your exact prescriptions before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Vialafil 675 mg?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Vialafil 675 mg interact with 1,628 drugs. Click any drug to see the details.
8 of the 12 ingredients in Vialafil 675 mg interact with drugs. Each result below shows which ingredient is responsible. Ginkgo biloba leaf extract Eleuthero Root Extract Yohimbe Bark Extract Epimedium Leaf, Stem Extract L-Arginine Hydrochloride Cnidium monnieri Seed Extract Oat Straw Whole Herb Extract Zinc
AmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Vialafil 675 mg — through 3 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractStimulant Drugs, Monoamine Oxidase Inhibitors (maois) +1 Major
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Amphetamine interactionGinkgo Biloba Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba Leaf Extract + Amphetamine interactionEleuthero Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
Read the full Eleuthero Root Extract + Amphetamine interactionIsocarboxazidMarplan
How Isocarboxazid interacts with Vialafil 675 mg — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Yohimbe Bark Extract + Isocarboxazid interactionMoclobemideManerix, Moclobemide
How Moclobemide interacts with Vialafil 675 mg — through 2 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Inhibitors, Monoamine Oxidase Inhibitors (maois) Major
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Yohimbe Bark Extract + Moclobemide interactionGinkgo Biloba Leaf ExtractCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Read the full Ginkgo Biloba Leaf Extract + Moclobemide interactionOzanimod HydrochlorideZeposia
How Ozanimod Hydrochloride interacts with Vialafil 675 mg — through 2 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Yohimbe Bark Extract + Ozanimod Hydrochloride interactionEleuthero Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Read the full Eleuthero Root Extract + Ozanimod Hydrochloride interactionPhenelzine SulfateNardil
How Phenelzine Sulfate interacts with Vialafil 675 mg — through 2 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Yohimbe Bark Extract + Phenelzine Sulfate interactionCnidium Monnieri Seed ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Seed Extract + Phenelzine Sulfate interactionRasagilineAzilect
How Rasagiline interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Monoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Rasagiline interactionEpimedium Leaf, Stem ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Epimedium Leaf, Stem Extract + Rasagiline interactionGinkgo Biloba Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo Biloba Leaf Extract + Rasagiline interactionEleuthero Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Root Extract + Rasagiline interactionSafinamide MesylateXadago
How Safinamide Mesylate interacts with Vialafil 675 mg — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Yohimbe Bark Extract + Safinamide Mesylate interactionSelegilineCarbex, Eldepryl, Emsam, Zelapar
How Selegiline interacts with Vialafil 675 mg — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Yohimbe Bark Extract + Selegiline interactionTalinololTalinolol
How Talinolol interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractTalinolol Major
Interaction Summary
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
Read the full Ginkgo Biloba Leaf Extract + Talinolol interactionL-arginine HydrochlorideAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine Hydrochloride + Talinolol interactionEpimedium Leaf, Stem ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, horny goat weed might increase the risk of hypotension.
Read the full Epimedium Leaf, Stem Extract + Talinolol interactionYohimbe Bark ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Read the full Yohimbe Bark Extract + Talinolol interactionTranylcypromineParnate
How Tranylcypromine interacts with Vialafil 675 mg — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Concomitant use of MAOIs with yohimbe can result in additive effects.
Read the full Yohimbe Bark Extract + Tranylcypromine interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Vialafil 675 mg — through 1 ingredient. Tap an ingredient for the detail:
Eleuthero Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Read the full Eleuthero Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Ado-trastuzumab Emtansine interactionEpimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Ado-trastuzumab Emtansine interactionEleuthero Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Root Extract + Ado-trastuzumab Emtansine interactionYohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Ado-trastuzumab Emtansine interactionAbametapirXeglyze
How Abametapir interacts with Vialafil 675 mg — through 1 ingredient. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Inhibitors Moderate
Interaction Summary
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
Read the full Yohimbe Bark Extract + Abametapir interactionAbciximabReoPro
How Abciximab interacts with Vialafil 675 mg — through 6 ingredients. Tap an ingredient for the detail:
Eleuthero Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Root Extract + Abciximab interactionCnidium Monnieri Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Seed Extract + Abciximab interactionL-arginine HydrochlorideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full L-arginine Hydrochloride + Abciximab interactionEpimedium Leaf, Stem ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, horny goat weed might increase the risk of bleeding.
