Well Child Immune Chewable Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Well Child Immune Chewable 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
Well Child Immune Chewable is a dietary supplement by Planetary Herbals with 14 active ingredients. Its ingredients are commonly taken for zinc deficiency, immune support, cold symptoms.Based on those ingredients, 2,248 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Marshmallow Root Extract, Echinacea purpurea root extract, Kudzu. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Well Child Immune Chewable by Planetary Herbals
Ask about any prescription or over-the-counter medication and we check it for interactions with Well Child Immune Chewable by Planetary Herbals — 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 Well Child Immune Chewable by Planetary Herbals
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
Well Child Immune Chewable contains 13 active ingredients chosen to support immune function. The primary active components include Ascorbic Acid and Vitamin C (both forms of vitamin C for antioxidant support), Zinc and Zinc Gluconate (mineral forms for immune cell function), Acerola (a natural vitamin C source), and Marshmallow Root Extract (a mucilage-rich herb).
The formula also contains herbal extracts — Elderberry fruit, Kudzu root, Echinacea purpurea root, Astragalus root, and Maitake Mushroom — along with Beta-1,3/1,6-Glucan (a polysaccharide from fungi) and Cassia cinnamon. A Proprietary Blend groups additional components not itemized separately.
The inactive ingredients — Fructose, natural Raspberry and Licorice flavors, Stearic Acid, and Magnesium Stearate — serve as sweetener, flavoring, and binder.
Does it work?
Not established
The evidence on this product's individual ingredients is mixed. Vitamin C is effective for vitamin C deficiency and possibly effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections.
Zinc is effective for zinc deficiency and likely effective for Wilson disease, and possibly effective for acne, age-related macular degeneration, and diabetes. Beta-glucan is likely effective for dyslipidemia and heart disease.
For most of the herbal and botanical ingredients — Acerola, Marshmallow, Elderberry, Kudzu, Echinacea, Astragalus, and Maitake Mushroom — the evidence in our data shows insufficient reliable evidence to rate their effectiveness for the conditions studied. Cassia cinnamon similarly lacks established evidence in the data we hold.
Because this is a children's immune supplement, the product's intended use (supporting immune health in general) is not directly addressed by the effectiveness ratings available.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal doses, though high doses can cause abdominal cramps, heartburn, diarrhea, nausea, and vomiting — adverse effects are more likely above 2 grams daily. Zinc is well tolerated in doses below 40 mg daily but may cause metallic taste, nausea, diarrhea, and abdominal cramps; high doses carry theoretical risk of copper deficiency.
Acerola (food amounts) is generally considered safe; large doses may cause osmotic diarrhea. Marshmallow is generally well tolerated for short-term use.
Elderberry prepared from ripe fruit is well tolerated; raw or unripe berries can cause nausea, vomiting, and severe diarrhea due to cyanogenic glycosides, which cooking eliminates. Echinacea is well tolerated but may rarely cause allergic reactions, especially in people sensitive to ragweed.
Astragalus, Kudzu, Maitake, and Cassia cinnamon are generally well tolerated in typical use but have limited long-term human safety data. Regarding pregnancy and lactation: Vitamin C is likely safe in normal amounts but possibly unsafe in high doses — the safety data advises caution with high-dose supplements.
Elderberry, Kudzu, Astragalus, Maitake, and Acerola lack sufficient safety information for pregnancy and breastfeeding; data on Zinc, Marshmallow, Echinacea, and Cassia is not on file for pregnancy/lactation. For a children's product, discuss use with your pediatrician or pharmacist.
Meds to double-check
Moderate interaction found
Before using this product, double-check if you take estrogens (oral contraceptives or hormone replacement therapy), blood thinners like warfarin (Coumadin), antibiotics (quinolones, tetracyclines, or cephalexin), antidiabetes medications, blood pressure drugs, or any HIV medications — all carry Moderate-severity interactions documented here. Also verify if you take chemotherapy drugs (alkylating agents or antitumor antibiotics), immunosuppressants, methotrexate, levothyroxine (Synthroid), or lithium.
Space zinc doses at least 2 hours before or 4–6 hours after quinolone and tetracycline antibiotics. If none of these apply, no interactions are documented for the few ingredients we could not fully check.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This is a multi-ingredient immune supplement with documented interactions affecting many medications — most notably estrogens, blood thinners, antibiotics, diabetes and blood pressure drugs, and drugs metabolized by liver enzymes. If your child or you take any regular medications, check them against our interaction tool before use.
