ViraThera CF Ingredients & Drug Interactions
by Klaire Labs
What is this page for?
First and foremost: checking ViraThera CF 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
ViraThera CF is a dietary supplement by Klaire Labs with 6 active ingredients. Its ingredients are commonly taken for heart health, high blood pressure, high cholesterol.Based on those ingredients, 1,367 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Goldenseal Root Extract, Licorice Root Extract, Echinacea Extract Blend. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against ViraThera CF by Klaire Labs
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HelloPharmacist Scorecard of ViraThera CF by Klaire Labs
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
Partial disclosure
ViraThera CF contains 7 active ingredients. The herbal extracts are olive leaf, licorice root, echinacea (a blend of angustifolia root plus purpurea flower, leaf, and stem), astragalus root, black elderberry fruit and flower, and goldenseal root.
The inactive ingredients are hydroxypropyl methylcellulose, water, microcrystalline cellulose, silicon dioxide, and L-leucine (the capsule and fillers that hold the product together).
Does it work?
Moderate evidence
The evidence for what ViraThera CF may do is not established in the data we hold. Olive leaf extract is rated insufficient evidence for respiratory infections, influenza, shingles, and other conditions.
Licorice is possibly effective for canker sores and eczema. Echinacea, astragalus, elderberry, and goldenseal all show insufficient evidence for the conditions listed in our data—including anxiety, respiratory infections, hay fever, and others.
If you're considering this product for a specific reason, talk with your pharmacist about what the research actually supports.
How safe is it?
Well-documented data
Olive leaf extract is well tolerated in typical food amounts, though concentrated supplements are less studied; headache and stomach discomfort are the most common side effects reported. Licorice root is fine in small food amounts but can cause serious problems with high doses or long-term use—avoid it in pregnancy due to the compound glycyrrhizin.
Echinacea is generally well tolerated short-term but may cause allergic reactions, especially in people sensitive to ragweed and related plants; rare cases of hepatitis have been reported. Astragalus is generally well tolerated short-term in healthy adults, though safety data in humans are limited, and it should be avoided in pregnancy and while breastfeeding.
Black elderberry made from ripe fruit is well tolerated, but raw or unripe berries and seeds contain toxins—avoid supplements during pregnancy and breastfeeding. Goldenseal should be avoided in pregnancy because berberine (its active compound) may harm the fetus and trigger contractions, and avoided while breastfeeding because berberine may pass to the infant.
Meds to double-check
Moderate interaction found
Before taking ViraThera CF, check with your pharmacist if you use digoxin or other heart medications, warfarin or other blood thinners, cancer drugs (cisplatin, paclitaxel, etoposide, pazopanib), immunosuppressants, lithium, diabetes drugs, blood-pressure medications, sleeping pills like midazolam, or berberine-containing products. Licorice can weaken warfarin, echinacea may interfere with immune therapy, and goldenseal can raise levels of many medications metabolized by your liver.
The bottom line
Scorecard at a glancePartially disclosed formula with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
ViraThera CF is a multi-ingredient herbal blend with several documented drug interactions, most notably with heart and blood-pressure medications, blood thinners, cancer drugs, and immune-modulating therapies. If you take any prescription medications—especially for the heart, anticoagulation, cancer, or immune suppression—check your specific drugs against the medication tool before starting.
Talk to your pharmacist or doctor, especially if you're pregnant or breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 7 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 21, 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 ViraThera CF, straight from the product label.
| Brand | Klaire Labs |
|---|---|
| Barcode (UPC) | 828054006102 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Dec 21, 2024 |
| DSLD ID | 322473 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years), Dairy 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 ViraThera CF by Klaire Labs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Olive Leaf Extract | 125 mg | -- |
| Licorice Root Extract | 100 mg | -- |
| Echinacea angustifolia Root Extract | 0 NP | -- |
| Astragalus Root Extract | 125 mg | -- |
| Echinacea Extract Blend | 125 mg | -- |
| Echinacea purpurea Flower, Leaf, Stem Extract | 0 NP | -- |
| Black Elderberry Flower, Fruit Extract | 50 mg | -- |
| Goldenseal Root Extract | 75 mg | -- |
Other ingredients: Hydroxypropyl Methylcellulose, Water, Microcrystalline Cellulose, Silicon Dioxide, L-Leucine
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.