Read the full Epimedium Leaf, Stem Extract + Abciximab interactionGinkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Abciximab interactionYohimbe Bark ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Read the full Yohimbe Bark Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Epimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Abemaciclib interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Abemaciclib interactionEleuthero Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Root Extract + Abemaciclib interactionYohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 3a4 (cyp3a4) Inhibitors +1 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Abiraterone interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Abiraterone interactionEpimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Abiraterone interactionEleuthero Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractCytochrome P450 2d6 (cyp2d6) Inhibitors, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
Read the full Yohimbe Bark Extract + Abiraterone Acetate interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Abiraterone Acetate interactionEpimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Abiraterone Acetate interactionEleuthero Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Vialafil 675 mg — through 6 ingredients. Tap an ingredient for the detail:
Epimedium Leaf, Stem ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, horny goat weed might increase the risk of bleeding.
Read the full Epimedium Leaf, Stem Extract + Abrocitinib interactionGinkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c19 (cyp2c19) Substrates +1 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Abrocitinib interactionL-arginine HydrochlorideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full L-arginine Hydrochloride + Abrocitinib interactionEleuthero Root ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
Read the full Eleuthero Root Extract + Abrocitinib interactionCnidium Monnieri Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Seed Extract + Abrocitinib interactionYohimbe Bark ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Read the full Yohimbe Bark Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Acalabrutinib interactionEleuthero Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Root Extract + Acalabrutinib interactionEpimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Acalabrutinib interactionYohimbe Bark ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Yohimbe Bark Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Oat Straw Whole Herb ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Read the full Oat Straw Whole Herb Extract + Acarbose interactionL-arginine HydrochlorideAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Read the full L-arginine Hydrochloride + Acarbose interactionGinkgo Biloba Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba Leaf Extract + Acarbose interactionEleuthero Root ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Read the full Eleuthero Root Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Vialafil 675 mg — through 3 ingredients. Tap an ingredient for the detail:
Epimedium Leaf, Stem ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, horny goat weed might increase the risk of hypotension.
Read the full Epimedium Leaf, Stem Extract + Acebutolol interactionL-arginine HydrochlorideAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
Read the full L-arginine Hydrochloride + Acebutolol interactionYohimbe Bark ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Read the full Yohimbe Bark Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Vialafil 675 mg — through 6 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Acenocoumarol interactionEpimedium Leaf, Stem ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, horny goat weed might increase the risk of bleeding.
Read the full Epimedium Leaf, Stem Extract + Acenocoumarol interactionEleuthero Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Root Extract + Acenocoumarol interactionCnidium Monnieri Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Seed Extract + Acenocoumarol interactionL-arginine HydrochlorideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full L-arginine Hydrochloride + Acenocoumarol interactionYohimbe Bark ExtractAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Read the full Yohimbe Bark Extract + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Vialafil 675 mg — through 2 ingredients. Tap an ingredient for the detail:
Yohimbe Bark ExtractPhenothiazines Moderate
Interaction Summary
Theoretically, using yohimbine with phenothiazines might have additive effects.
Read the full Yohimbe Bark Extract + Acepromazine interactionCnidium Monnieri Seed ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Seed Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Eleuthero Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Root Extract + Acetaminophen interactionGinkgo Biloba Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen interactionEpimedium Leaf, Stem ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen interactionYohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Vialafil 675 mg — through 6 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen, Aspirin interactionCnidium Monnieri Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Seed Extract + Acetaminophen, Aspirin interactionEleuthero Root ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Root Extract + Acetaminophen, Aspirin interactionL-arginine HydrochlorideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full L-arginine Hydrochloride + Acetaminophen, Aspirin interactionEpimedium Leaf, Stem ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen, Aspirin interactionYohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Vialafil 675 mg — through 6 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen, Aspirin, Caffeine interactionEpimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen, Aspirin, Caffeine interactionEleuthero Root ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Eleuthero Root Extract + Acetaminophen, Aspirin, Caffeine interactionCnidium Monnieri Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.
