Vira-Shield Ingredients & Drug Interactions
by DaVinci Laboratories Of Vermont
What is this page for?
First and foremost: checking Vira-Shield 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
Vira-Shield is a dietary supplement by DaVinci Laboratories Of Vermont with 7 active ingredients. Its ingredients are commonly taken for high blood pressure, high cholesterol, heart health.Based on those ingredients, 1,446 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Grapefruit seed extract, Garlic Bulb Extract, Black Cumin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Vira-Shield by DaVinci Laboratories Of Vermont
Ask about any prescription or over-the-counter medication and we check it for interactions with Vira-Shield by DaVinci Laboratories Of Vermont — 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 Vira-Shield by DaVinci Laboratories Of Vermont
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
Full disclosure
Vira-Shield contains 7 ingredients, of which the active ones are garlic bulb extract, olive leaf extract (which contains oleuropein), black walnut, black cumin (black seed), grapefruit seed extract, wormwood powder, and pau d'arco powder. These are combined with inactive ingredients — microcrystalline cellulose, stearic acid, croscarmellose sodium, stearate, silicon dioxide, and pharmaceutical glaze — that serve as binders, fillers, and tablet coatings.
Does it work?
Moderate evidence
Evidence for this product's ingredients is mixed. Garlic extract shows possibly effective evidence for managing blood sugar in diabetes, lowering blood pressure, and reducing heart disease risk (atherosclerosis); it's also possibly effective for certain liver conditions and gum disease (periodontitis).
Black cumin is possibly effective for acne, hay fever, asthma, and diabetes. Grapefruit seed extract and the other ingredients lack sufficient reliable evidence to rate their effectiveness for any condition in our data.
Black walnut, wormwood, and pau d'arco all show insufficient evidence across their studied uses.
How safe is it?
Well-documented data
Garlic is generally well tolerated when taken by mouth, though common side effects include stomach upset, gas, bad breath, and body odor; allergic reactions can occur in sensitive people, and there are rare case reports of increased bleeding. Black cumin is also generally well tolerated, but gastrointestinal complaints such as nausea, constipation, and burning stomach discomfort occur in some users; one case of heavy menstrual bleeding was reported.
Black walnut has limited human safety data; the leaf, bark, and hull contain tannins that may cause stomach upset and skin irritation, and tree nut allergies are common. Wormwood contains thujone, a neurotoxin, and short-term use of properly prepared products may be acceptable, but it can cause nausea, vomiting, and in serious cases kidney damage or seizures; chronic use is linked to addiction and neurological damage.
Grapefruit seed extract is generally well tolerated as a food, though allergic reactions are rare. Pau d'arco has limited safety data; at doses above 1.5 grams daily the lapachol it contains may cause anemia, increased bleeding, and severe nausea and vomiting.
Meds to double-check
Major interaction found
Check the following medication types with your pharmacist before taking Vira-Shield: heart rhythm drugs like amiodarone (Major severity); blood thinners and antiplatelet drugs (Moderate); blood pressure medications (Moderate); diabetes drugs (Moderate); immunosuppressants including cyclosporine (Moderate); HIV protease inhibitors (Moderate); CNS depressants and sedatives (Moderate); antidepressants with serotonergic effects (Moderate); and anticonvulsants (Moderate). This is not an exhaustive list — use the medication checker on this page with your full drug list.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Vira-Shield is not recommended if you take blood thinners, heart rhythm medications, blood pressure drugs, diabetes medications, or certain immunosuppressants — the interactions are serious and well documented. Even if you don't take those classes, check your exact medications with the tool on this page before starting, because grapefruit seed extract alone interacts with over 100 drugs.
Talk to your pharmacist or doctor before using this product, especially if you're pregnant, breastfeeding, or taking any prescription medication.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 24, 2024.
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 Vira-Shield, straight from the product label.
| Brand | DaVinci Laboratories Of Vermont |
|---|---|
| Barcode (UPC) | 026664273819 |
| Net contents | 120 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jan 24, 2024 |
| DSLD ID | 304058 |
| Product type | Botanical |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Vira-Shield by DaVinci Laboratories Of Vermont, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Garlic Bulb Extract | 200 mg | -- |
| Olive leaf extract | 200 mg | -- |
| Oleuropein | 30 mg | -- |
| Black Walnut | 400 mg | -- |
| Black Cumin | 200 mg | -- |
| Grapefruit seed extract | 200 mg | -- |
| Wormwood, Powder | 200 mg | -- |
| Pau D'Arco, Powder | 200 mg | -- |
Other ingredients: Microcrystalline Cellulose, Stearic Acid, Croscarmellose Sodium, Stearate, Silicon Dioxide, Pharmaceutical Glaze
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.
General Statements
Truth We pledge total truth in labeling. Our family of products contain only the purest and most potent ingredients. Guaranteed.
Formulation
Vira-Shield contains a combination of plant extracts that support the body's elimination of unwanted microorganisms while helping to maintain proper immune system and G.I. Tract Functions.
Color of this product may vary due to color variations of the natural ingredients.
Gluten free
Precautions
Warning: Do not take this product if pregnant or nursing.
Caution: If you have allergies to ragweed, chrysanthemums, marigolds or daisies, or if you are taking blood thinning medications, do not take this product without first consulting your healthcare practitioner.
Caution: If you have allergies to ragweed, chrysanthemums, marigolds or daisies, or if you are taking blood thinning medications, do not take this product without first consulting your healthcare practitioner.
Keep out of reach of children.
Contains: Tree nuts (black walnut).
To obtain product information or report a serious adverse event, call 1-800-325-1776. Not labeled for sale in California
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
FDA Statement of Identity
A Dietary Supplement
Suggested/Recommended/Usage/Directions
Suggested use: As a dietary supplement, take 2 tablets in AM on an empty stomach and 2 tablets in PM on an empty stomach. Take recommended amount for 1-3 months, or as directed by your healthcare practitioner.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Vira-Shield by DaVinci Laboratories Of Vermont 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 Vira-Shield by DaVinci Laboratories Of Vermont
These are the 7 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Garlic Bulb Extract
Interacts with989 drugs
Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usuall...
Garlic Bulb Extract monograph & interactionsOlive leaf extract
No knowninteractions
Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyr...
Olive leaf extract monograph & interactions- › Oleuropein
Black Walnut
No knowninteractions
Black walnut is a tree whose green hulls are traditionally used as a natural antiparasitic and digestive remedy, but solid human evidence for these us...
Black Walnut monograph & interactionsBlack Cumin
Interacts with912 drugs
Black seed (Nigella sativa) is a traditional spice and remedy that has been studied for asthma, blood sugar, cholesterol, and blood pressure, with ear...
Black Cumin monograph & interactionsGrapefruit seed extract
Interacts with990 drugs
Grapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for seri...
Grapefruit seed extract monograph & interactionsWormwood, Powder
Interacts with50 drugs
Wormwood is a very bitter herb traditionally used to stimulate appetite and ease digestion, and it has early research interest in Crohn's disease. It...
Wormwood, Powder monograph & interactionsPau D'Arco, Powder
Interacts with122 drugs
Pau d'arco is a South American tree bark traditionally used for infections and inflammation, and it contains compounds like lapachol that show activit...
Pau D'Arco, Powder monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Stearic Acid, Croscarmellose Sodium, Stearate, Silicon Dioxide, Pharmaceutical Glaze. These complete the product’s ingredient list but are not active constituents.
Vira-Shield by DaVinci Laboratories Of Vermont Drug Interactions
HelloPharmacist Interaction Report
Vira-Shield by DaVinci Laboratories Of Vermont contains several ingredients with documented interactions with medications, and the most serious concern involves grapefruit seed extract.
Grapefruit can significantly raise blood levels of certain drugs — including the heart rhythm medication amiodarone (which can increase by 50%), the anti-anxiety drug buspirone, the cough suppressant dextromethorphan, and the immunosuppressant cyclosporine — potentially causing serious side effects. It can also lower levels of the beta-blocker celiprolol and the cancer drug etoposide, reducing their effectiveness.
Read the full breakdown — every affected drug type, severity by severity
Garlic bulb extract carries several Moderate-severity interactions: it may increase bleeding risk with blood thinners (anticoagulants) and antiplatelet drugs, including warfarin; lower blood sugar too much if you're taking diabetes medications; or raise blood pressure medication effects too far. Garlic can also affect how your body breaks down certain other drugs through liver enzymes (CYP3A4 and CYP2E1 substrates), and may reduce levels of HIV protease inhibitors.
Black cumin (black seed) also has Moderate interactions with blood pressure drugs, blood thinners, diabetes medications, and certain immunosuppressants like cyclosporine. It may also increase sedation if combined with CNS depressants, or raise serotonin levels dangerously with serotonergic antidepressants.
Wormwood carries a Moderate interaction with anticonvulsant drugs, and pau d'arco may increase bleeding risk with anticoagulants and antiplatelet medications.
Altogether, these interactions span 1,428 individual medications. We could not check oleuropein for interactions.
Please use the medication search tool on this page to verify whether any of your current prescriptions interact with this product before you start it.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Vira-Shield?
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 Vira-Shield interact with 1,446 drugs. Click any drug to see the details.
5 of the 7 ingredients in Vira-Shield interact with drugs. Each result below shows which ingredient is responsible. Grapefruit seed extract Garlic Bulb Extract Black Cumin Pau D'Arco, Powder Wormwood, Powder
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Ado-trastuzumab Emtansine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Abemaciclib interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Abiraterone interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Abiraterone Acetate interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Abiraterone Acetate interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acalabrutinib interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acalabrutinib interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Vira-Shield — through 4 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Grapefruit Seed Extract + Acetaminophen, Aspirin, Caffeine interactionPau D'arco, PowderAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full Pau D'arco, Powder + Acetaminophen, Aspirin, Caffeine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Aspirin, Caffeine interactionBlack CuminAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black seed may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Black Cumin + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Butalbital, Caffeine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Grapefruit Seed Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionBlack CuminCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Grapefruit Seed Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionBlack CuminCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Caffeine, Codeine interactionBlack CuminCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Caffeine, Codeine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Grapefruit Seed Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBlack CuminCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Grapefruit Seed Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionBlack CuminCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Vira-Shield — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Caffeine, Isometheptene interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can decrease the clearance of caffeine, potentially increasing the effects and adverse effects of caffeine.
Read the full Grapefruit Seed Extract + Acetaminophen, Caffeine, Pyrilamine interactionBlack CuminDiuretic Drugs Moderate
Interaction Summary
Theoretically, taking black seed with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Read the full Black Cumin + Acetaminophen, Caffeine, Pyrilamine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionBlack CuminCns Depressants, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractDextromethorphan (robitussin Dm, Others), Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionBlack CuminCns Depressants, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Dextromethorphan interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Seed Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionGarlic Bulb ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2e1 (cyp2e1) Substrates Moderate
Interaction Summary
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Vira-Shield — through 3 ingredients. Tap an ingredient for the detail:
Grapefruit Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Dextromethorphan (robitussin Dm, Others) +1 Major
Interaction Summary
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Read the full Grapefruit Seed Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionGarlic Bulb ExtractCytochrome P450 2e1 (cyp2e1) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Garlic might increase levels of drugs metabolized by CYP2E1.
Read the full Garlic Bulb Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionBlack CuminSerotonergic Drugs Moderate
Interaction Summary
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Read the full Black Cumin + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Vira-Shield 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.
Grapefruit seed extract
Amiodarone (Cordarone)
Grapefruit juice can increase blood levels of amiodarone, potentially increasing the effects and adverse effects of amiodarone.
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption of amiodarone. Grapefruit juice increases amiodarone plasma levels by 50% and peak concentration by 84%.
Artemether (Artenam, Paluther)
Grapefruit juice can increase blood levels of oral artemether, potentially increasing the effects and adverse effects of artemether.
Clinical research shows that grapefruit juice increases the levels of oral artemether by 90% to 250% in healthy males.
Benzodiazepines
Grapefruit juice might increase blood levels of some oral benzodiazepines, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice can increase plasma triazolam concentrations. Repeated consumption of grapefruit juice greatly increases triazolam concentrations and prolongs the half-life, probably due to inhibition of cytochrome P450 3A4 (CYP3A4). Some studies show that grapefruit juice, particularly when taken in large quantities, reduces the clearance and increases the maximum blood levels, area under the plasma concentration curve (AUC), and duration of effect of midazolam. However, there is no effect on intravenous midazolam. Grapefruit juice has also been shown to increase the maximum blood levels and duration of effect of diazepam, but the clinical significance of this is not known. This interaction does not appear to occur with alprazolam.
Buspirone (Buspar)
Grapefruit juice can increase blood levels of buspirone, potentially increasing the effects and adverse effects of buspirone.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of buspirone.
Calcium Channel Blockers
Grapefruit juice can increase blood levels of oral calcium channel blockers, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of amlodipine, nifedipine, nisoldipine, verapamil, felodipine, nimodipine, nicardipine, diltiazem, pranidipine, nitrendipine, and manidipine,
This interaction is likely the result of the inhibition of intestinal metabolism of these drugs by CYP3A4, although some research suggests grapefruit may alter plasma drug levels by reducing the rate of gastric emptying. Consuming grapefruit juice 1 liter daily increases steady state concentrations of verapamil by as much as 50%. However, some references dispute the clinical relevance of the interactions with amlodipine, diltiazem, and verapamil. Other research in healthy individuals suggests plasma levels of felodipine and nifedipine are not affected when given intravenously. There is considerable interindividual variability in the effect of grapefruit juice on drug metabolism, which might account for inconsistent study results. In healthy older adults, the hemodynamic response to felodipine plus grapefruit juice might be influenced by altered autonomic regulation. In older healthy adults, a single dose of grapefruit juice and felodipine enhanced the blood pressure-lowering effects of felodipine. However, after a week of grapefruit juice and felodipine (steady state), the hypotensive activity was reduced, possibly due to compensatory tachycardia. Research indicates it is necessary to withhold grapefruit juice for as long as 3 days to avoid interactions with felodipine and nisoldipine.
Carbamazepine (Tegretol)
Grapefruit juice can increase blood levels of carbamazepine, potentially increasing the effects and adverse effects of carbamazepine.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of carbamazepine.