Precautions
Caution: If you are pregnant, nursing, have a medical condition (including high blood pressure or cardiovascular disease), or taking prescription drugs, consult your physician before using this product.
Keep out of reach of children.
Do not use if shrinkwrap is broken or missing.
Formulation
Free of the following common allergens: Milk/casein, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans. Contains no artificial colors, flavors, or preservatives.
Produced under a strict quality management system in compliance with Good Manufacturing Practices (GMPs) and third-party quality certifications.
Suggested/Recommended/Usage/Directions
Suggested use: 1 capsule, 1 to 4 times daily or as directed by a healthcare professional.
Storage
Store in a cool, dry place (59 degrees F - 85 degrees F) away from direct light.
FDA Statement of Identity
Herbal Supplement
General Statements
SFI
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
ViraThera CF by Klaire Labs 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 ViraThera CF by Klaire Labs
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Olive 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 & interactionsLicorice Root Extract
Interacts with1,040 drugs
Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regu...
Licorice Root Extract monograph & interactionsAstragalus Root Extract
Interacts with208 drugs
Astragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While...
Astragalus Root Extract monograph & interactionsEchinacea Extract Blend
Interacts with816 drugs
Echinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at bes...
Echinacea Extract Blend monograph & interactionsBlack Elderberry Flower, Fruit Extract
Interacts with121 drugs
Elderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu sym...
Black Elderberry Flower, Fruit Extract monograph & interactionsGoldenseal Root Extract
Interacts with1,237 drugs
Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for...
Goldenseal Root Extract monograph & interactionsOther (inactive) ingredients: Hydroxypropyl Methylcellulose, Water, Microcrystalline Cellulose, Silicon Dioxide, L-Leucine. These complete the product’s ingredient list but are not active constituents.
ViraThera CF by Klaire Labs Drug Interactions
HelloPharmacist Interaction Report
ViraThera CF by Klaire Labs contains several herbal ingredients with documented interactions.
The most serious concern is licorice root extract, which carries moderate-severity interactions with heart medications like digoxin (Lanoxin), blood thinners like warfarin (Coumadin), and cancer drugs like cisplatin and paclitaxel — potentially reducing their effectiveness or increasing cardiac toxicity.
Read the full breakdown — every affected drug type, severity by severity
Echinacea (both angustifolia root and purpurea flower/leaf/stem extracts) interacts moderately with drugs your liver metabolizes, including CYP1A2 and CYP3A4 substrates, and may also affect your body's ability to absorb or clear immunosuppressants and certain chemotherapy drugs like etoposide. Caffeine metabolism can be boosted by echinacea, raising caffeine levels by roughly 30%.
Astragalus root extract may interfere with immunosuppressant drugs and lithium, and theoretically could increase the risk of low blood sugar (hypoglycemia) when taken with diabetes medications. Goldenseal root extract inhibits several drug-metabolizing pathways (CYP2D6, CYP2C9, and CYP3A4), potentially raising levels of many common medications, and may increase bleeding risk with blood thinners or lower blood pressure further with blood-pressure drugs.
Black elderberry has a moderate interaction with the cancer drug pazopanib.
Altogether, these interactions span 1,347 individual medications. We could not check olive leaf extract against medications.
Please use the medication checker on this page to look up your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against ViraThera CF?
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 ViraThera CF interact with 1,367 drugs. Click any drug to see the details.