Read the full Cnidium Monnieri Seed Extract + Acetaminophen, Aspirin, Caffeine interactionYohimbe Bark ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Read the full Yohimbe Bark Extract + Acetaminophen, Aspirin, Caffeine interactionL-arginine HydrochlorideAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full L-arginine Hydrochloride + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Eleuthero Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionYohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Stimulant Drugs Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionEpimedium Leaf, Stem ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionGinkgo Biloba Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Seizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen, Butalbital interactionEleuthero Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Root Extract + Acetaminophen, Butalbital interactionEpimedium Leaf, Stem ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen, Butalbital interactionYohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Vialafil 675 mg — through 4 ingredients. Tap an ingredient for the detail:
Epimedium Leaf, Stem ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen, Butalbital, Caffeine interactionYohimbe Bark ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital, Caffeine interactionGinkgo Biloba Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen, Butalbital, Caffeine interactionEleuthero Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
Read the full Eleuthero Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Vialafil 675 mg — through 5 ingredients. Tap an ingredient for the detail:
Eleuthero Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
Read the full Eleuthero Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionEpimedium Leaf, Stem ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Read the full Epimedium Leaf, Stem Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionYohimbe Bark ExtractStimulant Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Read the full Yohimbe Bark Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionCnidium Monnieri Seed ExtractCns Depressants Moderate
Interaction Summary
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins.
Read the full Cnidium Monnieri Seed Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Vialafil 675 mg with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Ginkgo biloba leaf extract
Talinolol
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
There is some evidence that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of talinolol by 36% in healthy male individuals. However, single doses of ginkgo do not seem to affect talinolol pharmacokinetics.
Alprazolam (Xanax)
Theoretically, ginkgo might decrease the levels and clinical effects of alprazolam.
In clinical research, ginkgo extract (Ginkgold) 120 mg twice daily seems to decrease alprazolam levels by about 17%. However, ginkgo does not appear to decrease the elimination half-life of alprazolam. This suggests that ginkgo is more likely to decrease absorption of alprazolam rather than induce hepatic metabolism of alprazolam.
Anticoagulant/Antiplatelet Drugs
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin. Theoretically, ginkgo might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. However, population and clinical studies have produced mixed results. Some evidence shows that short-term use of ginkgo leaf does not significantly reduce platelet aggregation and blood clotting. A study in healthy males who took a specific ginkgo leaf extract (EGb 761) 160 mg twice daily for 7 days found no change in prothrombin time. An analysis of a large medical record database suggests that ginkgo increases the risk of a bleeding adverse event by 38% when taken concurrently with warfarin. It has been suggested that ginkgo has to be taken for at least 2-3 weeks to have a significant effect on platelet aggregation. However, a meta-analysis of 18 studies using standardized ginkgo extracts, 80-480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. In addition, a single dose of ginkgo plus clopidogrel or ticlopidine does not seem to significantly increase bleeding time or platelet aggregation. Also, taking ginkgo leaf extract daily for 8 days in conjunction with rivaroxaban does not affect anti-factor Xa activity; however, this study did not evaluate bleeding time.
Anticonvulsants
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Antidiabetes Drugs
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Ginkgo leaf extract seems to alter insulin secretion and metabolism, and might affect blood glucose levels in people with type 2 diabetes. The effect of ginkgo seems to differ depending on the insulin and treatment status of the patient. In diet-controlled diabetes patients with hyperinsulinemia, taking ginkgo does not seem to significantly affect insulin or blood glucose levels. In patients with hyperinsulinemia who are treated with oral hypoglycemic agents, taking ginkgo seems to decrease insulin levels and increase blood glucose following an oral glucose tolerance test. Researchers speculate that this could be due to ginkgo-enhanced hepatic metabolism of insulin. In patients with pancreatic exhaustion, taking ginkgo seems to stimulate pancreatic beta-cells, resulting in increased insulin and C-peptide levels, but with no significant change in blood glucose levels in response to an oral glucose tolerance test.
Atorvastatin (Lipitor)
Theoretically, ginkgo might decrease the levels and clinical effects of atorvastatin.