Carvedilol (Coreg)
Grapefruit juice can increase blood levels of carvedilol, potentially increasing the effects and adverse effects of carvedilol.
Clinical research shows that grapefruit juice increases the bioavailability of a single dose of carvedilol by 16%.
Celiprolol (Celicard)
Grapefruit juice can decrease blood levels of celiprolol, potentially decreasing the clinical effects of celiprolol.
In human research, taking grapefruit juice within two hours of celiprolol appears to decrease absorption and blood levels of celiprolol by approximately 85%. This interaction is due to grapefruit-induced inhibition of organic anion transporting polypeptide (OATP). Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Cisapride (Propulsid)
Grapefruit juice can increase blood levels of cisapride, potentially increasing the effects and adverse effects of cisapride.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cisapride. According to the cisapride prescribing information, grapefruit juice is contraindicated in patients taking cisapride.
Clomipramine (Anafranil)
Theoretically, grapefruit juice might increase blood levels of clomipramine, potentially increasing the effects and adverse effects of clomipramine.
Case reports have shown that clomipramine trough levels increase significantly after the addition of grapefruit juice to the therapeutic regimen.
Clopidogrel (Plavix)
Grapefruit juice can decrease blood levels of the active metabolite of clopidogrel, thereby decreasing the antiplatelet effect of clopidogrel.
Clopidogrel is an antiplatelet prodrug that is metabolized primarily by cytochrome P450 2C19 (CYP2C19) to form the active metabolite. A small clinical study shows that taking grapefruit juice with clopidogrel decreases plasma levels of the active metabolite by more than 80% and impairs the antiplatelet effect of clopidogrel. This effect is possibly due to grapefruit-induced inhibition of CYP2C19.
Cyclosporine (Neoral, Sandimmune)
Grapefruit juice can increase blood levels of oral cyclosporine, potentially increasing the effects and adverse effects of cyclosporine.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cyclosporine. The mechanism of action is unclear. However, there is no effect on intravenous cyclosporine.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Clinical research shows that grapefruit juice can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. When taken orally, effects of grapefruit juice on CYP3A4 levels appear to last at least 48 hours. Grapefruit's ability to inhibit CYP3A4 has even been harnessed to intentionally increase levels of venetoclax, which is metabolized by CYP3A4, in an elderly patient with acute myeloid leukemia who could not afford full dose venetoclax. The lower dose of venetoclax in combination with grapefruit juice resulted in serum levels of venetoclax in the therapeutic reference range of full dose venetoclax and positive treatment outcomes for the patient.
Professional consensus recommends the consideration of patient age, existing medical conditions, additional medications, and the potential for additive adverse effects when evaluating the risks of concomitant use of grapefruit juice with any medication metabolized by CYP3A4. While all patients are at risk for interactions with grapefruit juice consumption, patients older than 70 years of age and those taking multiple medications are at the greatest risk for a serious or fatal interaction with grapefruit juice.
Dextromethorphan (Robitussin Dm, Others)
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism, causing increased dextromethorphan levels.
Estrogens
Grapefruit juice can increase blood levels of estrogens, potentially increasing the effects and adverse effects of estrogens.
Clinical research shows that grapefruit increases the levels of endogenous and exogenous estrogens by inhibiting cytochrome P450 3A4 (CYP3A4) enzymes. Grapefruit juice increases exogenously administered 17-beta-estradiol by about 20% in females without ovaries and ethinyl-estradiol in healthy females.
Etoposide (Vepesid)
Grapefruit juice can decrease blood levels of etoposide, potentially decreasing the clinical effects of etoposide.
Clinical research shows that grapefruit juice decreases the absorption and plasma concentrations of etoposide. There is some evidence that grapefruit juice co-administered with oral etoposide can reduce levels of etoposide by about 26%. Grapefruit juice seems to inhibit organic anion transporting polypeptide (OATP), which is a drug transporter in the gut, liver, and kidney. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Halofantrine
Grapefruit juice can increase blood levels of halofantrine, potentially increasing the effects and adverse effects of halofantrine.
Clinical research shows that grapefruit juice inhibits cytochrome P450 3A4 (CYP3A4) metabolism, which increases halofantrine levels and peak concentration, as well as a marker of ventricular tachyarrhythmia potential.
Hmg-Coa Reductase Inhibitors ("Statins")
Grapefruit juice can increase blood levels of statins that are metabolized by cytochrome P450 3A4 (CYP3A4), potentially increasing the effects and adverse effects of these statins. Additionally, grapefruit juice might interfere with the bioavailability of statins that are substrates of organic anion transporting polypeptides (OATP).
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption and plasma concentrations of statins that are metabolized by CYP3A4. These include lovastatin, simvastatin, and atorvastatin. Keep in mind that there is considerable variability in the effect of grapefruit juice on drug metabolism, so individual patient response is difficult to predict.
Some statins, including pravastatin, fluvastatin, pitavastatin, and rosuvastatin, are not metabolized by CYP3A4. However, grapefruit juice might still affect the bioavailability of these statins. These statins are substrates of OATP. Grapefruit juice can inhibit OATP. Therefore, grapefruit juice may reduce the bioavailability or increase drug levels of these statins depending on the type of OATP. However, grapefruit juice affects OATP for only a short time. Therefore, separating drug administration by at least 4 hours is likely to avoid this interaction.
Methadone (Dolophine)
Grapefruit juice can increase blood levels of methadone, potentially increasing the effects and adverse effects of methadone.
Clinical research shows that grapefruit juice inhibits the metabolism of methadone, increasing methadone levels and peak concentrations. In one case, a 51-year-old male taking methadone 90 mg daily and no other medications was found unresponsive. The patient reported drinking grapefruit juice 500 mL daily for 3 days prior to the event. Methadone is a substrate of cytochrome P450 3A4 (CYP3A4), and grapefruit juice-induced inhibition of CYP3A4 is the likely cause of this interaction.
Methylprednisolone
Grapefruit juice can increase blood levels of methylprednisolone, potentially increasing the effects and adverse effects of methylprednisolone.
Clinical research shows that grapefruit juice can increase the plasma concentration of orally administered methylprednisolone. Grapefruit juice 200 mL three times daily given with methylprednisolone 16 mg increased methylprednisolone half-life by 35%, peak plasma concentration by 27%, and total area under the curve by 75%.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Grapefruit juice can decrease levels of drugs that are substrates of OATP.
In vitro and clinical research show that consuming grapefruit juice inhibits OATP, which reduces the bioavailability of oral drugs that are substrates of OATP. Various clinical studies have shown reduced absorption of OATP substrates when taken with grapefruit, including fexofenadine, acebutolol, aliskiren, celiprolol, levothyroxine, nadolol, and pitavastatin. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Praziquantel (Biltricide)
Grapefruit juice can increase blood levels of praziquantel, potentially increasing the effects and adverse effects of praziquantel.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism of praziquantel. Plasma concentrations of praziquantel can increase by as much as 160% when administered with 250 mL of commercially available grapefruit juice.
Qt Interval-Prolonging Drugs
Grapefruit or grapefruit juice, especially if consumed in large amounts, can cause additive QT interval prolongation when taken with QT interval-prolonging drugs, potentially increasing the risk of ventricular arrhythmias.
Clinical research in healthy volunteers shows that drinking 6 liters of grapefruit juice over 6 hours prolonged the QTc by a peak amount of 14 milliseconds (ms). This prolongation was similar to the QT prolongation caused by the drug moxifloxacin. In individuals with long QT syndrome, a smaller dose of grapefruit juice, 1.5 liters, resulted in a greater peak QTc prolongation of about 30 ms. The effect of smaller quantities of grapefruit juice on the QT interval is unclear.
Quetiapine (Seroquel)
Grapefruit juice may increase blood levels of quetiapine, increasing the effects and adverse effects of quetiapine.
Quetiapine is metabolized by cytochrome P450 3A4 (CYP3A4). Grapefruit can inhibit CYP3A4. In one case report, a healthy 28-year-old female with bipolar disorder stabilized on quetiapine 800 mg daily presented with quetiapine toxicity considered to be related to consuming a gallon of grapefruit juice over the past 24 hours.
Quinidine
Grapefruit juice can alter blood levels of quinidine, potentially increasing or decreasing the clinical effects of quinidine.
Clinical research shows that grapefruit juice decreases quinidine absorption, clearance, and metabolism, and prolongs the half-life by about 20%.
Garlic Bulb Extract
Anticoagulant/Antiplatelet Drugs
Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time.
Antidiabetes Drugs
Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that garlic and garlic extract lower blood glucose levels in healthy and diabetic individuals.
Antihypertensive Drugs
Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.
In human research, both garlic and garlic extracts have blood pressure-lowering effects.
Atazanavir (Reyataz)
Theoretically, garlic might decrease levels and effects of atazanavir.
In a case report, a patient consuming six stir-fried garlic cloves three times weekly developed suboptimal atazanavir levels and increases in HIV viral load. While the exact cause of this interaction is unclear, there is speculation that garlic might decrease the intestinal absorption of atazanavir or increase its metabolism by inducing cytochrome P450 3A4 (CYP3A4). Until more is known, advise patients not to consume large amounts of garlic while taking atazanavir.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Garlic might increase levels of drugs metabolized by CYP2E1.
Clinical research suggests garlic oil can inhibit the activity of CYP2E1 by 39%. Use garlic oil cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Some human research suggests that garlic may induce INTESTINAL CYP3A4, reducing levels of drugs metabolized by this enzyme. This is primarily based on a study showing that taking a specific allicin-containing garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induced CYP3A4 in the gut mucosa. Another study shows that giving docetaxel intravenously, bypassing the CYP3A4 enzymes in the gut mucosa, along with the same specific garlic product for 12 consecutive days, does not affect docetaxel levels. Conversely, there is concern that garlic may inhibit HEPATIC CYP3A4. In a single case report, increased tacrolimus levels and liver injury occurred in a liver transplant patient after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. Several other studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Isoniazid
Theoretically, garlic might decrease levels of isoniazid.
Animal research suggests that an aqueous extract of garlic reduces isoniazid levels by about 65%. Garlic reduced the maximum concentration (Cmax) and area under the curve (AUC), but not the half-life, of isoniazid. This suggests that garlic extract might inhibit isoniazid absorption across the intestinal mucosa; however, the exact mechanism of this potential interaction is not known.
Protease Inhibitors (Pis)
Theoretically, garlic products containing allicin might decrease levels of PIs.
Protease inhibitors are metabolized by cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4, reducing plasma levels of protease inhibitors. This is primarily based on a study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces levels of saquinavir, a PI, by approximately 50%. It is speculated that the allicin constituent induce CYP3A4 in the gut mucosa. Several studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin.
Saquinavir (Fortovase, Invirase)
Theoretically, garlic containing allicin might decrease levels of saquinavir.
Saquinavir is a substrate of cytochrome P450 3A4 (CYP3A4) isoenzymes. There is concern that garlic products containing allicin might induce intestinal CYP3A4 and cause subtherapeutic levels of saquinavir. This is primarily based on a pharmacokinetic study showing that taking a specific garlic product (GarliPure Maximum Allicin Formula, Natrol Inc.) twice daily for 3 days reduces saquinavir levels by approximately 50%. It is speculated that the allicin constituent induces CYP3A4 in the gut mucosa. Several pharmacokinetic studies have evaluated the impact of other garlic formulations on CYP3A4 substrates and have found no effect. Most of the products in these studies provided little or no allicin. Until more is known about this potential interaction, use garlic containing allicin cautiously in patients taking saquinavir.
Sofosbuvir (Sovaldi)
Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.
Tacrolimus (Prograf)
Theoretically, garlic might increase levels of tacrolimus.
In one case report, a liver transplant patient taking tacrolimus experienced increased tacrolimus levels and liver injury after taking a specific garlic supplement (Garlicin Cardio, Nature's Way) at up to three times the manufacturer recommended dose for 7 days. It is speculated that garlic inhibited hepatic cytochrome P450 3A4 (CYP3A4), which increased plasma levels of tacrolimus.
Warfarin (Coumadin)
Theoretically, garlic might increase the risk of bleeding with warfarin.
Raw garlic and a variety of garlic extracts have antiplatelet activity and can increase prothrombin time. In addition, there is a report of two patients who experienced an increase in a previously stabilized international normalized ratio (INR) with concomitant garlic and warfarin use. However, this report has been subsequently debated due to limited clinical information. Other clinical studies have not identified an effect of garlic on INR, warfarin pharmacokinetics, or bleeding risk. More evidence is needed to determine the safety of using garlic with warfarin.
Black Cumin
Anticoagulant/Antiplatelet Drugs
Theoretically, black seed may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that black seed extract can inhibit platelet aggregation and clotting, and increase bleeding time. In addition, decreased platelet counts have occurred in a human case report and in animal research.
Antidiabetes Drugs
Theoretically, taking black seed with antidiabetes drugs might increase the risk of hypoglycemia.
Some clinical research and numerous animal studies suggest that black seed, especially its constituent thymoquinone, can have hypoglycemic effects.
Antihypertensive Drugs
Theoretically, taking black seed with antihypertensive drugs might increase the risk of hypotension.
Clinical research suggests that black seed powder and oil might reduce blood pressure by 2-3 mmHg. In animal research, black seed modestly reduces blood pressure and concomitant use of black seed and amlodipine (Norvasc) or metoprolol (Lopressor) increased the blood pressure lowering effects of these drugs.
Clopidogrel (Plavix)
Theoretically, black seed may increase the risk of bleeding if used with clopidogrel.
Animal research shows that taking black seed extract daily for 2 weeks prior to a single dose of clopidogrel increases maximum concentrations of clopidogrel by approximately 31% and modestly decreases oral clearance. Furthermore, bleeding time was increased by 12%. This has not been shown in humans.
Cns Depressants
Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Animal research suggests that black seed may have CNS depressant effects.
Cyclosporine (Neoral, Sandimmune)
Theoretically taking black seed might reduce the levels and clinical effects of cyclosporine.
In animal research, black seed extract decreased the maximal levels of cyclosporine in the blood by 35.5%. This has not been shown in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, black seed might increase levels of drugs metabolized by CYP2C9.
In vitro research suggests that thymoquinone, a constituent of black seed, can decrease the metabolism of phenytoin by a mechanism possibly related to the inhibition of CYP2C9. The effect of black seed on CYP2C9 is unclear. This has not been shown in humans.