5 of the 6 ingredients in ViraThera CF interact with drugs. Each result below shows which ingredient is responsible. Goldenseal Root Extract Licorice Root Extract Echinacea Extract Blend Astragalus Root Extract Black Elderberry Flower, Fruit Extract
MethotrexateOtrexup, Rasuvo, Reditrex, Rheumatrex
How Methotrexate interacts with ViraThera CF — through 1 ingredient. Tap an ingredient for the detail:
Licorice Root ExtractMethotrexate (trexall, Others) Minor
Interaction Summary
Theoretically, licorice might increase levels of methotrexate.
Read the full Licorice Root Extract + Methotrexate interactionMethotrexate SodiumXatmep
How Methotrexate Sodium interacts with ViraThera CF — through 1 ingredient. Tap an ingredient for the detail:
Licorice Root ExtractMethotrexate (trexall, Others) Minor
Interaction Summary
Theoretically, licorice might increase levels of methotrexate.
Read the full Licorice Root Extract + Methotrexate Sodium interactionOseltamivir PhosphateTamiflu
How Oseltamivir Phosphate interacts with ViraThera CF — through 1 ingredient. Tap an ingredient for the detail:
Goldenseal Root ExtractOseltamivir (tamiflu) Minor
Interaction Summary
Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
Read the full Goldenseal Root Extract + Oseltamivir Phosphate interactionAcetaminophen, Dextromethorphan, Phenylephrine, GuaifenesinDayQuil Severe
How Acetaminophen, Dextromethorphan, Phenylephrine, Guaifenesin interacts with ViraThera CF — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea Flower, Leaf, Stem ExtractDayquil Severe Minor
Interaction Summary
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively.
Read the full Echinacea Purpurea Flower, Leaf, Stem Extract + Acetaminophen, Dextromethorphan, Phenylephrine, Guaifenesin interactionEach ingredient & the kinds of drugs it affects
For each ingredient in ViraThera CF 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.
Goldenseal Root Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, goldenseal might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Goldenseal contains berberine. In vitro and animal research shows that berberine can inhibit platelet aggregation. However, this effect has not been reported in humans.
Antidiabetes Drugs
Theoretically, goldenseal might increase the risk of hypoglycemia when used with antidiabetes drugs.
Goldenseal contains berberine. Clinical research shows that berberine can lower blood glucose levels. However, this effect has not been reported with goldenseal.
Antihypertensive Drugs
Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.
Cns Depressants
Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2E1.
In vitro research shows that goldenseal root extract can inhibit the activity of CYP2E1. However, this effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Goldenseal might increase serum levels of drugs metabolized by CYP3A4.
Most clinical and in vitro research shows that goldenseal inhibits CYP3A4 enzyme activity and increases serum levels of CYP3A4 substrates, such as midazolam. However, in one small clinical study, goldenseal did not affect the levels of indinavir, a CYP3A4 substrate, in healthy volunteers. This is likely due to the fact that indinavir has a high oral bioavailability, making it an inadequate probe for CYP3A4 interactions and/or that it is primarily metabolized by hepatic CYP3A, while goldenseal has more potential to inhibit intestinal CYP3A enzyme activity. Both goldenseal extract and its isolated constituents berberine and hydrastine inhibit CYP3A, with hydrastine possibly having more inhibitory potential than berberine.
Dextromethorphan (Robitussin Dm, Others)
Theoretically, goldenseal might increase serum levels of dextromethorphan.
Goldenseal contains berberine. A small clinical study shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.
Digoxin (Lanoxin)
Goldenseal might increase serum levels of digoxin, although this effect is unlikely to be clinically significant.
Clinical research shows that goldenseal modestly increases digoxin peak levels by about 14% in healthy volunteers. However, goldenseal does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal does not cause a clinically significant interaction with digoxin. Digoxin is a P-glycoprotein substrate. Some evidence suggests that goldenseal constituents might affect P-glycoprotein; however, it is unclear whether these constituents inhibit or induce P-glycoprotein.
Losartan (Cozaar)
Theoretically, goldenseal might decrease the conversion of losartan to its active form.