The vitamin C and zinc content is supported by evidence for certain deficiencies and conditions, but most herbal ingredients lack established evidence in our data. Talk to your pharmacist or pediatrician before starting, especially if medications are involved.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 13 of 13 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 20, 2017.
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 Well Child Immune Chewable, straight from the product label.
| Brand | Planetary Herbals |
|---|---|
| Barcode (UPC) | 021078105909 |
| Net contents | 60 Wafer(s) |
| Market status | On market |
| Date entered into DSLD | Nov 20, 2017 |
| DSLD ID | 80343 |
| Product type | Other Combinations |
| Supplement form | Other (e.g. Tea Bag) |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Children 4 or More Years of Age |
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 Well Child Immune Chewable by Planetary Herbals, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 10 Calorie(s) | -- |
| Total Carbohydrates | 2 Gram(s) | 1% |
| Sugar | 2 Gram(s) | -- |
| Ascorbic Acid | 0 NP | -- |
| Zinc | 5 mg | 33% |
| Acerola | 0 NP | -- |
| Proprietary Blend | 570 mg | -- |
| Marshmallow Root Extract | 0 NP | -- |
| Zinc Gluconate | 0 NP | -- |
| Elderberry fruit extract | 0 NP | -- |
| Kudzu | 0 NP | -- |
| Echinacea purpurea root extract | 0 NP | -- |
| Astragalus root extract | 0 NP | -- |
| Beta-1,3/1,6-Glucan | 0 NP | -- |
| Vitamin C | 150 mg | 250% |
| Maitake Mushroom extract | 0 NP | -- |
| Cassia | 0 NP | -- |
Other ingredients: Fructose, natural Raspberry flavor, Stearic Acid, natural Licorice flavor, 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.
General Statements
570 mg
Approved by Michael Tierra L.Ac, O.M.D
A strong immune system is vitally important for children, especially when they begin school or day care.
FDA Statement of Identity
Herbal Supplement
Storage
Store in a cool, dry place.
Precautions
Do not use if either tamper-evident seal is broken or missing.
Keep out of the reach of children.
Warning: If you are pregnant, may become pregnant, breastfeeding, have any blood glucose disorder, or if you are taking any prescription drug, consult your health care professional before using this product.
Children 3 years of age and under, consult your health care professional before using this product.
Formula
Containing acerola cherry, a natural source of vitamin C, echinacea, and astragalus as key ingredients, Well Child Immune Chewable wafers are specially formulated to support a healthy immune system in our children.
Containing acerola cherry, a natural source of vitamin C, echinacea, and astragalus as key ingredients, Well Child Immune Chewable wafers are specially formulated to support a healthy immune system in our children.
Suggested/Recommended/Usage/Directions
Suggested Use: Children: 4 to 8 years of age 1 wafer twice daily. Children: 9 to 13 years of age 1 wafer three times daily. Children: 14 years of age and up 1 wafer four times daily. Children 3 years of age and under, consult your health care professional before using this product.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
General
PF0590 REV J141-D
Brand IP Statement(s)
Planetary Herbals, LLC
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Well Child Immune Chewable by Planetary Herbals 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 Well Child Immune Chewable by Planetary Herbals
These are the 14 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Wafer(s) Dosage formOther (e.g. Tea Bag) 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.
Sugar
Zinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
Zinc monograph & interactionsProprietary Blend
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 & interactionsOther (inactive) ingredients: Fructose, Natural Raspberry flavor, Stearic Acid, Natural Licorice flavor, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Well Child Immune Chewable by Planetary Herbals Drug Interactions
HelloPharmacist Interaction Report
Well Child Immune Chewable by Planetary Herbals contains multiple ingredients with documented interactions with medications.
The most serious concern is with vitamin C (present as both Ascorbic Acid and Vitamin C in the formula), which has Moderate interactions affecting estrogens — oral contraceptives and hormone replacement therapy may have increased blood levels of up to 55% when combined with vitamin C.