Diuretic Drugs
Theoretically, taking black seed with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Black seed extract has shown diuretic effects in animals, which could theoretically increase potassium loss. This has not been shown in humans.
Immunosuppressants
Theoretically, black seed might interfere with immunosuppressive therapy.
Animal and in vitro studies suggest that black seed might stimulate immune function. However, other animal studies suggest that black seed may suppress immune function.
Phenytoin (Dilantin)
Theoretically, black seed might increase or decrease levels and effects of phenytoin.
In vitro research suggests that thymoquinone, a constituent of black seed, can decrease the metabolism of phenytoin. This effect may be due to inhibition of cytochrome P450 2C9 (CYP2C9). However, animal research shows that black seed decreases the maximum concentration of and total systemic exposure to phenytoin by 57% and 87%, respectively. This seems to be related to increased clearance and steady state volume of distribution. This interaction has not been shown in humans.
Serotonergic Drugs
Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Animal research suggests that black seed can increase brain serotonin levels. In one case report, a 35-year-old man undergoing endoscopic surgery experienced immediate postoperative serotonin syndrome that was likely associated with the use of black seed oil 600 mg daily starting 4 days before surgery, and precipitated by the use of serotonergic pain medications, including fentanyl and oxycodone. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using black seed with serotonergic drugs.
Sildenafil (Viagra)
Theoretically, black seed might reduce plasma levels and the therapeutic effects of sildenafil.
Animal research shows that black seed reduces the total systemic exposure to sildenafil by 43%. So far, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, black seed might increase levels of warfarin and increase the risk of bleeding.
In vitro research suggests that thymoquinone, a constituent of black seed, can decrease the metabolism of warfarin. This effect may be due to inhibition of cytochrome P450 2C9 (CYP2C9). The effect of black seed on warfarin metabolism is unclear. This has not been shown in humans.
Prednisolone
Theoretically black seed might reduce plasma levels and therapeutic effects of prednisolone.
In animal research, oral administration of a single dose of black seed oil 15 minutes prior to oral prednisolone decreases the prednisolone maximum plasma concentration by 65% and area under the curve by 25%. This has not been shown in humans.
Pau D'Arco, Powder
Anticoagulant/Antiplatelet Drugs
Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that pau d'arco reduces platelet aggregation and may interfere with vitamin K. One clinical study shows that taking the lapachol constituent of pau d'arco in doses above 1.5 grams daily increases the risk of bleeding. The effects of whole pau d'arco or pau d'arco extract in humans are unclear.
Wormwood, Powder
Anticonvulsants
Theoretically, taking wormwood might interfere with the effects of anticonvulsant drugs.
Thujone, a constituent of wormwood, has convulsant effects.
Brand information
Manufacturer and brand details for Vira-Shield, from the product label.
DaVinci Laboratories Of Vermont
See all DaVinci Laboratories Of Vermont products- Name
- DaVinci Laboratories a division of FoodScience LLC
- Street Address
- 929 Harvest Lane
- City
- Williston
- State
- VT
- ZipCode
- 05495
- Phone Number
- 1-800-325-1776
- Web Address
- www.davincilabs.com
Vira-Shield by DaVinci Laboratories Of Vermont: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Vira-Shield’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Garlic
Interacts with 989 drugsGarlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food am...
Read the full Garlic monograph → Herb & supplement monographOlive
Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...
Read the full Olive monograph → Herb & supplement monographBlack Walnut
Black walnut is a tree whose green hulls are traditionally used as a natural antiparasitic and digestive remedy, but solid human evidence for these uses is lacking. It contains a compound ca...
Read the full Black Walnut monograph → Herb & supplement monographBlack Seed
Interacts with 912 drugsBlack seed (Nigella sativa) is a traditional spice and remedy that has been studied for asthma, blood sugar, cholesterol, and blood pressure, with early research showing some promise but no...
Read the full Black Seed monograph → Herb & supplement monographGrapefruit
Interacts with 990 drugsGrapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription...
Read the full Grapefruit monograph → Herb & supplement monographWormwood
Interacts with 50 drugsWormwood is a very bitter herb traditionally used to stimulate appetite and ease digestion, and it has early research interest in Crohn's disease. It contains thujone, which can be toxic in...
Read the full Wormwood monograph → Herb & supplement monographPau D'arco
Interacts with 122 drugsPau d'arco is a South American tree bark traditionally used for infections and inflammation, and it contains compounds like lapachol that show activity in lab studies. However, strong human...
Read the full Pau D'arco monograph →Sources & How We Checked
Vira-Shield'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 392 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.
Garlic 154 references
- Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens 1994;12:463-8. DOI
- McMahon FG, Vargas R. Can garlic lower blood pressure? A pilot study. Pharmacotherapy 1993;13:406-7. DOI
- Auer W, Eiber A, Hertkorn E, et al. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl 1990;69:3-6.
- Garty BZ. Garlic burns. Pediatrics 1993;91:658-9.
- Rose KD, Croissant PD, Parliament CF, Levin MB. Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report. Neurosurg 1990;26:880-2. PubMed
- Burnham BE. Garlic as a possible risk for postoperative bleeding. Plast Reconstr Surg 1995;95:213.
- Sunter WH. Warfarin and garlic. Pharm J 1991;246:722.
- Berthold HK, Sudhop T, von Bergmann K. Effect of a garlic oil preparation on serum lipoproteins and cholesterol metabolism. JAMA 1998;279:1900-2.
- Steiner M, Khan AH, Holbert D, Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr 1996;64:866-70. PubMed
- Steiner M, Lin RS. Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract. J Cardiovasc Pharmacol 1998;31:904-8. PubMed
- Gwilt PR, Lear CL, Tempero MA, et al. The effect of garlic extract on human metabolism of acetaminophen. Cancer Epidemiol Biomarkers Prev 1994;3:155-60.
- Rahman K, Billington D. Dietary supplementation with aged garlic extract inhibits ADP-induced platelet aggregation in humans. J Nutr 2000;130:2662-5. PubMed
- Bloch AS. Pushing the Envelope of Nutrition Support: Complementary Therapies. Nutrition 2000;16:236-9. PubMed
- Steiner M, Li W. Aged garlic extract, a modulator of cardiovascular risk factors: a dose-finding study on the effects of AGE on platelet functions. J Nutr 2001;131:980S-4S. PubMed
- Mader FH. Treatment of hyperlipidaemia with garlic-powder tablets. Evidence from the German Association of General Practitioners' multicentric placebo-controlled double-blind study. Arzneimittelforschung 1990;40:1111-6.
- Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Symp Suppl 1990;69:7-11.
- Simons LA, Balasubramaniam S, von Konigsmark M, et al. On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemia. Atherosclerosis 1995;113:219-25. PubMed
- Neil HA, Silagy CA, Lancaster T, et al. Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis. J R Coll Physicians Lond 1996;30:329-34. DOI
- Koscielny J, Klussendorf D, Latza R, et al. The antiatherosclerotic effect of Allium sativum. Atherosclerosis 1999;144:237-49. PubMed
- Kiesewetter H, Jung F, Jung EM, et al. Effects of garlic coated tablets in peripheral arterial occlusive disease. Clin Investig 1993;71:383-6. PubMed
- Kiesewetter H, Jung F, Jung EM, et al. Effect of garlic on platelet aggregation in patients with increased risk of juvenile ischaemic attack. Eur J Clin Pharmacol 1993;45:333-6. PubMed
- Legnani C, Frascaro M, Guazzaloca G, et al. Effects of a dried garlic preparation on fibrinolysis and platelet aggregation in healthy subjects. Arzneimittelforschung 1993;43:119-22.
- Mennella JA, Johnson A, Beauchamp GK. Garlic ingestion by pregnant women alters the odor of amniotic fluid. Chem Senses 1995;20:207-9. PubMed
- Mennella JA, Beauchamp GK. Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics 1991;88:737-44. DOI
- Mennella JA, Beauchamp GK. The effects of repeated exposure to garlic-flavored milk on the nursling's behavior. Pediatr Res 1993;34:805-8. PubMed
- Cronin E. Dermatitis of the hands in caterers. Contact Dermatitis 1987;17:265-9. PubMed
- Lee TY, Lam TH. Contact dermatitis due to topical treatment with garlic in Hong Kong. Contact Dermatitis 1991;24:193-6. PubMed
- Bruynzeel DP. Bulb dermatitis. Dermatological problems in the flower bulb industries. Contact Dermatitis 1997;37:70-7.
- Stevinson C, Pittler MH, Ernst E. Garlic for treating hypercholesterolemia: a meta-analysis of randomized clinical trials. Ann Intern Med 2000;133:420-9. PubMed
- Ackermann RT, Mulrow CD, Ramirez G, et al. Garlic shows promise for improving some cardiovascular risk factors. Arch Intern Med 2001;161:813-24. PubMed
- Piscitelli SC, Burstein AH, Welden N, et al. The effect of garlic supplements on the pharmacokinetics of saquinavir. Clin Infect Dis 2002;34:234-8. PubMed
- Ziaei S, Hantoshzadeh S, Rezasoltani P, Lamyian M. The effect of garlic tablet on plasma lipids and platelet aggregation in nulliparous pregnants at high risk of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2001;99:201-6.. PubMed
- Markowitz JS, Devane CL, Chavin KD, et al. Effects of garlic (Allium sativum L.) supplementation on cytochrome P450 2D6 and 3A4 activity in healthy volunteers. Clin Pharmacol Ther 2003;74:170-7.. PubMed
- Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther 2001;18:189-93. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
- Farnsworth N, Bingel A, Cordell G, et al. Potential value of plants as sources of new antifertility agents I. J Pharm Sci 1975;64:535-98. DOI
- Carden SM, Good WV, Carden PA, Good RM. Garlic and the strabismus surgeon. Clin Experiment Ophthalmol 2002;30:303-4. PubMed
- Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
- Dehghani F, Merat A, Panjehshahin MR, Handjani F. Healing effect of garlic extract on warts and corns. Int J Dermatol 2005;44:612-5. PubMed
- Dhamija P, Malhotra S, Pandhi P. Effect of oral administration of crude aqueous extract of garlic on pharmacokinetic parameters of isoniazid and rifampicin in rabbits. Pharmacology 2006;77:100-4. PubMed
- Macan H, Uykimpang R, Alconcel M, et al. Aged garlic extract may be safe for patients on warfarin therapy. J Nutr 2006;136(3 Suppl):793S-795S. PubMed
- Hubbard VG, Goldsmith P. Garlic-fingered chefs. Contact Dermatitis 2005;52:165-6. PubMed
- Mohammed Abdul MI, Jiang X, Williams KM, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol 2008;154:1691-700. PubMed
- Ried K, Frank OR, Stocks NP, et al. Effect of garlic on blood pressure: A systematic review and meta-analysis. BMC Cardiovasc Disord 2008;8:13. PubMed
- Cox MC, Low J, Lee J, et al. Influence of garlic (Allium sativum) on the pharmacokinetics of docetaxel. Clin Cancer Res 2006;12:4636-40.
- van der Walt, A., Lopata, A. L., Nieuwenhuizen, N. E., and Jeebhay, M. F. Work-related allergy and asthma in spice mill workers - The impact of processing dried spices on IgE reactivity patterns. Int Arch.Allergy Immunol. 2010;152(3):271-278. PubMed
- Huang, J., Frohlich, J., and Ignaszewski, A. P. The impact of dietary changes and dietary supplements on lipid profile. Can J Cardiol 2011;27(4):488-505. PubMed
- Hasani-Ranjbar, S., Nayebi, N., Moradi, L., Mehri, A., Larijani, B., and Abdollahi, M. The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review. Curr.Pharm.Des 2010;16(26):2935-2947. PubMed
- Eming, S. A., Piontek, J. O., Hunzelmann, N., Rasokat, H., and Scharffetter-Kachanek, K. Severe toxic contact dermatitis caused by garlic. Br J Dermatol. 1999;141(2):391-392. PubMed
- Seuri, M., Taivanen, A., Ruoppi, P., and Tukiainen, H. Three cases of occupational asthma and rhinitis caused by garlic. Clin Exp.Allergy 1993;23(12):1011-1014. PubMed
- Rafaat, M. and Leung, A. K. Garlic burns. Pediatr Dermatol. 2000;17(6):475-476.
- Vaes, L. P. and Chyka, P. A. Interactions of warfarin with garlic, ginger, ginkgo, or ginseng: nature of the evidence. Ann Pharmacother 2000;34(12):1478-1482. PubMed
- Hviid, K. and Alsbjorn, B. ["Burns" caused by local application of garlic]. Ugeskr.Laeger 12-11-2000;162(50):6853-6854.
- Baruchin, A. M., Sagi, A., Yoffe, B., and Ronen, M. Garlic burns. Burns 2001;27(7):781-782.
- Pereira, F., Hatia, M., and Cardoso, J. Systemic contact dermatitis from diallyl disulfide. Contact Dermatitis 2002;46(2):124. PubMed
- Hughes, T. M., Varma, S., and Stone, N. M. Occupational contact dermatitis from a garlic and herb mixture. Contact Dermatitis 2002;47(1):48. PubMed
- Dillon, S. A., Burmi, R. S., Lowe, G. M., Billington, D., and Rahman, K. Antioxidant properties of aged garlic extract: an in vitro study incorporating human low density lipoprotein. Life Sci. 2-21-2003;72(14):1583-1594. PubMed
- Groppo, F. C., Ramacciato, J. C., Simoes, R. P., Florio, F. M., and Sartoratto, A. Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. Int.Dent.J. 2002;52(6):433-437. PubMed
- Lachter, J., Babich, J. P., Brookman, J. C., and Factor, A. Y. Garlic: a way out of work. Mil.Med 2003;168(6):499-500. DOI
- Hjorth, N. and Roed-Petersen, J. Occupational protein contact dermatitis in food handlers. Contact Dermatitis 1976;2(1):28-42. PubMed
- van Ketel, W. G. and de Haan, P. Occupational eczema from garlic and onion. Contact Dermatitis 1978;4(1):53-54. PubMed
- McFadden, J. P., White, I. R., and Rycroft, R. J. Allergic contact dermatitis from garlic. Contact Dermatitis 1992;27(5):333-334. PubMed
- Tanamai, J., Veeramanomai, S., and Indrakosas, N. The efficacy of cholesterol-lowering action and side effects of garlic enteric coated tablets in man. J Med Assoc.Thai. 2004;87(10):1156-1161.