Goldenseal contains berberine. A small clinical study shows that berberine inhibits cytochrome P450 2C9 (CYP2C9) activity and reduces the metabolism of losartan. However, this effect has not been reported with goldenseal.
Metformin (Glucophage)
Theoretically, goldenseal might reduce blood levels of metformin.
In vitro research shows that goldenseal extract decreases the bioavailability of metformin, likely by interfering with transport, intestinal permeability, or other processes involved in metformin absorption. It is unclear which, if any, of metformin's transporters are inhibited by goldenseal. Goldenseal does not appear to alter the clearance or half-life of metformin.
P-Glycoprotein Substrates
Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.
Pentobarbital (Nembutal)
Theoretically, goldenseal might increase the sedative effects of pentobarbital.
Animal research shows that berberine, a constituent of goldenseal, can prolong pentobarbital-induced sleeping time. However, this effect has not been reported with goldenseal.
Tacrolimus (Prograf)
Theoretically, goldenseal might increase serum levels of tacrolimus.
Goldenseal contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of tacrolimus dosing to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL.
Oseltamivir (Tamiflu)
Theoretically, goldenseal might reduce the therapeutic effects of oseltamivir by decreasing its conversion to its active form.
In vitro evidence suggests that goldenseal reduces the formation of the active compound from the prodrug oseltamivir. The mechanism of action and clinical relevance is unclear.
Licorice Root Extract
Antihypertensive Drugs
Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.
Cisplatin (Platinol-Aq)
Theoretically, licorice might reduce the effects of cisplatin.
In animal research, licorice diminished the therapeutic efficacy of cisplatin.
Corticosteroids
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
In vitro research shows that licorice extract and glabridin, a licorice constituent, inhibit CYP2B6 isoenzymes. Licorice extract from the species G. uralensis seems to inhibit CYP2B6 isoenzymes to a greater degree than G. glabra extract in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2B6; however, these interactions have not yet been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
Digoxin (Lanoxin)
Theoretically, concomitant use of licorice with digoxin might increase the risk of cardiac toxicity.
Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Diuretic Drugs
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Overuse of licorice might compound diuretic-induced potassium loss. In one case report, a 72-year-old male with a past medical history of hypertension, type 2 diabetes, hyperlipidemia, arrhythmia, stroke, and hepatic dysfunction was hospitalized with severe hypokalemia and uncontrolled hypertension due to pseudohyperaldosteronism. This was thought to be provoked by concomitant daily consumption of a product containing 225 mg of glycyrrhizin, a constituent of licorice, and hydrochlorothiazide 12.5 mg for 1 month.
Estrogens
Theoretically, licorice might increase or decrease the effects of estrogen therapy.
Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.
Loop Diuretics
Theoretically, loop diuretics might increase the mineralocorticoid effects of licorice.
Theoretically, loop diuretics might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
Midazolam (Versed)
Theoretically, licorice might decrease levels of midazolam.
In humans, the licorice constituent glycyrrhizin appears to moderately induce the metabolism of midazolam. This is likely due to induction of cytochrome P450 3A4 by licorice. Until more is known, licorice should be used cautiously in people taking midazolam.
P-Glycoprotein Substrates
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, licorice might decrease plasma levels and clinical effects of paclitaxel.
Multiple doses of licorice taken concomitantly with paclitaxel might reduce the effectiveness of paclitaxel. Animal research shows that licorice 3 grams/kg given orally for 14 days before intravenous administration of paclitaxel decreases the exposure to paclitaxel and increases its clearance. Theoretically, this occurs because licorice induces cytochrome P450 3A4 enzymes, which metabolize paclitaxel. Notably, a single dose of licorice did not affect exposure or clearance of paclitaxel.
Warfarin (Coumadin)
Theoretically, licorice might decrease plasma levels and clinical effects of warfarin.
Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.
Methotrexate (Trexall, Others)
Theoretically, licorice might increase levels of methotrexate.