Read the full breakdown — every affected drug type, severity by severity
Beyond estrogens, the vitamin C ingredients interact with several other drug types at Moderate severity: alkylating agents (certain chemotherapy drugs) and antitumor antibiotics may have reduced effectiveness due to vitamin C's antioxidant effects; blood thinners like warfarin (Coumadin) may become less effective at high doses; aluminum-containing products may be absorbed more readily; levothyroxine (Synthroid) absorption may increase; and fluphenazine (Prolixin) and indinavir (Crixivan) levels may decrease.
Zinc (present as both Zinc and Zinc Gluconate) interacts at Moderate severity with quinolone and tetracycline antibiotics, cephalexin (Keflex), penicillamine (Cuprimine, Depen), ritonavir (Norvir), cisplatin (Platinol-AQ), and HIV integrase inhibitors including bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy) — spacing doses by 2–6 hours is typically advised.
Additionally, Echinacea purpurea interacts with drugs metabolized by liver enzymes (CYP1A2 and CYP3A4 substrates, including caffeine), immunosuppressants, and warfarin. Elderberry may interfere with immunosuppressants and has a documented case of interaction with pazopanib (Votrient).
Kudzu interacts with estrogens, blood thinners, antidiabetes drugs, methotrexate (Trexall), tamoxifen (Nolvadex), hepatotoxic drugs, and caffeine. Astragalus interacts with immunosuppressants, lithium, cyclophosphamide, and antidiabetes drugs.
Beta-glucans may interact with blood pressure and immunosuppressant medications. Maitake mushroom may interact with blood pressure drugs, antidiabetes agents, and warfarin.
Marshmallow may reduce lithium excretion. Cassia cinnamon may interact with antidiabetes drugs and hepatotoxic medications.
Altogether, these interactions span 2,224 individual medications.
Acerola and Proprietary Blend components also carry interactions, though Acerola's effects are generally at Minor severity due to lower vitamin C content. Use the medication checker on this page with your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Well Child Immune Chewable?
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 Well Child Immune Chewable interact with 2,248 drugs. Click any drug to see the details.
11 of the 14 ingredients in Well Child Immune Chewable interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Root Extract Echinacea purpurea root extract Kudzu Cassia Beta-1,3/1,6-Glucan Maitake Mushroom extract Astragalus root extract Ascorbic Acid Acerola Elderberry fruit extract Zinc
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Well Child Immune Chewable — through 7 ingredients. Tap an ingredient for the detail:
Beta-1,3/1,6-glucanImmunosuppressants Moderate
Interaction Summary
Theoretically, beta-glucans might interfere with immunosuppressive therapy.
Read the full Beta-1,3/1,6-glucan + 6-mercaptopurine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + 6-mercaptopurine interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + 6-mercaptopurine interactionElderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry Fruit Extract + 6-mercaptopurine interactionEchinacea Purpurea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea Root Extract + 6-mercaptopurine interactionAstragalus Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus Root Extract + 6-mercaptopurine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Well Child Immune Chewable — through 1 ingredient. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea Root Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Well Child Immune Chewable — through 3 ingredients. Tap an ingredient for the detail:
KudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Abacavir Sulfate, Dolutegravir, Lamivudine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Abacavir Sulfate, Dolutegravir, Lamivudine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Well Child Immune Chewable — through 3 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Abacavir, Lamivudine interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Abacavir, Lamivudine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Well Child Immune Chewable — through 2 ingredients. Tap an ingredient for the detail:
KudzuAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, kudzu may increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.
Read the full Kudzu + Abciximab interactionMarshmallow Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow Root Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Well Child Immune Chewable — through 2 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea Root Extract + Abemaciclib interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Well Child Immune Chewable — through 4 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea Root Extract + Abiraterone interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Abiraterone interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Abiraterone interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Well Child Immune Chewable — through 4 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Abiraterone Acetate interactionEchinacea Purpurea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea Root Extract + Abiraterone Acetate interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Abiraterone Acetate interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Well Child Immune Chewable — through 6 ingredients. Tap an ingredient for the detail:
Elderberry Fruit ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, elderberry might interfere with immunosuppressant therapy due to its immunostimulant activity.
Read the full Elderberry Fruit Extract + Abrocitinib interactionKudzuAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, kudzu may increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.
Read the full Kudzu + Abrocitinib interactionBeta-1,3/1,6-glucanImmunosuppressants Moderate
Interaction Summary
Theoretically, beta-glucans might interfere with immunosuppressive therapy.
