Vitamin C Echinacea Ingredients & Drug Interactions
by Solaray
What is this page for?
First and foremost: checking Vitamin C Echinacea 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
Vitamin C Echinacea is a dietary supplement by Solaray with 3 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 1,382 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Echinacea, Vitamin C. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Vitamin C Echinacea by Solaray
Ask about any prescription or over-the-counter medication and we check it for interactions with Vitamin C Echinacea by Solaray — 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 Vitamin C Echinacea by Solaray
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This product contains six active ingredients: Vitamin C, Rose Hip, Acerola Cherry, Rutin concentrate, Echinacea, and a Vitamin C Support Base (a blend whose components are listed separately). The first three are vitamin C sources—straight vitamin C, rose hip fruit, and acerola cherry all deliver the nutrient in different forms.
Rutin is a bioflavonoid compound that may support blood vessel health. Echinacea is an herb traditionally used to support immune function.
There are also two inactive ingredients (cellulose and magnesium stearate) that serve as fillers and binders.
Does it work?
Moderate evidence
The evidence for this product's ingredients is mixed. Vitamin C is effective for preventing vitamin C deficiency and possibly effective for anemia related to chronic disease, respiratory infections triggered by exercise, cataracts, and atrial fibrillation.
Rose Hip is possibly effective for osteoarthritis and postoperative pain but has insufficient evidence for cholesterol support. Acerola Cherry is possibly effective for vitamin C deficiency but has insufficient evidence for colds, atherosclerosis, or diarrhea.
Rutin and Echinacea both lack reliable evidence for the conditions listed in our data—anxiety, ADHD, athletic performance, burnout, migraines, and others show insufficient evidence to rate. The Bioflavonoid Concentrate's effectiveness cannot be assessed from the data we hold.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal doses, but very high doses can cause stomach cramps, diarrhea, heartburn, nausea, and kidney stones in people prone to them—adverse effects become more likely above 2 grams daily. Rose Hip and Acerola are generally well tolerated in food amounts; concentrated supplements have less safety data.
Rutin is generally well tolerated short-term but may cause headaches, flushing, or rashes; long-term safety data are limited. Echinacea is well tolerated for short-term use but can cause stomach upset, rashes, and rarely severe allergic reactions, especially in people sensitive to ragweed and related plants.
For pregnancy: Vitamin C at normal prenatal doses is likely safe, but avoid high-dose supplements unless your doctor advises it. Rutin is likely safe in pregnancy.
Rose Hip, Acerola, and Echinacea have insufficient pregnancy data—talk with your doctor or pharmacist before use.
Meds to double-check
Moderate interaction found
Before taking this product, double-check your medications with a pharmacist if you use: estrogens (birth control or hormone therapy—Moderate severity); chemotherapy drugs, including alkylating agents and antitumor antibiotics (Moderate); blood thinners like warfarin (Moderate); diabetes medications (Moderate); drugs broken down by your liver through the CYP3A4 or CYP1A2 pathways (Moderate); immunosuppressant drugs (Moderate); or caffeine-containing products (Moderate). Echinacea also theoretically affects several other drug types at minor severity.
We could not check Bioflavonoid Concentrate for interactions.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product is a multi-ingredient vitamin C and immune support supplement best suited for people seeking general wellness with these nutrients. If you take birth control, blood thinners, chemotherapy drugs, diabetes medications, or any psychiatric or antiviral medication, talk with your pharmacist before adding this to your routine—several ingredients interact with common drugs.
Pregnant or breastfeeding individuals should check with their doctor first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 6 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2023.