Animal research suggests that intravenous administration of glycyrrhizin, a licorice constituent, and high-dose methotrexate may delay methotrexate excretion and increase systemic exposure, leading to transient elevations in liver enzymes and total bilirubin. This interaction has not yet been reported in humans.
Echinacea Extract Blend
Caffeine
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Echinacea seems to increase plasma concentrations of caffeine by around 30%. This is likely due to inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Echinacea appears to inhibit CYP1A2 enzymes in humans. Additionally, echinacea seems to increase plasma concentrations of caffeine, a CYP1A2 substrate, by around 30%. Theoretically, echinacea might increase levels of other drugs metabolized by CYP1A2.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.
Several clinical trials have shown that taking echinacea for up to one month does not significantly affect the metabolism of various CYP3A4 substrates, including midazolam, docetaxel, etravirine, lopinavir-ritonavir, and darunavir-ritonavir. However, other clinical research shows that echinacea may increase the clearance of midazolam, suggesting that echinacea might induce CYP3A4. The discrepancy is thought to be due to differing effects of echinacea on intestinal versus hepatic CYP3A4 enzymes. Echinacea appears to induce hepatic CYP3A4 but inhibit intestinal CYP3A4. In some cases, these effects might cancel each other out, but in others, drug levels may be increased or decreased depending on the level of effect at hepatic and intestinal sites. The effect of echinacea on CYP3A4 activity may differ depending on the CYP3A4 substrate.
Etoposide (Vepesid)
Echinacea may increase levels of etoposide.
In one report, concomitant use of etoposide and echinacea was associated with more severe thrombocytopenia than the use of etoposide alone, suggesting inhibition of etoposide metabolism. Etoposide is a cytochrome P450 3A4 (CYP3A4) substrate. Echinacea has variable effects on CYP3A4, but some studies have reported inhibition of the enzyme.
Immunosuppressants
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Theoretically, echinacea may interfere with immunosuppressant therapy because of its immunostimulant activity.
Darunavir (Prezista)
Theoretically, echinacea may interfere with the metabolism of darunavir; however, a small clinical study found no effect.
Darunavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but administration of an E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg four times daily for 14 days did not affect darunavir/ritonavir pharmacokinetics in 15 HIV-infected patients.
Dayquil Severe
Echinacea is reported to have varying effects on a number of Cytochrome P450 metabolizing enzymes in the liver, including CYP1A2 and CYP3A4, which play a role in acetaminophen and dextromethorphan metabolism (both contained in DayQuil Severe), respectively. Studies have reported both enzyme inhibition and induction, making it difficult to predict clinically significant drug interactions with reliability. Specific drug interaction studies reporting definitive results are rare, and potential drug interactions involving echinacea should likely be taken on a case-by-case basis. Based on what we know about how acetaminophen and dextromethorphan are metabolized, the risk of a clinically significant interaction between echinacea and DayQuil Severe is low.
Docetaxel (Taxotere)
Theoretically, echinacea may interfere with the metabolism of docetaxel; however, a small clinical study found no effect.
Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea whole plant extract (Echinaforce, A. Vogel Biopharma AG) 20 drops three times daily for 2 weeks did not alter the pharmacokinetics of docetaxel in one clinical study.
Etravirine (Intelence)
Theoretically, echinacea may interfere with the metabolism of etravirine; however, a small clinical study found no effect.
Etravirine is metabolized by cytochrome P450 3A4 (CYP3A4). Echinacea has variable effects on CYP3A4, but taking E. purpurea root extract (Arkocapsulas Echinacea, Arkopharma) 500 mg three times daily for 14 days did not alter the pharmacokinetics of etravirine in HIV-infected patients.
Lopinavir/Ritonavir (Kaletra)
Theoretically, echinacea may interfere with the metabolism of lopinavir; however, a small clinical study found no effect.
Lopinavir is metabolized by cytochrome P450 3A4 (CYP3A4) and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Echinacea has variable effects on CYP3A4, but taking E. purpurea (Echinamide, Natural Factors Nutritional Products, Inc.) 500 mg three times daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in healthy volunteers.