Read the full Beta-1,3/1,6-glucan + Abrocitinib interactionAstragalus Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus Root Extract + Abrocitinib interactionEchinacea Purpurea Root ExtractImmunosuppressants Moderate
Interaction Summary
Echinacea has immunostimulant activity which may interfere with immunosuppressant therapy.
Read the full Echinacea Purpurea Root Extract + Abrocitinib interactionMarshmallow Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Well Child Immune Chewable — through 2 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Echinacea may induce hepatic CYP3A4 and inhibit intestinal CYP3A4.
Read the full Echinacea Purpurea Root Extract + Acalabrutinib interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
Astragalus Root ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Astragalus Root Extract + Acarbose interactionKudzuAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking kudzu with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Kudzu + Acarbose interactionMaitake Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Maitake Mushroom Extract + Acarbose interactionCassiaAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Read the full Cassia + Acarbose interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acebutolol interactionBeta-1,3/1,6-glucanAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking beta-glucans with antihypertensive drugs might increase the risk of hypotension.
Read the full Beta-1,3/1,6-glucan + Acebutolol interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acebutolol interactionMaitake Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Maitake Mushroom Extract + Acebutolol interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Well Child Immune Chewable — through 2 ingredients. Tap an ingredient for the detail:
KudzuAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, kudzu may increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.
Read the full Kudzu + Acenocoumarol interactionMarshmallow Root ExtractAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow Root Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
KudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Well Child Immune Chewable — through 6 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Aspirin interactionKudzuHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Aspirin interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Aspirin interactionAcerolaAspirin 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 + Acetaminophen, Aspirin interactionMarshmallow Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Aspirin interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Well Child Immune Chewable — through 6 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Aspirin, Caffeine interactionKudzuAnticoagulant/antiplatelet Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, kudzu may increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.
Read the full Kudzu + Acetaminophen, Aspirin, Caffeine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Aspirin, Caffeine interactionVitamin CAcetaminophen (tylenol, Others), Aspirin Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Aspirin, Caffeine interactionAcerolaAspirin 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 + Acetaminophen, Aspirin, Caffeine interactionMarshmallow Root ExtractOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
KudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Butalbital interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Butalbital interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Butalbital interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Butalbital, Caffeine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Butalbital, Caffeine interactionKudzuHepatotoxic Drugs, Caffeine Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Butalbital, Caffeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
KudzuCaffeine, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking kudzu with caffeine might increase levels of caffeine.
Read the full Kudzu + Acetaminophen, Butalbital, Caffeine, Codeine interactionEchinacea Purpurea Root ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Butalbital, Caffeine, Codeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Butalbital, Codeine interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Butalbital, Codeine interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Butalbital, Codeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Butalbital, Codeine Phosphate interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Butalbital, Codeine Phosphate interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Butalbital, Codeine Phosphate interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
KudzuCaffeine, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking kudzu with caffeine might increase levels of caffeine.
Read the full Kudzu + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionEchinacea Purpurea Root ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + 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 Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Caffeine, Codeine interactionKudzuHepatotoxic Drugs, Caffeine Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Caffeine, Codeine interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Caffeine, Codeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Codeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Caffeine, Codeine, Salicylamide interactionKudzuHepatotoxic Drugs, Caffeine Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Caffeine, Codeine, Salicylamide interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Codeine, Salicylamide interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
KudzuCaffeine, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking kudzu with caffeine might increase levels of caffeine.
Read the full Kudzu + Acetaminophen, Caffeine, Dihydrocodeine interactionEchinacea Purpurea Root ExtractCaffeine, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Caffeine, Dihydrocodeine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Caffeine, Isometheptene interactionKudzuHepatotoxic Drugs, Caffeine Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Caffeine, Isometheptene interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Caffeine, Isometheptene interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Isometheptene interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
Echinacea Purpurea Root ExtractCaffeine, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.
Read the full Echinacea Purpurea Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Caffeine, Pyrilamine interactionKudzuCaffeine, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking kudzu with caffeine might increase levels of caffeine.