In humans, intake of ginkgo extract appears to increase atorvastatin clearance, reducing the area under the curve of atorvastatin by 10% to 14% and the maximum concentration by 29%. However, this interaction does not appear to affect cholesterol synthesis and absorption. Further, a model in rats with hyperlipidemia suggests that administering ginkgo extract does not impact blood levels of atorvastatin and leads to lower total cholesterol, low-density lipoprotein cholesterol, and triglycerides when compared with rats given atorvastatin alone.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that ginkgo leaf extract can mildly inhibit CYP1A2 enzymes. However, clinical research suggests ginkgo might not affect CYP1A2. Until more is known, use ginkgo cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Some clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce CYP2C19 enzymes and potentially decrease levels of drugs metabolized by these enzymes. However, other clinical research shows that taking ginkgo 120 mg twice daily for 12 days has no effect on levels of drugs metabolized by CYP2C19.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
In vitro, a specific standardized extract of ginkgo leaf (EGb 761) inhibits CYP2C9 activity . The terpenoid (ginkgolides) and flavonoid (quercetin, kaempferol, etc.) constituents seem to be responsible for this effect. Most ginkgo extracts contain some amount of these constituents. Therefore, other ginkgo leaf extracts might also inhibit the CYP2C9 enzyme. However, clinical research suggests that ginkgo might not have a significant effect on CYP2C9 in humans. Ginkgo does not seem to significantly affect the pharmacokinetics of CYP2C9 substrates diclofenac or tolbutamide.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
There is conflicting evidence about whether ginkgo induces or inhibits CYP3A4. Ginkgo does not appear to affect hepatic CYP3A4. However, it is not known if ginkgo affects intestinal CYP3A4. Preliminary clinical research suggests that taking ginkgo does not significantly affect levels of donepezil, lopinavir, or ritonavir, which are all CYP3A4 substrates. Other clinical research also suggests ginkgo does not significantly affect CYP3A4 activity. However, there are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4).
Efavirenz (Sustiva)
Theoretically, ginkgo might decrease the levels and clinical effects of efavirenz.
There are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. In one case, an HIV-positive male experienced over a 50% decrease in efavirenz levels over the course of 14 months while taking ginkgo extract. HIV-1 RNA copies also increased substantially, from less than 50 to more than 1500. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4). In another case report, a patient stable on antiviral therapy including efavirenz for 10 years, had an increase in viral load from <50 copies/mL to 1350 copies/mL after 2 months of taking a combination of supplements including ginkgo. After stopping ginkgo, the viral load was again controlled with the same antiviral therapy regimen.
Ibuprofen (Advil, Others)
Theoretically, ginkgo might increase the risk of bleeding when used with ibuprofen.
Ginkgo might have antiplatelet effects and has been associated with several case reports of spontaneous bleeding. In one case, a 71-year-old male had taken a specific ginkgo extract (Gingium, Biocur) 40 mg twice daily for 2.5 years. About 4 weeks after starting ibuprofen 600 mg daily he experienced a fatal intracerebral hemorrhage. However, the antiplatelet effects of ginkgo have been questioned. A meta-analysis and other studies have not found a significant antiplatelet effect with standardized ginkgo extracts, 80 mg to 480 mg taken daily for up to 32 weeks.
P-Glycoprotein Substrates
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
A small clinical study in healthy volunteers shows that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of the P-glycoprotein substrate, talinolol, by 36% in healthy male individuals. However, single doses of ginkgo do not have the same effect.
Risperidone (Risperdal)
Theoretically, taking ginkgo with risperidone might increase the levels and adverse effects of risperidone.
A single case of priapism has been reported for a 26-year-old male with schizophrenia who used risperidone 3 mg daily along with ginkgo extract 160 mg daily. Risperidone is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4. CYP3A4 activity might be affected by ginkgo. Theoretically, ginkgo may inhibit the metabolism of risperidone and increase the risk of adverse effects.
Rosiglitazone (Avandia)
Theoretically, ginkgo might decrease the levels and clinical effects of rosiglitazone.
Animal research shows that ginkgo leaf extract orally 100 or 200 mg/kg daily for 10 days alters the pharmacodynamics of rosiglitazone in a dose-dependent manner. The 100 mg/kg and 200 mg/kg doses reduce the area under the concentration time curve (AUC) of rosiglitazone by 39% and 52%, respectively, and the half-life by 28% and 39%, respectively. It is hypothesized that these changes may be due to induction of cytochrome P450 2C8 by ginkgo.
Seizure Threshold Lowering Drugs
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Simvastatin (Zocor)
Theoretically, ginkgo might decrease the levels and clinical effects of simvastatin.
Clinical research shows that taking ginkgo extract can reduce the area under the curve and maximum concentration of simvastatin by 32% to 39%. However, ginkgo extract does not seem to affect the cholesterol-lowering ability of simvastatin.
Sofosbuvir (Sovaldi)
Theoretically, ginkgo might increase the levels and clinical effects of sofosbuvir.
Animal research in rats shows that giving a ginkgo extract 25 mg/kg orally daily for 14 days increases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 11%, increases the half-life by 60%, and increases the plasma concentration at 4 hours by 38%. This interaction appears to be related to the inhibition of intestinal P-glycoprotein by ginkgo.