- Ashraf, R., Aamir, K., Shaikh, A. R., and Ahmed, T. Effects of garlic on dyslipidemia in patients with type 2 diabetes mellitus. J Ayub.Med Coll.Abbottabad. 2005;17(3):60-64.
- Laing, M. E., Barry, J., Buckley, A. M., and Murphy, G. M. Immediate and delayed hypersensitivity reactions to food and latex in a chef. Contact Dermatitis 2006;55(3):193-194. PubMed
- Friedman, T., Shalom, A., and Westreich, M. Self-inflicted garlic burns: our experience and literature review. Int.J Dermatol. 2006;45(10):1161-1163. PubMed
- van Doorn, M. B., Espirito Santo, S. M., Meijer, P., Kamerling, I. M., Schoemaker, R. C., Dirsch, V., Vollmar, A., Haffner, T., Gebhardt, R., Cohen, A. F., Princen, H. M., and Burggraaf, J. Effect of garlic powder on C-reactive protein and plasma lipids
- Ekeowa-Anderson, A. L., Shergill, B., and Goldsmith, P. Allergic contact cheilitis to garlic. Contact Dermatitis 2007;56(3):174-175. PubMed
- Gadkari JV, Joshi VD. Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects. J Postgrad.Med 1991;37:128-131.
- McFadden, J. P., White, J. M., Basketter, D. A., and Kimber, I. Reduced allergy rates in atopic eczema to contact allergens used in both skin products and foods: atopy and the 'hapten-atopy hypothesis'. Contact Dermatitis 2008;58(3):156-158. PubMed
- Lembo, G., Balato, N., Patruno, C., Auricchio, L., and Ayala, F. Allergic contact dermatitis due to garlic (Allium sativum). Contact Dermatitis 1991;25(5):330-331.
- Bordel-Gomez, M. T. and Miranda-Romero, A. Sensitivity to diallyl disulfide in a Spanish population. Contact Dermatitis 2008;59(2):125-126. PubMed
- Reinhart, K. M., Coleman, C. I., Teevan, C., Vachhani, P., and White, C. M. Effects of garlic on blood pressure in patients with and without systolic hypertension: a meta-analysis. Ann.Pharmacother. 2008;42(12):1766-1771. PubMed
- Bagga, S., Thomas, B. S., and Bhat, M. Garlic burn as self-inflicted mucosal injury--a case report and review of the literature. Quintessence.Int. 2008;39(6):491-494.
- Shakeel, M., Trinidade, A., McCluney, N., and Clive, B. Complementary and alternative medicine in epistaxis: a point worth considering during the patient's history. Eur.J.Emerg.Med. 2010;17(1):17-19. PubMed
- Smyth, A. R., Cifelli, P. M., Ortori, C. A., Righetti, K., Lewis, S., Erskine, P., Holland, E. D., Givskov, M., Williams, P., Camara, M., Barrett, D. A., and Knox, A. Garlic as an inhibitor of Pseudomonas aeruginosa quorum sensing in cystic fibrosis--a p
- Russell, J. E. Chinese complementary therapy for stress causing bilateral chemical burns to the feet. Emerg.Med.J. 2010;27(10):787. PubMed
- Adachi, A. [Two cases of eosinophilic gastroenteritis whose causative allergens are usefully diagnosed by patch test]. Arerugi 2010;59(5):545-551.
- Ried, K., Frank, O. R., and Stocks, N. P. Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial. Maturitas 2010;67(2):144-150. PubMed
- Hansanugrum, A. and Barringer, S. A. Effect of milk on the deodorization of malodorous breath after garlic ingestion. J.Food Sci. 8-1-2010;75(6):C549-C558. PubMed
- Hurley, M. N., Forrester, D. L., and Smyth, A. R. Antibiotic adjuvant therapy for pulmonary infection in cystic fibrosis. Cochrane.Database.Syst.Rev. 2010;(10):CD008037. PubMed
- Nahas, R. and Balla, A. Complementary and alternative medicine for prevention and treatment of the common cold. Can.Fam.Physician 2011;57(1):31-36.
- Takeuchi, S., Matsuzaki, Y., Ikenaga, S., Nishikawa, Y., Kimura, K., Nakano, H., and Sawamura, D. Garlic-induced irritant contact dermatitis mimicking nail psoriasis. J.Dermatol. 2011;38(3):280-282. PubMed
- Davis, L. E., Shen, J. K., and Cai, Y. Antifungal activity in human cerebrospinal fluid and plasma after intravenous administration of Allium sativum. Antimicrob.Agents Chemother. 1990;34(4):651-653. PubMed
- Ashraf, R., Khan, R. A., and Ashraf, I. Garlic (Allium sativum) supplementation with standard antidiabetic agent provides better diabetic control in type 2 diabetes patients. Pak.J.Pharm.Sci. 2011;24(4):565-570.
- Bakhshi, M., Taheri, J. B., Shabestari, S. B., Tanik, A., and Pahlevan, R. Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis. Gerodontology. 2012;29(2):e680-e684. PubMed
- Kianoush, S., Balali-Mood, M., Mousavi, S. R., Moradi, V., Sadeghi, M., Dadpour, B., Rajabi, O., and Shakeri, M. T. Comparison of therapeutic effects of garlic and d-Penicillamine in patients with chronic occupational lead poisoning. Basic Clin.Pharmacol
- Filobbos, G., Chapman, T., and Gesakis, K. Iatrogenic burns from garlic. J.Burn Care Res. 2012;33(1):e21. PubMed
- Nantz, M. P., Rowe, C. A., Muller, C. E., Creasy, R. A., Stanilka, J. M., and Percival, S. S. Supplementation with aged garlic extract improves both NK and gammadelta-T cell function and reduces the severity of cold and flu symptoms: a randomized, double
- Fedder, S. L. Spinal epidural hematoma and garlic ingestion. Neurosurgery 1990;27(4):659. DOI
- Lissiman, E., Bhasale, A. L., and Cohen, M. Garlic for the common cold. Cochrane.Database.Syst.Rev. 2012;3:CD006206. PubMed
- Kaplan, B., Schewach-Millet, M., and Yorav, S. Factitial dermatitis induced by application of garlic. Int J Dermatol. 1990;29(1):75-76. PubMed
- Harenberg, J., Giese, C., and Zimmermann, R. Effect of dried garlic on blood coagulation, fibrinolysis, platelet aggregation and serum cholesterol levels in patients with hyperlipoproteinemia. Atherosclerosis 1988;74(3):247-249. PubMed
- Parish, R. A., McIntire, S., and Heimbach, D. M. Garlic burns: a naturopathic remedy gone awry. Pediatr.Emerg.Care 1987;3(4):258-260.
- Bojs, G. and Svensson, A. Contact allergy to garlic used for wound healing. Contact Dermatitis 1988;18(3):179-181. PubMed
- Bleumink, E. and Nater, J. P. Contact dermatitis to garlic; crossreactivity between garlic, onion and tulip. Arch.Dermatol.Forsch 8-15-1973;247(2):117-124. PubMed
- Yoshikawa, K., Hadame, K., Saitoh, K., and Hijikata, T. Patch tests with common vegetables in hand dermatitis patients. Contact Dermatitis 1979;5(4):274-275. PubMed
- Bleumink, E., Doeglas, H. M., Klokke, A. H., and Nater, J. P. Allergic contact dermatitis to garlic. Br.J Dermatol. 1972;87(1):6-9. PubMed
- Papageorgiou, C., Corbet, J. P., Menezes-Brandao, F., Pecegueiro, M., and Benezra, C. Allergic contact dermatitis to garlic (Allium sativum L.). Identification of the allergens: the role of mono-, di-, and trisulfides present in garlic. A comparative stu DOI
- anonymous. Garlic in cryptococcal meningitis: a preliminary report of 21 cases. Chin Med J (Engl.) 1980;93(2):123-126.
- Szybejko, J., Zukowski, A., and Herbec, R. [Unusual cause of obturation of the small intestine]. Wiad.Lek. 4-15-1982;35(2):163-164.
- Mitchell, J. C. Contact sensitivity to garlic (Allium). Contact Dermatitis 1980;6(5):356-357. PubMed
- German, K., Kumar, U., and Blackford, H. N. Garlic and the risk of TURP bleeding. Br J Urol 1995;76(4):518. PubMed
- Petry, J. J. Garlic and postoperative bleeding. Plast.Reconstr.Surg 1995;96(2):483-484. PubMed
- Canduela, V., Mongil, I., Carrascosa, M., Docio, S., and Cagigas, P. Garlic: always good for the health? Br J Dermatol. 1995;132(1):161-162. PubMed
- Farrell, A. M. and Staughton, R. C. Garlic burns mimicking herpes zoster. Lancet 4-27-1996;347(9009):1195. PubMed
- Delaney, T. A. and Donnelly, A. M. Garlic dermatitis. Austr J Dermatol 1996;37(2):109-110.
- Ruocco, V., Brenner, S., and Lombardi, M. L. A case of diet-related pemphigus. Dermatology 1996;192(4):373-374. PubMed
- Jain, R. C. Effect of garlic on serum lipids, coagulability and fibrinolytic activity of blood. Am J Clin Nutr 1977;30(9):1380-1381. PubMed
- Rance, F. and Dutau, G. Labial food challenge in children with food allergy. Pediatr Allergy Immunol. 1997;8(1):41-44. PubMed
- Roberge, R. J., Leckey, R., Spence, R., and Krenzelok, E. J. Garlic burns of the breast. Am J Emerg.Med 1997;15(5):548. PubMed
- Kumar, M. and Berwal, J. S. Sensitivity of food pathogens to garlic (Allium sativum). J Appl.Microbiol. 1998;84(2):213-215. PubMed
- Bimmermann A, Weingart K, and Schwartzkopff W. Allium sativum: Studie zur Wirksamkeit bei Hyperlipoproteinamie. Therapiewoche 1988;38:3885-3890.
- Czerny B and Samochowiec J. Klinische Untersuchungen mit einem Knoblauch-Lezithin-Präparat. Arztezeitschr Naturheilverf 1996;37:126-129.
- Yeh YY, Lin RI, Yeh SM, and et al. Garlic reduces plasma cholesterol in hypercholesterolemic men maintaining habitual diets. In: Ohigashi H, Osawa T, Terao J, and et al. Food Factors for Cancer Prevention. Tokyo, Japan: Springer-Verlag;1997. DOI
- Edelstein AJ and Johnstown PA. Dermatitis caused by garlic. Arch Dermatol 1950;61:111. PubMed
- Fleischer S, Bayerl C, and Jung EG. [Occupational allergic hand dermatitis to garlic in a pizza baker]. Aktuelle Dermatol 1996;22:278-279.
- Gaddoni G, Selvi M, Resta F, and et al. Allergic contact dermatitis to garlic in a cook. Ann Ital Dermatol Clin Sperimentale 1994;48:120-121.
- Ince DI, Sonmez GT, and Ince ML. Effects garlic on aerobic performance. Turkish Journal of Medical Sciences 2000;30(6):557-561.
- Soltani PR. Preecampisia [sic] is an important complication of pregnancy which can result in morbidity and mortality in mother, fetus and the neonate. Journal of Medical Council of Islamic Republic of Iran (J MED COUNC ISLAMIC REPUB IRAN) 2005;23(3):319.
- Gravas S, Tzortzis V Rountas C Melekos MD. Extracorporeal shock-wave lithotripsy and garlic consumption: a lesson to learn. Urol Res. 2010;38(1):61-63. PubMed
- Sunter WH. Warfarin and garlic. Pharm J 1991;246:722.
- Jeyaraj S, Shivaji G, and Jeyaraj SD. Effect of a combined supplementation of fish oil (MEGA-3) with garlic pearls on the serum lipid profile, blood pressure and body mass index of hypercholesterolemic subjects. Heart 2000;83(suppl 2):A4.
- Ashraf R, Khan RA, Ashraf I, Qureshi AA. Effects of Allium sativum (garlic) on systolic and diastolic blood pressure in patients with essential hypertension. Pak J Pharm Sci 2013;26(5):859-63.
- Duncan A, Mills J. An unusual case of HIV virologic failure during treatment with boosted atazanavir. AIDS 2013;27:1361-2. PubMed
- Ergul B, Cakal B. Dysphagia caused by garlic induced esophagitis. Clin Res Hepatol Gastroenterol 2012;36(6):e134. PubMed
- Karabacak E, Aydin E, Kutlu A, Dogan B. An unusual garlic burn occurring on an unexpected area. BMJ Case Rep 2014. PubMed
- Ma S, Yin J. Anaphylaxis induced by ingestion of raw garlic. Foodborne Pathog Dis 2012;9(8):773-5. PubMed
- Mane SK, Jordan PA, Bahna SL. Eosinophilic esophagitis to unsuspected rare food allergen. Ann Allergy Asthma Immunol 2013;111(1):64-5. PubMed
- Ried K, Frank OR, Stocks NP. Aged garlic extract reduces blood pressure in hypertensives: a dose-response trial. Eur J Clin Nutr 2013;67(1):64-70. PubMed
- Roussos AP, Hirsch AR. Alliaceous migraines. Headache 2014;54(2):378-82. PubMed
- Watson CJ, Grando D, Fairley CK, et al. The effects of oral garlic on vaginal candida colony counts: a randomised placebo controlled double-blind trial. BJOG 2014;121(4):498-506. PubMed
- Xu S, Heller M, Wu PA, Nambudri VE. Chemical burn caused by topical application of garlic under occlusion. Dermatol Online J 2014;20(1):21261. DOI
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Gallicano K, Foster B, Choudhri S. Effect of short-term administration of garlic supplements on single-dose ritonavir pharmacokinetics in healthy volunteers. Br J Clin Pharmacol. 2003;55(2):199-202. PubMed
- Hou LQ, Liu YH, Zhang YY. Garlic intake lowers fasting blood glucose: meta-analysis of randomized controlled trials. Asia Pac J Clin Nutr. 2015;24(4):575-82.