Read the full Kudzu + Acetaminophen, Caffeine, Pyrilamine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Caffeine, Pyrilamine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
KudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionCassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Well Child Immune Chewable — through 5 ingredients. Tap an ingredient for the detail:
CassiaHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
Read the full Cassia + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEchinacea Purpurea Root ExtractCytochrome 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 Purpurea Root Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionKudzuHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might have additive hepatotoxic effects.
Read the full Kudzu + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionVitamin CAcetaminophen (tylenol, Others) Minor
Interaction Summary
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
Read the full Vitamin C + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionMarshmallow Root ExtractOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow Root Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Well Child Immune Chewable 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.
Marshmallow Root Extract
Lithium
Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.
Anticoagulant/Antiplatelet Drugs
Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Oral Drugs
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Echinacea purpurea root extract
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.
Kudzu
Anticoagulant/Antiplatelet Drugs
Theoretically, kudzu may increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.
Kudzu isoflavones are reported to have antiplatelet activity.
Caffeine
Theoretically, taking kudzu with caffeine might increase levels of caffeine.
In healthy males injected with the kudzu constituent puerarin, caffeine clearance and metabolism is inhibited. This effect has been attributed to inhibition of cytochrome P450 1A2 (CYP1A2) enzyme, which is involved in caffeine metabolism. It is unclear if taking kudzu orally would have this same effect.
Estrogens
Theoretically, kudzu might alter the effects of estrogen therapy.
Some research suggests that kudzu has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive hepatotoxic effects.
There is some concern that kudzu can adversely affect the liver.
Methotrexate (Trexall, Others)
Theoretically, taking kudzu with methotrexate might increase the risk of methotrexate toxicity.
Preclinical research suggests that kudzu extract greatly reduces the elimination and increases the toxicity of methotrexate. Kudzu might inhibit organic anion transporters (OATs) that are responsible for hepatobiliary and renal excretion of anions, similar to the interaction between methotrexate and non-steroidal anti-inflammatory drugs (NSAIDs).
Tamoxifen (Nolvadex)
Theoretically, kudzu might interfere with tamoxifen activity.
Some research suggests that kudzu may have estrogenic effects.
Antidiabetes Drugs
Theoretically, taking kudzu with antidiabetes drugs might increase the risk of hypoglycemia.
Kudzu might lower blood glucose levels and have additive effects in patients treated with antidiabetic agents. The dose of diabetes medications might need to be adjusted.
Cassia
Antidiabetes Drugs
Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.
Hepatotoxic Drugs
Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.
Beta-1,3/1,6-Glucan
Antihypertensive Drugs
Theoretically, taking beta-glucans with antihypertensive drugs might increase the risk of hypotension.
Clinical research shows that taking beta-glucans may reduce systolic and diastolic blood pressure in some hypertensive individuals.
Immunosuppressants
Theoretically, beta-glucans might interfere with immunosuppressive therapy.
Some clinical research shows that beta-glucans have immunostimulant effects.
Maitake Mushroom extract
Antidiabetes Drugs
Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking maitake mushroom polysaccharide (MMP) can lower blood glucose levels in patients with types 2 diabetes.
Antihypertensive Drugs
Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that maitake mushroom can lower blood pressure.
Warfarin (Coumadin)
There is limited evidence that maitake mushroom may increase the anticoagulant effects of warfarin.
In a case report, a patient previously stabilized on warfarin developed an elevated international normalized ratio (INR) of 5.1 after taking maitake mushroom (Grifron-Pro Maitake D-Fraction) 1 drop/kg daily in three divided doses for one week. The elevated INR resolved after holding warfarin for two days, then reducing the dose by 11%. It is thought that the beta-glucan constituent of maitake mushroom might cause warfarin dissociation from proteins, resulting in increased free warfarin levels and increased warfarin effects.
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.
Ascorbic Acid
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.
Acerola
Alkylating Agents
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as alkylating agents. In contrast, other researchers theorize that antioxidants might make alkylating 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.
Antitumor Antibiotics
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic 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 antitumor antibiotic chemotherapy.
Aluminum
Theoretically, concomitant use of acerola with aluminum salts might increase the amount of aluminum absorbed.
Acerola contains vitamin C. It is thought that vitamin C chelates aluminum, keeping it in solution and available for absorption. In people with normal renal function, urinary excretion of aluminum likely increases, making aluminum retention and toxicity unlikely. However, patients with renal failure who take aluminum-containing compounds, such as phosphate binders, should avoid acerola in doses that provide more vitamin C than the recommended dietary allowances.