Tacrolimus (Prograf)
Theoretically, ginkgo might increase the blood levels of tacrolimus.
In vitro evidence suggests that certain biflavonoids in ginkgo leaves (i.e. amentoflavone, ginkgetin, bilobetin) may inhibit the metabolism of tacrolimus by up to 50%. This interaction appears to be time-dependent and due to inhibition of cytochrome P450 (CYP) 3A4 by these bioflavonoids. In rats given tacrolimus 1 mg/kg orally, amentoflavone was shown to increase the area under the concentration time curve (AUC) of tacrolimus by 3.8-fold.
Trazodone (Desyrel)
Theoretically, ginkgo might increase the levels and clinical effects of trazodone.
In a case report, an Alzheimer patient taking trazodone 20 mg twice daily and ginkgo leaf extract 80 mg twice daily for four doses became comatose. The coma was reversed by administration of flumazenil (Romazicon). Coma might have been induced by excessive GABA-ergic activity. Ginkgo flavonoids are thought to have GABA-ergic activity and act directly on benzodiazepine receptors. Ginkgo might also increase metabolism of trazodone to active GABA-ergic metabolites, possibly by inducing cytochrome P450 3A4 (CYP3A4) metabolism.
Warfarin (Coumadin)
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. Information from a medical database suggests that when taken concurrently with warfarin, ginkgo increases the risk of a bleeding adverse event by 38%. There is also some evidence that ginkgo leaf extract can inhibit cytochrome P450 2C9, an enzyme that metabolizes warfarin. This could result in increased warfarin levels. However, population and clinical research has produced mixed results. Clinical research in healthy people suggests that ginkgo has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. A meta-analysis of 18 studies using standardized ginkgo extracts, 80 mg to 480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. There is also some preliminary clinical research that suggests ginkgo might not significantly increase the effects of warfarin in patients that have a stable INR.
Nifedipine (Procardia)
Theoretically, taking ginkgo with oral, but not intravenous, nifedipine might increase levels and adverse effects of nifedipine.
Animal research and some clinical evidence suggests that taking ginkgo leaf extract orally in combination with oral nifedipine might increase nifedipine levels and cause increased side effects, such as headaches, dizziness, and hot flushes. However, taking ginkgo orally does not seem to affect the pharmacokinetics of intravenous nifedipine.
Omeprazole (Prilosec)
Theoretically, taking ginkgo with omeprazole might decrease the levels and clinical effects of omeprazole.
Clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce cytochrome P450 (CYP) 2C19 enzymes and decrease levels of omeprazole by about 27% to 42%.
Eleuthero Root Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that a constituent of eleuthero, dihydroxybenzoic acid, appears to inhibit platelet aggregation. Concomitant use with anticoagulant or antiplatelet drugs might increase the risk of bleeding. This effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Animal research suggests that certain constituents of eleuthero have hypoglycemic activity in both healthy and diabetic animals. A small study in adults with type 2 diabetes also shows that taking eleuthero for 3 months can lower blood glucose levels. However, one very small study in healthy individuals shows that taking powdered eleuthero 3 grams, 40 minutes prior to a 75-gram oral glucose tolerance test, significantly increases postprandial blood glucose levels when compared with placebo. These contradictory findings might be due to patient-specific variability and variability in active ingredient ratios.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2C9. This effect has not been reported in humans.
Digoxin (Lanoxin)
Eleuthero might increase serum digoxin levels and increase the risk of side effects.
In one case report, a 74-year-old male who was stabilized on digoxin presented with an elevated serum digoxin level after starting an eleuthero supplement, without symptoms of toxicity. After stopping the supplement, serum digoxin levels returned to normal. It is not clear whether this was due to a pharmacokinetic interaction or to interference with the digoxin assay. Although the product was found to be free of digoxin and digitoxin, it was not tested for other contaminants.
Immunosuppressants
Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.
P-Glycoprotein Substrates
Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, eleuthero might decrease levels of drugs metabolized by OATP.
In vitro research suggests that eleuthero inhibits OATP2B1, which might reduce the bioavailability of oral drugs that are substrates of OATP2B1. Due to the weak inhibitory effect identified in this study, this interaction is not likely to be clinically significant.
Yohimbe Bark Extract
Monoamine Oxidase Inhibitors (Maois)
Concomitant use of MAOIs with yohimbe can result in additive effects.