- Oberle M, Wachs T, Brisson P. Garlic burn to the face. J Spec Oper Med. Winter 2016;16(4):80-81. PubMed
- Ried K. Garlic lowers blood pressure in hypertensive individuals, regulates serum cholesterol, and stimulates immunity: An updated meta-analysis and review. J Nutr. 2016;146(2):389S-396S. PubMed
- Shaikh SA, Tischer S, Choi EK, Fontana RJ. Good for the lung but bad for the liver? Garlic-induced hepatotoxicity following liver transplantation. J Clin Pharm Ther. 2017;42(5):646-648. PubMed
- Suzuki Y, Saito J, Misa K, Fukuhara N, Fukuhara A, Munakata M. A case of black garlic-induced pneumonia as an adverse reaction. Allergol Int. 2016;65(3):353-5. PubMed
- Treudler R, Reuter A, Engin AM, Simon JC. A case of anaphylaxis after garlic ingestion: Is alliinase the only culprit allergen? J Investig Allergol Clin Immunol. 2015;25(5):374-5.
- Woodbury A, Sniecinski R. Garlic-induced surgical bleeding: How much is too much? A Case Rep. 2016;7(12):266-269. PubMed
- Yagami A, Suzuki K, Sano A, et al. Immediate allergy due to raw garlic (Allium sativum L.). J Dermatol. 2015;42(10):1026-7.
- Gandomkar H, Mahmoodzadeh H, Tavakoli H, Fazeli M, Rezaei J. Garlic-induced esophageal perforation: A case series. Asian J Surg. 2020;43(6):696-697. PubMed
- Dev T, Bharti P, Patel U, Bhari N. Chronic paronychia and nail dystrophy: an atypical presentation of allergic contact dermatitis to garlic. Int J Dermatol 2021 Feb 11. doi: 10.1111/ijd.15430. PubMed
- Jafari F, Tabarrai M, Abbassian A, Jafari F, Ayati MH. Effect of Garlic (Allium sativum) Supplementation on Premenstrual Disorders: A Randomized, Double-Blind, Placebo-Controlled Trial. Evid Based Complement Alternat Med 2021;2021:9965064. PubMed
- Tomo S, Santos IDS, Cruz TMD, Miyahara GI, Simonato LE. Garlic burn trauma of the oral mucosa in a patient with trigeminal neuralgia: A case report. Dent Traumatol 2022. PubMed
- Wasef AK, Wahdan SA, Saeed NM, El-Demerdash E. Effects of aged garlic and ginkgo biloba extracts on the pharmacokinetics of sofosbuvir in rats. Biopharm Drug Dispos. 2022;43(4):152-62. PubMed
- Sangouni AA, Alizadeh M, Jamalzehi A, Hosseinzadeh M, Parastouei K. Garlic supplementation improves intestinal transit time, lipid accumulation product and cardiometabolic indices in subjects with metabolic syndrome: A randomized controlled trial. Phytoth PubMed
- Taghavi MR, Tavanaei Tamanaei T, Oghazian MB, et al. Effectiveness of fortified garlic extract oral capsules as adjuvant therapy in hospitalized patients with coronavirus disease 2019: A triple-blind randomized controlled clinical trial. Curr Ther Res Cli PubMed
- Jamaluddin J, Jamil SN. An unexpected reaction to topical garlic medicament - A case report of irritant contact dermatitis successfully managed in primary care. Cureus 2023;15(1):e33657. PubMed
- Nair A, Abdelqader B, Sureshkumar S, Katmawai-Sabbagh S. Hematuria and dietary supplements - A case report on pronounced bleeding following a minimally invasive urological intervention in a patient on long term garlic supplements. Urol Case Rep 2023;50:10 PubMed
- Zhao X, Cheng T, Xia H, Yang Y, Wang S. Effects of Garlic on Glucose Parameters and Lipid Profile: A Systematic Review and Meta-Analysis on Randomized Controlled Trials. Nutrients 2024;16(11):1692. PubMed
- Bhat GS, Shastry A. Prospective, randomized, placebo-controlled, two-arm study to evaluate the efficacy of coadministration of garlic as a hydrogen sulfide donor and tadalafil in patients with erectile dysfunction not responding to tadalafil alone - A pil
Olive 2 references
- Liccardi G, D'Amato M, D'Amato G. Oleaceae pollinosis: a review. Int Arch Allergy Immunol 1996;111:210-7. PubMed
- Somerville V, Moore R, Braakhuis A. The effect of olive leaf extract on upper respiratory illness in high school athletes: A randomised control trial. Nutrients. 2019;11(2). pii: E358. PubMed
Black Walnut 3 references
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Food and Drug Administration. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA); Public Law 108-282, Title II. Accessed on May 19, 2021. Available at: https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-infor
Black Seed 60 references
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Aqel M, Shaheen R. Effects of the volatile oil of black seed seeds on the uterine smooth muscle of rat and guinea pig. J Ethnopharmacol 1996;52:23-6.
- Keshri G, Singh MM, Lakshmi V, Kamboj VP. Post-coital contraceptive efficacy of the seeds of Black seed in rats. Indian J Physiol Pharmacol 1995;39:59-62.
- Tennekoon KH, Jeevathayaparan S, Kurukulasooriya AP, Karunanayake EH. Possible hepatotoxicity of Nigella sativa seeds and Dregea volubilis leaves. J Ethnopharmacol 1991;31:283-9. PubMed
- Dehkordi FR, Kamkhah AF. Antihypertensive effect of Nigella sativa seed extract in patients with mild hypertension. Fundam Clin Pharmacol 2008;22:447-52.
- Zaoui, A., Cherrah, Y., Lacaille-Dubois, M. A., Settaf, A., Amarouch, H., and Hassar, M. [Diuretic and hypotensive effects of Nigella sativa in the spontaneously hypertensive rat]. Therapie 2000;55(3):379-382.
- Enomoto, S., Asano, R., Iwahori, Y., Narui, T., Okada, Y., Singab, A. N., and Okuyama, T. Hematological studies on black cumin oil from the seeds of Nigella sativa L. Biol.Pharm.Bull 2001;24(3):307-310. PubMed
- Meral, I., Yener, Z., Kahraman, T., and Mert, N. Effect of Nigella sativa on glucose concentration, lipid peroxidation, anti-oxidant defence system and liver damage in experimentally-induced diabetic rabbits. J Vet.Med A Physiol Pathol.Clin Med 2001;48(1
- Al Jishi, S. A. and Abuo, Hozaifa B. Effect of Nigella sativa on blood hemostatic function in rats. J Ethnopharmacol. 2003;85(1):7-14. PubMed
- Ali, B. H. and Blunden, G. Pharmacological and toxicological properties of Nigella sativa. Phytother.Res. 2003;17(4):299-305.
- Al Naggar, T. B., Gomez-Serranillos, M. P., Carretero, M. E., and Villar, A. M. Neuropharmacological activity of Nigella sativa L. extracts. J Ethnopharmacol. 2003;88(1):63-68. PubMed
- Kalus, U., Pruss, A., Bystron, J., Jurecka, M., Smekalova, A., Lichius, J. J., and Kiesewetter, H. Effect of Nigella sativa (black seed) on subjective feeling in patients with allergic diseases. Phytother.Res. 2003;17(10):1209-1214.
- Islam, S. N., Begum, P., Ahsan, T., Huque, S., and Ahsan, M. Immunosuppressive and cytotoxic properties of Nigella sativa. Phytother.Res. 2004;18(5):395-398.
- Fararh, K. M., Atoji, Y., Shimizu, Y., Shiina, T., Nikami, H., and Takewaki, T. Mechanisms of the hypoglycaemic and immunopotentiating effects of Nigella sativa L. oil in streptozotocin-induced diabetic hamsters. Res Vet.Sci 2004;77(2):123-129. PubMed
- Awad, E. M. and Binder, B. R. In vitro induction of endothelial cell fibrinolytic alterations by Nigella sativa. Phytomedicine 2005;12(3):194-202. PubMed
- El Obeid, A., Al Harbi, S., Al Jomah, N., and Hassib, A. Herbal melanin modulates tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) production. Phytomedicine. 2006;13(5):324-333.
- Abbas, A. T., Abdel-Aziz, M. M., Zalata, K. R., and Tel, Abd Al-Galel. Effect of dexamethasone and Nigella sativa on peripheral blood eosinophil count, IgG1 and IgG2a, cytokine profiles and lung inflammation in murine model of allergic asthma. Egypt J Im
- Kaleem, M., Kirmani, D., Asif, M., Ahmed, Q., and Bano, B. Biochemical effects of Nigella sativa L seeds in diabetic rats. Indian J Exp.Biol. 2006;44(9):745-748.
- Hawsawi, Z. A., Ali, B. A., and Bamosa, A. O. Effect of Nigella sativa (Black Seed) and thymoquinone on blood glucose in albino rats. Ann.Saudi Med 2001;21(3-4):242-244.
- Massadeh, A. M., Al Safi, S. A., Momani, I. F., Al Mahmoud, M., and Alkofahi, A. S. Analysis of cadmium and lead in mice organs: effect of Nigella sativa L. (Black Cumin) on the distribution and immunosuppressive effect of cadmium-lead mixture in mice. B PubMed
- Akhondian, J., Parsa, A., and Rakhshande, H. The effect of Nigella sativa L. (black cumin seed) on intractable pediatric seizures. Med Sci Monit. 2007;13(12):CR555-CR559.
- Meddah, B., Ducroc, R., El Abbes, Faouzi M., Eto, B., Mahraoui, L., Benhaddou-Andaloussi, A., Martineau, L. C., Cherrah, Y., and Haddad, P. S. Nigella sativa inhibits intestinal glucose absorption and improves glucose tolerance in rats. J Ethnopharmacol. PubMed
- Najmi, A., Nasiruddin, M., Khan, R. A., and Haque, S. F. Effect of Nigella sativa oil on various clinical and biochemical parameters of insulin resistance syndrome. Int J Diabetes Dev.Ctries. 2008;28(1):11-14.
- al Sheikh, O. A. and Gad el-Rab, M. O. Allergic contact dermatitis: clinical features and profile of sensitizing allergens in Riyadh, Saudi Arabia. Int J Dermatol. 1996;35(7):493-497.
- Steinmann, A., Schatzle, M., Agathos, M., and Breit, R. Allergic contact dermatitis from black cumin (Nigella sativa) oil after topical use. Contact Dermatitis 1997;36(5):268-269.
- Al-Jenoobi FI, Al-Suwayeh SA, Muzaffar I, et al. Effects of Nigella sativa and Lepidium sativum on cyclosporine pharmacokinetics. Biomed Res Int 2013;2013:953520.
- Arslan E, Sayin S, Demirbas S, et al. A case study report of acute renal failure associated with Nigella sativa in a diabetic patient. J Integr Med 2013;11:64-6. PubMed
- Bamosa AO, Kaatabi H, Lebdaa FM, et al. Effect of Nigella sativa seeds on the glycemic control of patients with type 2 diabetes mellitus. Indian J Physiol Pharmacol 2010;54:344-54.
- Bonhomme A, Poreaux C, Jouen F, et al. Bullous drug eruption to Nigella sativa oil: Consideration of the use of a herbal medicine - clinical report and review of the literature. J Eur Acad Dermatol Venereol 2017;31:e217-e219.
- Farhangi MA, Dehghan P, Tajmiri S, Abbasi MM. The effects of Nigella sativa on thyroid function, serum Vascular Endothelial Growth Factor (VEGF) - 1, Nesfatin-1 and anthropometric features in patients with Hashimoto's thyroiditis: a randomized controlled
- Kaatabi H, Bamosa AO, Badar A, et al. Nigella sativa improves glycemic control and ameliorates oxidative stress in patients with type 2 diabetes mellitus: placebo controlled participant blinded clinical trial. PLoS One 2015;10:e0113486. PubMed
- Mohtashami R, Huseini HF, Heydari M, et al. Efficacy and safety of honey based formulation of Nigella sativa seed oil in functional dyspepsia: A double blind randomized controlled clinical trial. J Ethnopharmacol 2015;175:147-52. PubMed
- Perveen T, Haider S, Zuberi NA, et al. Increased 5-HT levels following repeated administration of Nigella sativa L. (Black Seed) oil produce antidepressant effects in rats. Sci Pharm 2013;82:161-70. PubMed
- Sahebkar A, Soranna D, Liu X, et al. A systematic review and meta-analysis of randomized controlled trials investigating the effects of supplementation with Nigella sativa (black seed) on blood pressure. J Hypertens 2016;34:2127-35. PubMed
- Shawki M, El Wakeel L, Shatla R, et al. The clinical outcome of adjuvant therapy with black seed oil on intractable paediatric seizures: a pilot study. Epileptic Disord 2013;15:295-301. PubMed
- Muneera KE, Majeed A, Naveed AK. Comparative evaluation of nigella sativa (Kalonji) and simvastatin for the treatment of hyperlipidemia and in the induction of hepatotoxicity. Pak J Pharm Sci. 2015 Mar;28(2):493-8.
- Mahdavi R, Namazi N, Alizadeh M, Farajnia S. Effects of Nigella sativa oil with a low-calorie diet on cardiometabolic risk factors in obese women: a randomized controlled clinical trial. Food Funct. 2015;6(6):2041-8. PubMed
- Fallah Huseini H, Amini M, Mohtashami R, et al. Blood pressure lowering effect of Nigella sativa L. seed oil in healthy volunteers: a randomized, double-blind, placebo-controlled clinical trial. Phytother Res. 2013;27(12):1849-53.
- Dehavay F, Kolivras A, Scheers C. Local and systemic adverse skin reactions following the use of herbal products believed to contain Nigella sativa seeds and oil. Contact Dermatitis. 2019 Mar;80(3):176-177.
- Kooshki A, Tofighiyan T, Rastgoo N, Rakhshani MH, Miri M. Effect of Nigella sativa oil supplement on risk factors for cardiovascular diseases in patients with type 2 diabetes mellitus. Phytother Res. 2020.