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 Vitamin C Echinacea, straight from the product label.
| Brand | Solaray |
|---|---|
| Barcode (UPC) | 076280043945 |
| Net contents | 120 VegCap(s) |
| Market status | On market |
| Date entered into DSLD | Aug 23, 2023 |
| DSLD ID | 296252 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, 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 Vitamin C Echinacea by Solaray, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin C | 500 mg | 556% |
| Rose Hip | 0 NP | -- |
| Acerola Cherry | 0 NP | -- |
| Vitamin C Support Base | 13 mg | -- |
| Bioflavonoid Concentrate | 0 NP | -- |
| Rutin concentrate | 0 NP | -- |
| Echinacea | 300 mg | -- |
Other ingredients: Cellulose, Magnesium Stearate
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.
Brand IP Statement(s)
Solaray Est. 1973 A brighter way 1973
Formula
Vitamin C 500 mg Echinacea 300 mg
Discussion: Vitamin C is a powerful antioxidant and is intended to support a healthy immune system.
Formulation
Immune System
Vegan
FDA Statement of Identity
Dietary Supplement
General Statements
Since 1973, we've scoured the globe for the highest quality ingredients, connecting you with the most efficacious supplements that help you live brighter & embrace the moments that matter most.
100% PCR Bottles
Precautions
Warning: Do not use if safety seal is broken or missing. Keep your licensed health care practitioner informed when using this product.
Keep out of reach of children.
Suggested/Recommended/Usage/Directions
Directions: Use only as directed. Take 1 VegCap daily with a meal or glass of water. For optimal results, take continually for 14 days. Not recommended to exceed 8 weeks of continual usage without a rest period.
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
Seals/Symbols
Lab Verified
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Vitamin C Echinacea by Solaray 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 Vitamin C Echinacea by Solaray
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 VegCap(s) Dosage formCapsule Servings per container120 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Vitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsVitamin C Support Base
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C Support Base monograph & interactionsEchinacea
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 monograph & interactionsOther (inactive) ingredients: Cellulose, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Vitamin C Echinacea by Solaray Drug Interactions
HelloPharmacist Interaction Report
Vitamin C Echinacea by Solaray contains six active ingredients, and the product does interact with a number of medications.
The most serious concern is with Vitamin C and estrogens (birth control pills and hormone therapy): vitamin C can raise estrogen blood levels by up to 55% in some cases, which may increase side effects or reduce contraceptive reliability.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C also interacts with blood thinners like warfarin at high doses, potentially reducing their effectiveness; chemotherapy drugs including alkylating agents and antitumor antibiotics, where vitamin C's antioxidant activity may interfere with treatment; and several other drug types including aluminum supplements, the antipsychotic fluphenazine, the HIV medication indinavir, and thyroid hormone (levothyroxine). Rose Hip (which contains vitamin C) adds theoretical concerns about anticoagulants and antiplatelet drugs, lithium, and aspirin, though its vitamin C content is likely too low for clinically significant effects on the latter two.
Rutin in this product interacts with diabetes medications—there's a theoretical risk of low blood sugar (hypoglycemia). Echinacea is the final major player: it can increase caffeine levels by around 30% by slowing caffeine breakdown, interact with drugs metabolized through the CYP3A4 and CYP1A2 liver pathways (a broad group including some HIV and cancer medications), and may interfere with immunosuppressant drugs through its immune-stimulating effects.
Altogether, these interactions span 1,013 individual medications. We could not check Bioflavonoid Concentrate—we hold no data for it.
Use the medication checker below with your specific prescriptions and supplements before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Vitamin C Echinacea?
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 Vitamin C Echinacea interact with 1,382 drugs. Click any drug to see the details.
2 of the 3 ingredients in Vitamin C Echinacea interact with drugs. Each result below shows which ingredient is responsible. Echinacea Vitamin C
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Vitamin C Echinacea — through 1 ingredient. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Ado-trastuzumab Emtansine interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Vitamin C Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Rose HipAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abemaciclib interactionBioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abiraterone interactionBioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Abiraterone Acetate interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea + Abrocitinib interactionRose HipAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip + Abrocitinib interactionBioflavonoid ConcentrateCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Bioflavonoid Concentrate + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.