Yohimbine, a constituent of yohimbe, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO.
Antihypertensive Drugs
Theoretically, yohimbe might reduce the effects of antihypertensive drugs.
Yohimbine, a constituent of yohimbe, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Theoretically, concomitant use of yohimbe and antihypertensive drugs can interfere with blood pressure control.
Clonidine (Catapres)
Theoretically, yohimbe might precipitate clonidine withdrawal.
Chronic clonidine use can downregulate alpha-2 adrenoreceptors. Animal research and one human case report suggest that concomitant administration of yohimbine, an alpha-2 adrenoceptor antagonist, may precipitate clonidine withdrawal and lead to sympathomimetic toxicity, including hypertensive crisis.
Cytochrome P450 2D6 (Cyp2D6) Inhibitors
CYP2D6 inhibitors may increase the levels and adverse effects of yohimbine, a constituent of yohimbe.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP2D6 isoenzymes. Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine and reduces the clearance of yohimbine compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers..
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, yohimbe might increase the levels and adverse effects of CYP2D6 substrates.
In vitro research suggests that yohimbine, a constituent of yohimbe bark, inhibits CYP2D6 enzyme activity.
Cytochrome P450 3A4 (Cyp3A4) Inhibitors
Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP3A4 enzymes. Theoretically, drugs that inhibit CYP3A4 might increase the levels and adverse effects of yohimbine.
Paroxetine (Paxil)
Paroxetine decreases the clearance of yohimbine and may increase its effects.
Paroxetine, a cytochrome P450 (CYP) 2D6 inhibitor, increases the maximum serum concentration of yohimbine by about 350% and reduces the clearance of yohimbine by about 80% compared to yohimbine alone in patients who are extensive CYP2D6 metabolizers. No significant changes in pharmacokinetic parameters of yohimbine were observed with coadministration of paroxetine in patients who are poor CYP2D6 metabolizers.
Phenothiazines
Theoretically, using yohimbine with phenothiazines might have additive effects.
Yohimbine, a constituent of yohimbe, has alpha-2 adrenergic antagonist effects. Theoretically, combining it with phenothiazines can cause additive alpha-2 adrenergic antagonism.
Stimulant Drugs
Theoretically, taking yohimbe with stimulant drugs can have additive effects.
Yohimbine, a constituent of yohimbe, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking yohimbe with stimulant drugs can have additive stimulant and hypertensive effects.
Tricyclic Antidepressants (Tcas)
Theoretically, taking yohimbe with TCAs can increase adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. The effects of yohimbe bark itself are unclear; oral yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.
Anticoagulant/Antiplatelet Drugs
Theoretically, combining yohimbe bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Research in healthy adults shows that taking yohimbine, a constituent of yohimbe bark, in doses of 8 mg or more, seems to inhibit platelet aggregation in vitro by binding to the alpha-2 adrenoceptor. The effects of yohimbe bark itself are unclear; yohimbe bark contains 0.6% to 1.38% yohimbine, but it is unclear how much is absorbed.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that yohimbe extract induces CYP1A2 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that yohimbe extract induces CYP3A4 enzymes.
Epimedium Leaf, Stem Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, horny goat weed might increase the risk of bleeding.
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation. This effect has not been reported in humans.
Antihypertensive Drugs
Theoretically, horny goat weed might increase the risk of hypotension.
Laboratory research suggests that horny goat weed might have hypotensive effects. This effect has not been reported in humans.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
In vitro, horny goat weed leaf extract inhibits CYP1A2. This effect has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP2B6 substrates.
In vitro, horny goat weed leaf extract inhibits CYP2B6. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression. This effect has not been reported in humans.
Estrogens
Theoretically, concomitant use of horny goat weed with estrogens might increase their therapeutic and adverse effects.
In vitro evidence suggests that horny goat weed has estrogenic activity. In clinical research, horny goat weed has been shown to increase blood levels of estrogen in some females.
L-Arginine Hydrochloride
Ace Inhibitors (Aceis)
Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.
Angiotensin Receptor Blockers (Arbs)
Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.
Antihypertensive Drugs
Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.
Isoproterenol (Isuprel)
Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.
Potassium-Sparing Diuretics
Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.
Testosterone
Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.
Cnidium monnieri Seed Extract
Anticoagulant/Antiplatelet Drugs
Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets. Theoretically, cnidium might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Cns Depressants
In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins. Theoretically, cnidium may potentiate the effects of barbiturates, other sedatives, and anxiolytics.