Midazolam (Versed)
Theoretically, echinacea may increase the metabolism of intravenous midazolam.
Echinacea induces hepatic CYP3A4 and might decrease plasma levels of midazolam by about 20%, reducing the effectiveness of intravenous midazolam. Echinacea also appears to inhibit intestinal CYP3A4, which could theoretically increase the bioavailability of oral midazolam. This may cancel out the decrease in availability caused by induction of hepatic CYP3A4, such that overall plasma levels after oral administration of midazolam are not affected by echinacea.
Warfarin (Coumadin)
Echinacea seems to increase the clearance of warfarin, although the effect may not be clinically significant.
Preliminary clinical research in healthy male volunteers suggests that taking echinacea increases the clearance of the active S-isomer of warfarin after a single dose of warfarin, but there was not a clinically significant effect on the INR.
Astragalus Root Extract
Antidiabetes Drugs
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.
Cyclophosphamide
Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.
Immunosuppressants
Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.
Lithium
Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.
Black Elderberry Flower, Fruit Extract
Immunosuppressants
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Elderberry has immunostimulant activity, increasing the production of cytokines, including interleukin and tumor necrosis factor.
Pazopanib (Votrient)
Theoretically, elderberry might interact with pazopanib, potentially increasing the risk of adverse effects.
Brand information
Manufacturer and brand details for ViraThera CF, from the product label.
Klaire Labs
See all Klaire Labs products- Name
- SFI USA
- City
- Reno
- State
- NV
- ZipCode
- 89521
- Web Address
- Klaire.com
ViraThera CF by Klaire Labs: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind ViraThera CF’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Olive
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 monographLicorice
Interacts with 1,040 drugsLicorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, whic...
Read the full Licorice monograph → Herb & supplement monographAstragalus
Interacts with 208 drugsAstragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong h...
Read the full Astragalus monograph → Herb & supplement monographEchinacea
Interacts with 816 drugsEchinacea is a popular herb taken to help prevent or shorten the common cold, but study results are mixed and the overall benefit appears small at best. It is generally well tolerated for sh...
Read the full Echinacea monograph → Herb & supplement monographElderberry
Interacts with 121 drugsElderberry is a popular herbal supplement, mainly taken to help with colds and flu. Some small studies suggest it may modestly shorten cold or flu symptoms, but the evidence is limited and n...
Read the full Elderberry monograph → Herb & supplement monographGoldenseal
Interacts with 1,237 drugsGoldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lac...
Read the full Goldenseal monograph →Sources & How We Checked
ViraThera CF'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 198 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.
Olive 2 references
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Licorice 92 references
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- Lozano, P., Flores, D., Martinez, S., Artigues, I., Rimbau, E. M., and Gomez, F. Upper limb ischemia induced by chronic licorice ingestion. J Cardiovasc.Surg (Torino) 2000;41(4):631-632.
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- Abe K, Higurashi T, Takahashi M, et al. Concomitant Use of High-dose Methotrexate and Glycyrrhizin Affects Pharmacokinetics of Methotrexate, Resulting in Hepatic Toxicity. In Vivo 2021;35(4):2163-2169. PubMed
- Awad N, Makar G, Burroughs V, Ravi P, Burroughs SR. Licorice-induced apparent mineralocorticoid excess causing persistent hypertension and hypokalemia. Acta Endocrinol (Buchar) 2020;16(4):508-510. PubMed
- Patel P, Aknouk M, Dawson A, et al. How Much Is Too Much? Exploring Pseudohyperaldosteronism in Glycyrrhizic Acid Toxicity From Chronic Licorice Root Consumption. Cureus 2021;13(7):e16454. PubMed
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- Gatica-Ortega ME, Pastor-Nieto MA. Allergic contact dermatitis to Glycyrrhiza inflata root extract in an anti-acne cosmetic product. Contact Dermatitis 2021;85(4):454-455.
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Echinacea 51 references
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