- Warner ME, Warner PA, Sprung J, Warner MA. Black seed oil and perioperative serotonin syndrome: A case report. A A Pract. 2019;13(11):420-422. PubMed
- Alam MA, Bin Jardan YA, Raish M, Al-Mohizea AM, Ahad A, Al-Jenoobi FBI. Effect of Nigella sativa and fenugreek on the pharmacokinetics and pharmacodynamics of amlodipine in hypertensive rats. Curr Drug Metab. 2020;21(4):318-325. PubMed
- Moustafa HAM, El Wakeel LM, Halawa MR, Sabri NA, El-Bahy AZ, Singab AN. Effect of Nigella sativa oil versus metformin on glycemic control and biochemical parameters of newly diagnosed type 2 diabetes mellitus patients. Endocrine 2019;65(2):286-94. PubMed
- Safi S, Razmpoosh E, Fallahzadeh H, et al. The effect of Nigella sativa on appetite, anthropometric and body composition indices among overweight and obese women: A crossover, double-blind, placebo-controlled, randomized clinical trial. Complement Ther Me PubMed
- Wang X, Jiang A, Batra V. Severe thrombocytopenia associated with black seed oil and evening primrose oil. Cureus. 2020;12(6):e8390. PubMed
- Alkharfy K, Jan B, Alotaibi K, et al. Clopidogrel-herb Interactions: A Pharmacokinetic and Pharmacodynamic Assessment in a Rat Model. Curr Drug Metab 2021;22(12):969-977. PubMed
- Bin Jardan YA, Ahad A, Raish M, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effects of garden cress, fenugreek and black seed on the pharmacodynamics of metoprolol: an herb-drug interaction study in rats with hypertension. Pharm Biol 2021;59(1):1088-1097. PubMed
- Thomas JV, Mohan ME, Prabhakaran P, Das S S, Maliakel B, I M K. A phase I clinical trial to evaluate the safety of thymoquinone-rich black cumin oil (BlaQmax®) on healthy subjects: Randomized, double-blinded, placebo-controlled prospective study. Toxicol PubMed
- Assier H, Kouby F, Ingen-Housz-Oro S, Roux C. Severe allergic contact connubial dermatitis to Nigella Sativa Seed Oil due to repeated contacts to beard cosmetics. Contact Dermatitis 2022. PubMed
- Koshak AE, Koshak EA, Mobeireek AF, et al. Nigella sativa for the treatment of COVID-19: An open-label randomized controlled clinical trial. Complement Ther Med 2021;61:102769. PubMed
- Hadi S, Daryabeygi-Khotbehsara R, Mirmiran P, et al. Effect of Nigella sativa oil extract on cardiometabolic risk factors in type 2 diabetes: A randomized, double-blind, placebo-controlled clinical trial. Phytother Res 2021;35(7):3747-3755.
- Ali SM, Chen P, Sheikh S, et al. Thymoquinone with metformin decreases fasting, post prandial glucose, and HbA1c in type 2 diabetic patients. Drug Res (Stuttg) 2021;71(6):302-306. PubMed
- Tavakoli-Rouzbehani OM, Abbasnezhad M, Kheirouri S, Alizadeh M. Effects of Nigella sativa oil supplementation on selected metabolic parameters and anthropometric indices in patients with coronary artery disease: A randomized, double-blind, placebo-control
- Fargeas M, Calugareanu A, Ben-Said B. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome after topical use of Nigella sativa (black cumin) oil. Contact Dermatitis 2022;87(2):203-204.
- Wang Z, Wang Z, Wang X, et al. Potential food-drug interaction risk of thymoquinone with warfarin. Chem Biol Interact. 2022;365:110070. PubMed
- Wang Z, Wang X, Wang Z, et al. Potential herb-drug interaction risk of thymoquinone and phenytoin. Chem Biol Interact. 2022;353:109801. PubMed
- Al-Mohizea AM, Ahad A, El-Maghraby GM, et al. Effects of Nigella sativa, Lepidium sativum and Trigonella foenum-graecum on sildenafil disposition in beagle dogs. Eur J Drug Metab Pharmacokinet. 2015;40(2):219-24. PubMed
- Alkharfy KM, Al-Jenoobi FI, Al-Mohizea AM, et al. Effects of Lepidium sativum, Nigella sativa and Trigonella foenum-graceum on phenytoin pharmacokinetics in beagle dogs. Phytother Res. 2013;27(12):1800-4.
- Abutaima R, Al-Ebini Y, Alkofahi A, et al. In vivo assessment of black seed oil single dose on prednisolone pharmacokinetics. J Pharm Pharmacol 2024;76(1):57-63.
- Sener K, Cakir A, Yesiloglu O, Altug E, Guven R, Korkut S. Rhabdomyolysis and acute kidney injury after consumption of black seed oil. Toxicon 2024;245:107787. PubMed
Grapefruit 157 references
- Penzak SR, Gubbins PO, Gurley BJ, et al. Grapefruit juice decreases the systemic availability of itraconazole capsules in healthy volunteers. Ther Drug Monit 1999;21:304-9. PubMed
- Ioannides-Demos LL, Christophidis N, et al. Dosing implications of a clinical interaction between grapefruit juice and cyclosporine and metabolite concentrations in patients with autoimmune diseases. J Rheumatol 1997;24:49-54.
- Josefsson M, Zackrisson AL, Ahlner J. Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers. Eur J Clin Pharmacol 1996;51:189-93. PubMed
- Garg SK, Kumar N, Bhargava VK, Prabhakar SK. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther 1998;64:286-8. PubMed
- Weber A, Jager R, Borner A, et al. Can grapefruit juice influence ethinylestradiol bioavailability? Contraception 1996;53:41-7.
- Schubert W, Cullberg G, Edgar B, Hedner T. Inhibition of 17 beta-estradiol metabolism by grapefruit juice in ovariectomized women. Maturitas 1994;20:155-63.
- Kantola T, Kivisto KT, Neuvonen PJ, et al. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 1998 63:397-402. PubMed
- Bailey DG, Spence JD, Munoz C, Arnold JM. Interaction of citrus juices with felodipine and nifedipine. Lancet 1991;337:268-9. PubMed
- Bailey DG, Arnold JM, Strong HA, et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther 1993;54:589-94. PubMed
- Rau SE, Bend JR, Arnold MO, et al. Grapefruit juice-terfenadine single-dose interaction: magnitude, mechanism, and relevance. Clin Pharmacol Ther 1997 61:401-9. PubMed
- Offman EM, Freeman DJ, Dresser GK, et al. Cisapride interaction with grapefruit juice and red wine. Clin Pharmacol Ther 2000;67:110 (abstract PI-83).
- Bailey DG, Dresser GK, Kreeft JH, et al. Grapefruit juice-felodipine interaction: Effect of segments and an extract from unprocessed fruit. Clin Pharmacol Ther 2000;67:107 (abstract PI-71).
- Soldner A, Christians U, Susanto M, et al. Grapefruit juice activates P-glycoprotein-mediated drug transport. Pharm Res 1999;16:478-85. PubMed
- Zaidenstein R, Avni B, Dishi V, et al. Effect of grapefruit juice on the pharmacokinetics of losartan in healthy volunteers. Clin Pharmacol Ther 1998;65:(abstract PI-60). DOI
- Dresser GK, Bailey DG, Carruthers SG. Grapefruit juice-felodipine interaction in healthy seniors. Clin Pharmacol Ther 1998;65:(abstract PIII-63).
- Varis T, Kivisto KT, Neuvonen PJ. Grapefruit juice can increase the plasma concentration of methylprednisolone. Eur J Clin Pharmacol 2000;56:489-93.
- Gross AS, Goh YD, Addison RS, et al. Influence of grapefruit juice on cisapride pharmacokinetics. Clin Pharmacol Ther 1999;65:395-401. PubMed
- Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther 1999;66:118-27. DOI
- Ozdemir M, Aktan Y, Boydag BS. Interaction between grapefruit juice and diazepam in humans. Eur J Drug Metab Pharmacokinet 1998;23:55-9. PubMed
- Zaidenstein R, Dishi V, Gips M, et al. The effect of grapefruit juice on the pharmacokinetics of orally administered verapamil. Eur J Clin Pharmacol 1998;54:337-40. PubMed
- Lilja JJ, Kivisto KT, Backman JT, et al. Grapefruit juice substantially increases plasma concentrations of buspirone. Clin Pharmacol Ther 1998;64:655-60. PubMed
- Kupferschmidt HH, Fattinger KE, Ha HR, et al. Grapefruit juice enhances the bioavailability of the HIV protease inhibitor saquinavir in man. Br J Clin Pharmacol 1998;45:355-9. DOI
- Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Clin Pharmacol Ther 1998;64:477-83. PubMed
- Curhan GC, Willett WC, Speizer FE, Stamfer MJ. Beverage use and risk of kidney stones in women. Ann Intern Med 1998;128:534-40.
- Fuhr U. Drug Interactions with Grapefruit Juice. Drug Saf 1998;18:251-72. DOI
- Oesterheld J, Kallepalli BR. Grapefruit juice and clomipramine: shifting metabolitic ratios. J Clin Psychopharmacol 1997;17:62-3. PubMed
- van Agtmael MA, Gupta V, van der Wosten TH, et al. Grapefruit juice increases the bioavailability of artemether. Eur J Clin Pharmacol 1999;55:405-10. PubMed
- van Agtmael MA, Gupta V, van der Graaf CA, van Boxtel CJ. The effect of grapefruit juice on the time-dependent decline of artemether plasma levels in healthy subjects. Clin Pharmacol Ther 1999;66:408-14.
- Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol 1999;48:829-38. PubMed
- Takanaga H, Ohnishi A, Murakami H, et al. Relationship between time after intake of grapefruit juice and the effect on pharmacokinetics and pharmacodynamics of nisoldipine in healthy subjects. Clin Pharmacol Ther 2000:67:201-14. PubMed
- Takanaga H, Ohnishi A, Matsuo H, et al. Pharmacokinetic analysis of felodipine-grapefruit juice interaction based on an irreversible enzyme inhibition model. Br J Clin Pharmacol 2000;49:49-58. PubMed
- Coreg monograph. In: Gillis MC, Ed. Compendium of Pharmaceuticals and Specialities (CPS). 34th ed. Ottawa, Ontario, CAN:Canadian Pharmacists Assn, 1999:395.
- Dresser GK, Bailey DG, Carruthers SG. Grapefruit juice-felodipine interaction in the elderly. Clin Pharmacol Ther 2000;68:28-34. PubMed
- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Lilja JJ, Kivisto KT, Backman JT, Neuvonen PJ. Effect of grapefruit juice dose on grapefruit juice-triazolam interaction: repeated consumption prolongs triazolam half-life. Eur J Clin Pharmacol 2000;56:411-5. PubMed
- Erlund I, Meririnne E, Alfthan G, Aro A. Plasma kinetics and urinary excretion of the flavanones naringenin and hesperetin in humans after ingestion of orange juice and grapefruit juice. J Nutr 2001;131:235-41. PubMed
- Ho PC, Ghose K, Saville D, Wanwimolruk S. Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil enantiomers in healthy volunteers. Eur J Clin Pharmacol 2000;56:693-8. PubMed
- Uno T, Ohkubo T, Sugawara K, et al. Effects of grapefruit juice on the stereoselective disposition of nicardipine in humans: evidence for dominant presystemic elimination at the gut site. Eur J Clin Pharmacol 2000;56:643-9. PubMed
- Bailey DG, Dresser GK. Grapefruit juice-lovastatin interaction. Clin Pharmacol Ther 2000;67:690.
- Lilja JJ, Kivisto KT, Neuvonen PJ. Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin. Clin Pharmacol Ther 2000;68:384-90. PubMed
- Castro N, Jung H, Medina R, et al. Interaction between grapefruit juice and praziquantel in humans. Antimicrob Agents Chemother 2002;46:1614-6. PubMed
- Jetter A, Kinzig-Schippers M, Walchner-Bonjean M, et al. Effects of grapefruit juice on the pharmacokinetics of sildenafil. Clin Pharmacol Ther 2002;71:21-9. PubMed
- Ebert U, Oertel R, Kirch W. Influence of grapefruit juice on scopolamine pharmacokinetics and pharmacodynamics in healthy male and female subjects. Int J Clin Pharmacol Ther 2000;38:523-31. PubMed
- Fuhr U, Muller-Peltzer H, Kern R, et al. Effects of grapefruit juice and smoking on verapamil concentrations in steady state. Eur J Clin Pharmacol 2002;58:45-53. PubMed
- Kanazawa S, Ohkubo T, Sugawara K. The effects of grapefruit juice on the pharmacokinetics of erythromycin. Eur J Clin Pharmacol 2001;56:799-803. PubMed
- Reif S, Nicolson M, Bisset D, et al. Effect of grapefruit juice intake on etoposide bioavailability. Eur J Clin Pharmacol 2002;58:491-4.. PubMed
- Greenblatt DJ, von Moltke LL, Harmatz JS. Time course of recovery of cytochrome P450 3A function after single doses of grapefruit juice. Clin Pharmacol Ther 2003;74:121-29 . PubMed
- Gupta MC, Garg SK, Badyal D, et al. Effect of grapefruit juice on the pharmacokinetics of theophylline in healthy male volunteers. Methods Find Exp Clin Pharmacol 1999;21:679-82. PubMed
- Edwards DJ, Fitzsimmons ME, Schuetz EG, et al. 6',7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice: effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther 1999;65:237-44. PubMed
- Rogers JD, Zhao J, Liu L, et al. Grapefruit juice has minimal effects on plasma concentrations of lovastatin-derived 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Clin Pharmacol Ther 1999;66:358-66. PubMed
- Veronese ML, Gillen LP, Burke JP, et al. Exposure-dependent inhibition of intestinal and hepatic CYP3A4 in vivo by grapefruit juice. J Clin Pharmacol 2003;43:831-9. . PubMed
- Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome P450 3A4 activity: comparison with grapefruit juice. Clin Pharmacol Ther 2003;73:529-37 . PubMed
- Becquemont L, Verstuyft C, Kerb R, et al. Effect of grapefruit juice on digoxin pharmacokinetics in humans. Clin Pharmacol Ther 2001;70:311-6. DOI
- Dresser GK, Bailey DG, Leake BF, et al. Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther 2002;71:11-20. PubMed
- Parker RB, Yates CR, Soberman JE, Laizure SC. Effects of grapefruit juice on intestinal P-glycoprotein: evaluation using digoxin in humans. Pharmacotherapy 2003;23:979-87. PubMed
- Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Life Sci 2002;71:1149-60. PubMed
- Gaudineau C, Beckerman R, Welbourn S, Auclair K. Inhibition of human P450 enzymes by multiple constituents of the Ginkgo biloba extract. Biochem Biophys Res Comm 2004;318:1072–8. PubMed
- Sullivan DM, Ford MA, Boyden TW. Grapefruit juice and the response to warfarin. Am J Health-Syst Pharm 1998;55:1581-3. PubMed
- Fukazawa I, Uchida N, Uchida E, Yasuhara H. Effects of grapefruit juice on the pharmacokinetics of atorvastatin and pravastatin in Japanese. Br J Clin Pharmacol 2003;57:448-55.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zitron E, Scholz E, Owen RW, et al. QTc prolongation by grapefruit juice and its potential pharmacological basis: HERG channel blockade by flavonoids. Circulation 2005;835:835-8. PubMed
- Monroe KR, Murphy SP, Kolonel LN, Pike MC. Prospective study of grapefruit intake and risk of breast cancer in postmenopausal women: the Mutliethnic Cohort Study. Br J Cancer 2007;97:440-5.