Oat Straw Whole Herb Extract
Antidiabetes Drugs
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Insulin
Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Zinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Brand information
Manufacturer and brand details for Vialafil 675 mg, from the product label.
NewtonEverett
See all NewtonEverett products- Name
- Newton-Everett Nutraceuticals
- Street Address
- 2675 S. 16th St
- City
- Phoenix
- State
- AZ
- ZipCode
- 85034
- Web Address
- www.newton-everett.com
Vialafil 675 mg by NewtonEverett: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Vialafil 675 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Zinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographMaca
Maca is a nutrient-rich Andean root often used for energy, libido, and menopause symptoms. Early studies suggest it may modestly help sexual desire and some menopause symptoms, but the evide...
Read the full Maca monograph → Herb & supplement monographL-arginine
Interacts with 403 drugsL-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and...
Read the full L-arginine monograph → Herb & supplement monographEleuthero
Interacts with 1,140 drugsEleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so...
Read the full Eleuthero monograph → Herb & supplement monographYohimbe
Interacts with 1,125 drugsYohimbe is a West African tree bark that contains yohimbine, a compound mainly promoted for erectile dysfunction and as an aphrodisiac. A prescription form of yohimbine has some evidence for...
Read the full Yohimbe monograph → Herb & supplement monographMuira Puama
Muira puama is a Brazilian plant traditionally used as an aphrodisiac and general tonic, often nicknamed 'potency wood.' Human research is very limited, so its benefits are not well proven,...
Read the full Muira Puama monograph → Herb & supplement monographCatuaba
Catuaba is a Brazilian herbal bark long used as a traditional aphrodisiac and energy tonic, but there is very little reliable human research to show it works for any health condition. Qualit...
Read the full Catuaba monograph → Herb & supplement monographCnidium
Interacts with 351 drugsCnidium is the dried fruit of an Asian plant long used in traditional Chinese medicine, mostly for skin problems and sexual health. Modern human evidence for these uses is very limited, with...
Read the full Cnidium monograph → Herb & supplement monographGinkgo
Interacts with 1,266 drugsGinkgo is one of the world's most popular herbal supplements, mostly taken to support memory and circulation. The evidence for these uses is mixed and generally weak, and it is not proven to...
Read the full Ginkgo monograph → Herb & supplement monographXanthoparmelia
Xanthoparmelia is a type of lichen marketed mainly in supplements promoted for erectile dysfunction and sexual performance, but there is very little reliable human research to support these...
Read the full Xanthoparmelia monograph → Herb & supplement monographOats
Interacts with 86 drugsOats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...
Read the full Oats monograph → Herb & supplement monographHorny Goat Weed
Interacts with 963 drugsHorny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these uses is lacking. While short-term use s...
Read the full Horny Goat Weed monograph →Sources & How We Checked
Vialafil 675 mg's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 370 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.
Zinc 88 references
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- Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
- Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
- Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
- Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
- Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
- Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
- Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
- Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
- Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
- Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
- Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
- Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
- Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
- Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. PubMed
- Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM 2003;96:35-43. DOI
- Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst 2003;95:1004-7.. PubMed
- Jafek BW, Linschoten M, Murrow BW. Zicam Induced Anosmia. American Rhinologic Society 49th Annual Fall Scientific Meeting abstract. Orlando, Florida. September 20, 2003. http://app.american-rhinologic.org/programs/2003ARSFallProgram071503.pdf (Accessed 24
- Uebayashi H, Hatanaka T, Kanemura F, Tonosaki K. Acute anosmia in the mouse: behavioral discrimination among the four basic taste substances. Physiol Behav 2001;72:291-6.. PubMed
- Barrett S. Zicam Marketers Sued. United States District Court Western District of Michigan Southern Division, Filed October 14, 2003, Case No. 4:03CV0146.
- Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:181-90.. PubMed
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
- Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7. PubMed
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
- Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70. PubMed
- Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.
- McBride K, Slotnick B, Margolis FL. Does intranasal application of zinc sulfate produce anosmia in the mouse? An olfactometric and anatomical study. Chem Senses 2003;28:659-70. PubMed
- Burd GD. Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb. Microsc Res Tech 1993;24:195-213. PubMed
- Ducray A, Bondier JR, Michel G, et al. Recovery following peripheral destruction of olfactory neurons in young and adult mice. Eur J Neurosci 2002;15:1907-17. PubMed
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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