Read the full Bioflavonoid Concentrate + Acalabrutinib interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Bioflavonoid Concentrate + Acarbose interactionRutin ConcentrateAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking rutin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Rutin Concentrate + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Vitamin C Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Bioflavonoid ConcentrateAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.
Read the full Bioflavonoid Concentrate + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Vitamin C Echinacea — through 1 ingredient. Tap an ingredient for the detail:
Rose HipAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Vitamin C Echinacea — through 5 ingredients. Tap an ingredient for the detail:
Rose HipAnticoagulant/antiplatelet Drugs, Aspirin Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip + Acetaminophen, Aspirin interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Aspirin interactionBioflavonoid ConcentrateOrganic Anion Transporter 3 (oat3) Substrates, Organic Anion Transporter 1 (oat1) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Aspirin interactionAcerola CherryAspirin Minor
Interaction Summary
Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Read the full Acerola Cherry + Acetaminophen, Aspirin interactionVitamin C Support BaseAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Vitamin C Echinacea — through 5 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateOrganic Anion Transporter 3 (oat3) Substrates, Organic Anion Transporter 1 (oat1) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Aspirin, Caffeine interactionRose HipAspirin, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Read the full Rose Hip + Acetaminophen, Aspirin, Caffeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Caffeine +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Aspirin, Caffeine interactionAcerola CherryAspirin Minor
Interaction Summary
Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Read the full Acerola Cherry + Acetaminophen, Aspirin, Caffeine interactionVitamin C Support BaseAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Vitamin C Echinacea — through 2 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea + Acetaminophen, Butalbital, Caffeine interactionBioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Butalbital, Caffeine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Butalbital, Caffeine, Codeine interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Codeine interactionBioflavonoid ConcentrateCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Butalbital, Codeine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Butalbital, Codeine Phosphate interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Butalbital, Codeine Phosphate interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionBioflavonoid ConcentrateCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + 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 Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Caffeine, Codeine interactionEchinaceaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea + Acetaminophen, Caffeine, Codeine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBioflavonoid ConcentrateCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Caffeine, Codeine, Salicylamide interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Caffeine, Dihydrocodeine interactionEchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Caffeine, Dihydrocodeine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea + Acetaminophen, Caffeine, Isometheptene interactionBioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Caffeine, Isometheptene interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Caffeine, Pyrilamine interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Caffeine, Pyrilamine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
EchinaceaCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea might inhibit the metabolism of CYP1A2 and increase plasma levels of some drugs.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionBioflavonoid ConcentrateCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Vitamin C Echinacea — through 3 ingredients. Tap an ingredient for the detail:
Bioflavonoid ConcentrateCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concomitant use might increase the levels and adverse effects of CYP2D6 substrates.
Read the full Bioflavonoid Concentrate + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionEchinaceaCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionVitamin C Support BaseAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C Support Base + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Vitamin C Echinacea 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.
Echinacea
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.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Brand information
Manufacturer and brand details for Vitamin C Echinacea, from the product label.
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Vitamin C Echinacea’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographRose Hip
Interacts with 213 drugsRose hip is the vitamin C–rich fruit of the wild rose, used traditionally for colds and joint pain. A standardized rose hip powder has some research support for easing osteoarthritis symptom...
Read the full Rose Hip monograph → Herb & supplement monographAcerola
Interacts with 128 drugsAcerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and antioxidants. While vitamin C itself has w...
Read the full Acerola monograph → Herb & supplement monographQuercetin
Interacts with 1,169 drugsQuercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood...
Read the full Quercetin monograph → Herb & supplement monographRutin
Interacts with 86 drugsRutin is a plant flavonoid (often taken from buckwheat or citrus) that people use mainly for blood vessel and circulation problems like varicose veins and hemorrhoids. The evidence is limite...
Read the full Rutin 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 →Sources & How We Checked
Vitamin C Echinacea'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 174 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.
Vitamin C 51 references
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- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
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- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
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- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
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- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
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- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
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- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
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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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