- Farkas D, Oleson LE, Zhao Y, et al. Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice. J Clin Pharmacol 2007;47:286-94. PubMed
- Potential drug interactions with grapefruit. Pharmacist's Letter / Prescriber's Letter 2007;23(2):230204.
- Dresser GK, Kim RB, Bailey DG. Effect of grapefruit juice volume on the reduction of fexofenadine bioavailability: possible role of organic anion transporting polypeptides. Clin Pharmacol Ther 2005;77:170-7. PubMed
- Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
- Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
- Product information for Cordarone. Wyeth Pharmaceuticals, Inc. Philadelphia, PA 19101. September 2006.
- Demarles D, Gillotin C, Bonaventure-Paci S, et al. Single-dose pharmacokinetics of amprenavir coadministered with grapefruit juice. Antimicrob Agents Chemother 2002;46:1589-90. PubMed
- Yasui N, Kondo T, Furukori H, et al. Effects of repeated ingestion of grapefruit juice on the single and multiple oral-dose pharmacokinetics and pharmacodynamics of alprazolam. Psychopharmacology (Berl) 2000;150:185-90. PubMed
- Hori H, Yoshimura R, Ueda N, et al. Grapefruit juice-fluvoxamine interaction -- is it risky or not? J Clin Psychopharmacol 2003;23:422-4. PubMed
- Benmebarek M, Devaud C, Gex-Fabry M, et al. Effects of grapefruit juice on the pharmacokinetics of the enantiomers of methadone. Clin Pharmacol Ther 2004;76:55-63.
- Yin OQ, Gallagher N, Li A, et al. Effect of grapefruit juice on the pharmacokinetics of nilotinib in healthy participants. J Clin Pharmacol 2010;50:188-94. PubMed
- Lilja JJ, Raaska K, Neuvonen PJ. Effects of grapefruit juice on the pharmacokinetics of acebutolol. Br J Clin Pharmacol 2005;60:659-63. PubMed
- Hollander, A. A., van Rooij, J., Lentjes, G. W., Arbouw, F., van Bree, J. B., Schoemaker, R. C., van Es, L. A., van der Woude, F. J., and Cohen, A. F. The effect of grapefruit juice on cyclosporine and prednisone metabolism in transplant patients. Clin Ph PubMed
- Sigusch, H., Hippius, M., Henschel, L., Kaufmann, K., and Hoffmann, A. Influence of grapefruit juice on the pharmacokinetics of a slow release nifedipine formulation. Pharmazie 1994;49(7):522-524.
- Andersen, V., Pedersen, N., Larsen, N. E., Sonne, J., and Larsen, S. Intestinal first pass metabolism of midazolam in liver cirrhosis --effect of grapefruit juice. Br J Clin Pharmacol 2002;54(2):120-124. PubMed
- Hukkinen, S. K., Varhe, A., Olkkola, K. T., and Neuvonen, P. J. Plasma concentrations of triazolam are increased by concomitant ingestion of grapefruit juice. Clin Pharmacol Ther 1995;58(2):127-131. PubMed
- Kupferschmidt, H. H., Ha, H. R., Ziegler, W. H., Meier, P. J., and Krahenbuhl, S. Interaction between grapefruit juice and midazolam in humans. Clin Pharmacol Ther 1995;58(1):20-28. PubMed
- Libersa, C. C., Brique, S. A., Motte, K. B., Caron, J. F., Guedon-Moreau, L. M., Humbert, L., Vincent, A., Devos, P., and Lhermitte, M. A. Dramatic inhibition of amiodarone metabolism induced by grapefruit juice. Br J Clin Pharmacol 2000;49(4):373-378. PubMed
- Min, D. I., Ku, Y. M., Geraets, D. R., and Lee, H. Effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of quinidine in healthy volunteers. J Clin Pharmacol 1996;36(5):469-476. PubMed
- Lee, A. J., Chan, W. K., Harralson, A. F., Buffum, J., and Bui, B. C. The effects of grapefruit juice on sertraline metabolism: an in vitro and in vivo study. Clin Ther 1999;21(11):1890-1899. PubMed
- Kawakami, M., Suzuki, K., Ishizuka, T., Hidaka, T., Matsuki, Y., and Nakamura, H. Effect of grapefruit juice on pharmacokinetics of itraconazole in healthy subjects. Int J Clin Pharmacol Ther 1998;36(6):306-308.
- Benton, R. E., Honig, P. K., Zamani, K., Cantilena, L. R., and Woosley, R. L. Grapefruit juice alters terfenadine pharmacokinetics, resulting in prolongation of repolarization on the electrocardiogram. Clin Pharmacol Ther 1996;59(4):383-388. PubMed
- Clifford, C. P., Adams, D. A., Murray, S., Taylor, G. W., Wilkins, M. R., Boobis, A. R., and Davies, D. S. The cardiac effects of terfenadine after inhibition of its metabolism by grapefruit juice. Eur J Clin Pharmacol 1997;52(4):311-315. PubMed
- Ando, H., Tsuruoka, S., Yanagihara, H., Sugimoto, K., Miyata, M., Yamazoe, Y., Takamura, T., Kaneko, S., and Fujimura, A. Effects of grapefruit juice on the pharmacokinetics of pitavastatin and atorvastatin. Br J Clin Pharmacol 2005;60(5):494-497. DOI
- Lilja, J. J., Neuvonen, M., and Neuvonen, P. J. Effects of regular consumption of grapefruit juice on the pharmacokinetics of simvastatin. Br J Clin Pharmacol 2004;58(1):56-60. PubMed
- Charbit, B., Becquemont, L., Lepere, B., Peytavin, G., and Funck-Brentano, C. Pharmacokinetic and pharmacodynamic interaction between grapefruit juice and halofantrine. Clin Pharmacol Ther 2002;72(5):514-523. PubMed
- Cuong, B. T., Binh, V. Q., Dai, B., Duy, D. N., Lovell, C. M., Rieckmann, K. H., and Edstein, M. D. Does gender, food or grapefruit juice alter the pharmacokinetics of primaquine in healthy subjects? Br J Clin Pharmacol 2006;61(6):682-689. PubMed
- Culm-Merdek, K. E., von Moltke, L. L., Gan, L., Horan, K. A., Reynolds, R., Harmatz, J. S., Court MH, and Greenblatt, D. J. Effect of extended exposure to grapefruit juice on cytochrome P450 3A activity in humans: comparison with ritonavir. Clin Pharmacol
- Hugen, P. W., Burger, D. M., Koopmans, P. P., Stuart, J. W., Kroon, F. P., van Leusen, R., and Hekster, Y. A. Saquinavir soft-gel capsules (Fortovase) give lower exposure than expected, even after a high-fat breakfast. Pharm World Sci 2002;24(3):83-86.
- Sugimoto, K., Araki, N., Ohmori, M., Harada, K., Cui, Y., Tsuruoka, S., Kawaguchi, A., and Fujimura, A. Interaction between grapefruit juice and hypnotic drugs: comparison of triazolam and quazepam. Eur J Clin Pharmacol 2006;62(3):209-215. PubMed
- Lilja, J. J., Backman, J. T., Laitila, J., Luurila, H., and Neuvonen, P. J. Itraconazole increases but grapefruit juice greatly decreases plasma concentrations of celiprolol. Clin Pharmacol Ther 2003;73(3):192-198. PubMed
- Schwarz, U. I., Seemann, D., Oertel, R., Miehlke, S., Kuhlisch, E., Fromm, M. F., Kim, R. B., Bailey, D. G., and Kirch, W. Grapefruit juice ingestion significantly reduces talinolol bioavailability. Clin Pharmacol Ther 2005;77(4):291-301. PubMed
- Bailey, D. G., Arnold, J. M., Munoz, C., and Spence, J. D. Grapefruit juice--felodipine interaction: mechanism, predictability, and effect of naringin. Clin Pharmacol Ther 1993;53(6):637-642. PubMed
- Bailey, D. G., Arnold, J. M., Bend, J. R., Tran, L. T., and Spence, J. D. Grapefruit juice-felodipine interaction: reproducibility and characterization with the extended release drug formulation. Br J Clin Pharmacol 1995;40(2):135-140.
- Christensen, H., Asberg, A., Holmboe, A. B., and Berg, K. J. Coadministration of grapefruit juice increases systemic exposure of diltiazem in healthy volunteers. Eur J Clin Pharmacol 2002;58(8):515-520. PubMed
- Edgar, B., Bailey, D., Bergstrand, R., Johnsson, G., and Regardh, C. G. Acute effects of drinking grapefruit juice on the pharmacokinetics and dynamics of felodipine--and its potential clinical relevance. Eur J Clin Pharmacol 1992;42(3):313-317.
- Goosen, T. C., Cillie, D., Bailey, D. G., Yu, C., He, K., Hollenberg, P. F., Woster, P. M., Cohen, L., Williams, J. A., Rheeders, M., and Dijkstra, H. P. Bergamottin contribution to the grapefruit juice-felodipine interaction and disposition in humans. Cl PubMed
- Fuhr, U., Maier-Bruggemann, A., Blume, H., Muck, W., Unger, S., Kuhlmann, J., Huschka, C., Zaigler, M., Rietbrock, S., and Staib, A. H. Grapefruit juice increases oral nimodipine bioavailability. Int J Clin Pharmacol Ther 1998;36(3):126-132.
- Hashimoto, K., Shirafuji, T., Sekino, H., Matsuoka, O., Sekino, H., Onnagawa, O., Okamoto, T., Kudo, S., and Azuma, J. Interaction of citrus juices with pranidipine, a new 1,4-dihydropyridine calcium antagonist, in healthy subjects. Eur J Clin Pharmacol 1 PubMed
- Lundahl, J., Regardh, C. G., Edgar, B., and Johnsson, G. Effects of grapefruit juice ingestion--pharmacokinetics and haemodynamics of intravenously and orally administered felodipine in healthy men. Eur J Clin Pharmacol 1997;52(2):139-145. PubMed
- Lundahl, J., Regardh, C. G., Edgar, B., and Johnsson, G. Relationship between time of intake of grapefruit juice and its effect on pharmacokinetics and pharmacodynamics of felodipine in healthy subjects. Eur J Clin Pharmacol 1995;49(1-2):61-67. PubMed
- Rashid, T. J., Martin, U., Clarke, H., Waller, D. G., Renwick, A. G., and George, C. F. Factors affecting the absolute bioavailability of nifedipine. Br J Clin Pharmacol 1995;40(1):51-58. PubMed
- Soons, P. A., Vogels, B. A., Roosemalen, M. C., Schoemaker, H. C., Uchida, E., Edgar, B., Lundahl, J., Cohen, A. F., and Breimer, D. D. Grapefruit juice and cimetidine inhibit stereoselective metabolism of nitrendipine in humans. Clin Pharmacol Ther 1991; PubMed
- Rashid, J., McKinstry, C., Renwick, A. G., Dirnhuber, M., Waller, D. G., and George, C. F. Quercetin, an in vitro inhibitor of CYP3A, does not contribute to the interaction between nifedipine and grapefruit juice. Br J Clin Pharmacol 1993;36(5):460-463.
- Uno, T., Ohkubo, T., Motomura, S., and Sugawara, K. Effect of grapefruit juice on the disposition of manidipine enantiomers in healthy subjects. Br J Clin Pharmacol 2006;61(5):533-537. DOI
- Bistrup, C., Nielsen, F. T., Jeppesen, U. E., and Dieperink, H. Effect of grapefruit juice on Sandimmun Neoral absorption among stable renal allograft recipients. Nephrol Dial.Transplant. 2001;16(2):373-377. PubMed
- Ducharme, M. P., Warbasse, L. H., and Edwards, D. J. Disposition of intravenous and oral cyclosporine after administration with grapefruit juice. Clin Pharmacol Ther 1995;57(5):485-491. PubMed
- Ku, Y. M., Min, D. I., and Flanigan, M. Effect of grapefruit juice on the pharmacokinetics of microemulsion cyclosporine and its metabolite in healthy volunteers: does the formulation difference matter? J Clin Pharmacol 1998;38(10):959-965. PubMed
- Lee, M., Min, D. I., Ku, Y. M., and Flanigan, M. Effect of grapefruit juice on pharmacokinetics of microemulsion cyclosporine in African American subjects compared with Caucasian subjects: does ethnic difference matter? J Clin Pharmacol 2001;41(3):317-323 PubMed
- Schwarz, U. I., Johnston, P. E., Bailey, D. G., Kim, R. B., Mayo, G., and Milstone, A. Impact of citrus soft drinks relative to grapefruit juice on ciclosporin disposition. Br J Clin Pharmacol 2006;62(4):485-491. PubMed
- Yee, G. C., Stanley, D. L., Pessa, L. J., Dalla, Costa T., Beltz, S. E., Ruiz, J., and Lowenthal, D. T. Effect of grapefruit juice on blood cyclosporin concentration. Lancet 4-15-1995;345(8955):955-956. PubMed
- Paine, M. F., Widmer, W. W., Hart, H. L., Pusek, S. N., Beavers, K. L., Criss, A. B., Brown, S. S., Thomas, B. F., and Watkins, P. B. A furanocoumarin-free grapefruit juice establishes furanocoumarins as the mediators of the grapefruit juice-felodipine in
- Sigusch, H., Henschel, L., Kraul, H., Merkel, U., and Hoffmann, A. Lack of effect of grapefruit juice on diltiazem bioavailability in normal subjects. Pharmazie 1994;49(9):675-679.
- Fingerova, H., Oborna, I., Petrova, P., Budikova, M., and Jezdinsky, J. [Does grapefruit juice increase the bioavailability of orally administered sex steroids?]. Ceska.Gynekol. 2003;68(2):117-121.
- Glaeser, H., Bailey, D. G., Dresser, G. K., Gregor, J. C., Schwarz, U. I., McGrath, J. S., Jolicoeur, E., Lee, W., Leake, B. F., Tirona, R. G., and Kim, R. B. Intestinal drug transporter expression and the impact of grapefruit juice in humans. Clin Pharma PubMed
- Lilja, J. J., Laitinen, K., and Neuvonen, P. J. Effects of grapefruit juice on the absorption of levothyroxine. Br J Clin Pharmacol 2005;60(3):337-341. PubMed
- Kivisto, K. T., Lilja, J. J., Backman, J. T., and Neuvonen, P. J. Repeated consumption of grapefruit juice considerably increases plasma concentrations of cisapride. Clin Pharmacol Ther 1999;66(5):448-453. PubMed
- Desta, Z., Kivisto, K. T., Lilja, J. J., Backman, J. T., Soukhova, N., Neuvonen, P. J., and Flockhart, D. A. Stereoselective pharmacokinetics of cisapride in healthy volunteers and the effect of repeated administration of grapefruit juice. Br J Clin Pharm PubMed
- Odou, P., Ferrari, N., Barthelemy, C., Brique, S., Lhermitte, M., Vincent, A., Libersa, C., and Robert, H. Grapefruit juice-nifedipine interaction: possible involvement of several mechanisms. J Clin Pharm Ther 2005;30(2):153-158. PubMed
- Wason, S., DiGiacinto, J. L., and Davis, M. W. Effects of grapefruit and Seville orange juices on the pharmacokinetic properties of colchicine in healthy subjects. Clin Ther 2012;34(10):2161-2173. PubMed
- Bailey, D. G., Dresser, G. K., Kreeft, J. H., Munoz, C., Freeman, D. J., and Bend, J. R. Grapefruit-felodipine interaction: effect of unprocessed fruit and probable active ingredients. Clin Pharmacol Ther 2000;68(5):468-477. PubMed
- Kumar, A., Teuber, S. S., Naguwa, S., Prindiville, T., and Gershwin, M. E. Eosinophilic gastroenteritis and citrus-induced urticaria. Clin Rev Allergy Immunol 2006;30(1):61-70. PubMed
- Ferdman, R. M., Ong, P. Y., and Church, J. A. Pectin anaphylaxis and possible association with cashew allergy. Ann.Allergy Asthma Immunol. 2006;97(6):759-760. PubMed
- Guo, L. Q., Chen, Q. Y., Wang, X., Liu, Y. X., Chu, X. M., Cao, X. M., Li, J. H., and Yamazoe, Y. Different roles of pummelo furanocoumarin and cytochrome P450 3A5*3 polymorphism in the fate and action of felodipine. Curr Drug Metab 2007;8(6):623-630. PubMed
- Curhan, G. C., Willett, W. C., Rimm, E. B., Spiegelman, D., and Stampfer, M. J. Prospective study of beverage use and the risk of kidney stones. Am J Epidemiol. 2-1-1996;143(3):240-247. PubMed
- Holmberg MT, Tornio A, Joutsi-Korhonen L, Neuvonen M, Neuvonen PJ, Lassila R, Niemi M, Backman JT. Grapefruit juice markedly increases the plasma concentrations and antiplatelet effects of ticagrelor in healthy subjects. Br J Clin Pharmacol. 2013 Jun;75(6 PubMed
- Holmberg MT, Tornio A, Neuvonen M, Neuvonen PJ, Backman JT, Niemi M. Grapefruit juice inhibits the metabolic activation of clopidogrel. Clin Pharmacol Ther. 2014 Mar;95(3):307-13. PubMed
- Hu M, Mak VW, Yin OQ, Chu TT, Tomlinson B. Effects of grapefruit juice and SLCO1B1 388A>G polymorphism on the pharmacokinetics of pitavastatin. Drug Metab Pharmacokinet. 2013;28(2):104-8.
- Ieiri I, Doi Y, Maeda K, Sasaki T, Kimura M, Hirota T, Chiyoda T, Miyagawa M, Irie S, Iwasaki K, Sugiyama Y. Microdosing clinical study: pharmacokinetic, pharmacogenomic (SLCO2B1), and interaction (grapefruit juice) profiles of celiprolol following the or
- Misaka S, Miyazaki N, Yatabe MS, Ono T, Shikama Y, Fukushima T, Kimura J. Pharmacokinetic and pharmacodynamic interaction of nadolol with itraconazole, rifampicin and grapefruit juice in healthy volunteers. J Clin Pharmacol. 2013 Jul;53(7):738-45. PubMed
- Nieminen TH, Hagelberg NM, Saari TI, Neuvonen M, Neuvonen PJ, Laine K, Olkkola KT. Grapefruit juice enhances the exposure to oral oxycodone. Basic Clin Pharmacol Toxicol. 2010 Oct;107(4):782-8. PubMed
- Piccirillo G, Magrì D, Matera S, Magnanti M, Pasquazzi E, Schifano E, Velitti S, Mitra M, Marigliano V, Paroli M, Ghiselli A. Effects of pink grapefruit juice on QT variability in patients with dilated or hypertensive cardiomyopathy and in healthy subject
- Seidegård J, Randvall G, Nyberg L, Borgå O. Grapefruit juice interaction with oral budesonide: equal effect on immediate-release and delayed-release formulations. Pharmazie. 2009 Jul;64(7):461-5. DOI
- Shoaf SE, Mallikaarjun S, Bricmont P. Effect of grapefruit juice on the pharmacokinetics of tolvaptan, a non-peptide arginine vasopressin antagonist, in healthy subjects. Eur J Clin Pharmacol. 2012 Feb;68(2):207-11. PubMed
- Tanaka S, Uchida S, Miyakawa S, Inui N, Takeuchi K, Watanabe H, Namiki N. Comparison of inhibitory duration of grapefruit juice on organic anion-transporting polypeptide and cytochrome P450 3A4. Biol Pharm Bull. 2013;36(12):1936-41. PubMed
- Tapaninen T, Neuvonen PJ, Niemi M. Grapefruit juice greatly reduces the plasma concentrations of the OATP2B1 and CYP3A4 substrate aliskiren. Clin Pharmacol Ther. 2010 Sep;88(3):339-42. PubMed
- van Erp NP, Baker SD, Zandvliet AS, Ploeger BA, den Hollander M, Chen Z, den Hartigh J, König-Quartel JM, Guchelaar HJ, Gelderblom H. Marginal increase of sunitinib exposure by grapefruit juice. Cancer Chemother Pharmacol. 2011 Mar;67(3):695-703. PubMed
- Goldbart A, Press J, Sofer S, Kapelushnik J. Near fatal acute colchicine intoxication in a child. A case report. Eur J Pediatr. 2000;159(12):895-7. PubMed
- Dahan A, Amidon GL. Grapefruit juice and its constituents augment colchicine intestinal absorption: potential hazardous interaction and the role of p-glycoprotein. Pharm Res. 2009 Apr;26(4):883-92. PubMed
- Bailey DG. Predicting clinical relevance of grapefruit-drug interactions: a complicated process. J Clin Pharm Ther. 2017 Apr;42(2):125-27. PubMed
- Mouly S, Lloret-Linares C, Sellire PO, Sene D, Bergmann JF. Is the clinical relevance of drug-food and drug-herb interactions limited to grapefruit juice and Saint-John's Wort? Pharmacol Res. 2017 Apr;118:82-92. PubMed
- Tsuji H, Ohmura K, Nakashima R, et al. Efficacy and safety of grapefruit juice intake accompanying tacrolimus treatment in connective tissues disease patients. Intern Med. 2016;55(12):1547-52.
- Jia Y, Liu J, Xu J. Influence of grapefruit juice on pharmacokinetics of triptolide in rats grapefruit juice on the effects of triptolide. Xenobiotica. 2017 Apr 16:1-5. PubMed
- Kawaguchi-Suzuki M, Nasiri-Kenari N, Shuster J, et al. Effect of low-furanocoumarin hybrid grapefruit juice consumption on midazolam pharmacokinetics. J Clin Pharmacol. 2017 Mar;57(3):305-11. PubMed
- Chorin E, Hochstadt A, Granot Y, et al. Grapefruit juice prolongs the QT interval of healthy volunteers and patients with long QT syndrome. Heart Rhythm. 2019. pii: S1547-5271(19)30368-6. PubMed
- Ershad M, Cruz MD, Mostafa A, Mckeever R, Vearrier D, Greenberg MI. Opioid toxidrome following grapefruit juice consumption in the setting of methadone maintenance. J Addict Med 2019;[Epub ahead of print]. PubMed
- Shen X, Chen F, Wang F, Huang P, Luo W. The effect of grapefruit juice on the pharmacokinetics of tadalafil in rats. Biomed Res Int 2020;2020:1631735. PubMed
- Loretz C, Ho MD, Alam N, Mitchell W, Li AP. Application of cryopreserved human intestinal mucosa and cryopreserved human enterocytes in the evaluation of herb-drug interactions: evaluation of CYP3A inhibitory potential of grapefruit juice and commercial f
- Holmberg MT, Tornio A, Hyvärinen H, et al. Effect of grapefruit juice on the bioactivation of prasugrel. Br J Clin Pharmacol. 2015;80(1):139-45. PubMed
- Guideline on the investigation of drug interactions. CPMP/EWP/560/95/Rev. 1 Corr. 2. European Medicines Agency, 2015. Available at: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-investigation-drug-interactions-revision-1_en.pdf (As
- Cinderella MA, Morell B, Munjal S. Grapefruit Juice Cleanse Mimicking Quetiapine Overdose: Case Report and Review of Literature. J Clin Psychopharmacol 2021;41(6):690-692. PubMed
- Long Z, Ruan M, Wu W, Zeng Q, Li Q, Huang Z. The successful combination of grapefruit juice and venetoclax in an unfit acute myeloid leukemia patient with adverse risk: A case report. Front Oncol 2022;12:912696. PubMed
- Piscitelli J, Nikanjam M, Capparelli EV, et al. Fexofenadine Plasma Concentrations to Estimate Systemic Exposure in Healthy Adults Using a Limited Sampling Strategy with a Population Pharmacokinetic Approach. Ther Drug Monit 2023;45(4):539-545. PubMed
- Abu Dayyih W, Zakaraya Z, Hailat M, et al. The Validation and Determination of Empagliflozin Concentration in the Presence of Grapefruit Juice Using HPLC for Pharmacokinetic Applications. Molecules 2024;29(6):1236. PubMed
- Moffid MA, Mostafa EA, Mahmoud ST, Sayed RM. An eco-friendly ultra-performance liquid chromatography-mass spectrometry method for quantification of rivaroxaban and ticagrelor in rat plasma: grapefruit interactions. Bioanalysis 2023;15(22):1327-1341. PubMed
Wormwood 10 references
- Weisbord SD, Soule JB, Kimmel PL. Poison on line-acute renal failure caused by oil of wormwood purchased through the internet. N Engl J Med 1997;337:825-7. PubMed
- Gambelunghe C, Melai P. Absinthe: enjoying a new popularity among young people? Forensic Sci Int 2002;130:183-6.
- Hold KM, Sirisoma NS, Casida JE. Detoxification of alpha- and beta-Thujones (the active ingredients of absinthe): site specificity and species differences in cytochrome P450 oxidation in vitro and in vivo. Chem Res Toxicol 2001;14:589-95.
- Lachenmeier DW, Walch SG, Padosch SA, Kroner LU. Absinthe--a review. Crit Rev Food Sci Nutr 2006;46:365-77.
- Padosch SA, Lachenmeier DW, Kroner LU. Absinthism: a fictitious 19th century syndrome with present impact. Subst Abuse Treat Prev Policy 2006;1:14. PubMed
- Lachenmeier DW, Emmert J, Kuballa T, Sartor G. Thujone--cause of absinthism? Forensic Sci Int 2006;158:1-8. PubMed
- Dettling, A., Grass, H., Schuff, A., Skopp, G., Strohbeck-Kuehner, P., and Haffner, H. T. Absinthe: attention performance and mood under the influence of thujone. J Stud.Alcohol 2004;65(5):573-581. PubMed
- Benezet-Mazuecos, J. and de la Fuente, A. Electrocardiographic findings after acute absinthe intoxication. Int J Cardiol. 11-10-2006;113(2):e48-e50. PubMed
- El Makrini NI, Hassam B. Artemisia absinthium: burning plant! Pan Afr Med J. 2016 Jan 22;23:10. PubMed
- Kocaoglu C, Ozel A. Persistent metabolic acidosis and severe diarrhoea due to Artemisia absinthium poisoning. J Pak Med Assoc. 2014 Sep;64(9):1081-3.
Pau D'arco 6 references
- Gómez Castellanos JR, Prieto JM, Heinrich M. Red Lapacho (Tabebuia impetiginosa)--a global ethnopharmacological commodity? J Ethnopharmacol 2009;121:1-13. PubMed
- Guerra, Mde O., Mazoni, A. S., Brandao, M. A., and Peters, V. M. Toxicology of Lapachol in rats: embryolethality. Braz.J Biol. 2001;61(1):171-174. PubMed
- Felicio, A. C., Chang, C. V., Brandao, M. A., Peters, V. M., and Guerra, Mde O. Fetal growth in rats treated with lapachol. Contraception 2002;66(4):289-293. PubMed
- Son, D. J., Lim, Y., Park, Y. H., Chang, S. K., Yun, Y. P., Hong, J. T., Takeoka, G. R., Lee, K. G., Lee, S. E., Kim, M. R., Kim, J. H., and Park, B. S. Inhibitory effects of Tabebuia impetiginosa inner bark extract on platelet aggregation and vascular s
- Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.
- Algranti E, Mendonça EM, Ali SA, Kokron CM, Raile V. Occupational asthma caused by Ipe (Tabebuia spp) dust. J Investig Allergol Clin Immunol 2005;15(1):81-3.
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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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