Aspirin
Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing 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. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and aspirin is unlikely.
Estrogens
Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.
Acerola contains vitamin C. Increases in plasma estrogen levels of up to 55% have occurred 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. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.
Warfarin (Coumadin)
Theoretically, acerola might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and warfarin is unlikely.
Elderberry 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.
Zinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Brand information
Manufacturer and brand details for Well Child Immune Chewable, from the product label.
Planetary Herbals
See all Planetary Herbals products- Name
- Planetary Herbals, LLC
- Street Address
- P.O. Box 1760
- City
- Soquel
- State
- CA
- ZipCode
- 95073
- Web Address
- www.planetaryherbals.com
Well Child Immune Chewable by Planetary Herbals: Common Questions
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The Full Monographs Behind Well Child Immune Chewable’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Zinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc monograph → Herb & supplement monographVitamin 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 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 monographMarshmallow
Interacts with 2,040 drugsMarshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...
Read the full Marshmallow 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 monographKudzu
Interacts with 584 drugsKudzu is a fast-growing vine whose root has long been used in traditional Chinese medicine and is now studied mostly for reducing alcohol intake. Early research is promising for cutting back...
Read the full Kudzu 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 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 monographBeta-glucans
Interacts with 293 drugsBeta-glucans are natural fibers found in oats, barley, mushrooms, and yeast. The strongest evidence supports the oat and barley types for modestly lowering cholesterol and blood sugar, while...
Read the full Beta-glucans monograph → Herb & supplement monographMaitake Mushroom
Interacts with 260 drugsMaitake is an edible mushroom long used as food and in traditional Japanese medicine, and it is being studied for possible immune, blood sugar, and blood pressure effects. The human evidence...
Read the full Maitake Mushroom monograph → Herb & supplement monographCassia Cinnamon
Interacts with 442 drugsCassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed a...
Read the full Cassia Cinnamon monograph →Sources & How We Checked
Well Child Immune Chewable'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 294 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
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- 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
- Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- 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/.
- Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
- 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
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- 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
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- 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
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- 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.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
Zinc 88 references
- Barceloux DG. Zinc. J Toxicol Clin Toxicol 1999;37:279-92.
- Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 1984;25:20-4. DOI
- Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
- Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
- Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
- Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
- Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
- Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
- Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
- Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
- Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
- Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
- Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
- Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
- Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
- Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
- Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. PubMed
- Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM 2003;96:35-43. DOI
- Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst 2003;95:1004-7.. PubMed
- Jafek BW, Linschoten M, Murrow BW. Zicam Induced Anosmia. American Rhinologic Society 49th Annual Fall Scientific Meeting abstract. Orlando, Florida. September 20, 2003. http://app.american-rhinologic.org/programs/2003ARSFallProgram071503.pdf (Accessed 24
- Uebayashi H, Hatanaka T, Kanemura F, Tonosaki K. Acute anosmia in the mouse: behavioral discrimination among the four basic taste substances. Physiol Behav 2001;72:291-6.. PubMed
- Barrett S. Zicam Marketers Sued. United States District Court Western District of Michigan Southern Division, Filed October 14, 2003, Case No. 4:03CV0146.
- Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:181-90.. PubMed
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
- Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7. PubMed
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
- Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70. PubMed
- Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.
- McBride K, Slotnick B, Margolis FL. Does intranasal application of zinc sulfate produce anosmia in the mouse? An olfactometric and anatomical study. Chem Senses 2003;28:659-70. PubMed
- Burd GD. Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb. Microsc Res Tech 1993;24:195-213. PubMed
- Ducray A, Bondier JR, Michel G, et al. Recovery following peripheral destruction of olfactory neurons in young and adult mice. Eur J Neurosci 2002;15:1907-17. PubMed
- Mayer AD, Rosenblatt JS. Peripheral olfactory deafferentation of the primary olfactory system in rats using ZnSO4 nasal spray with special reference to maternal behavior. Physiol Behav 1993;53:587-92. PubMed
- DeCook CA, Hirsch AR. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
- Tisdall FF, Brown A, Defries RD. Persistent anosmia following zinc sulfate nasal spraying. JPed 1938;18:60-2. DOI
- Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
- Public Health Advisory. Loss of sense of smell with intranasal cold remedies containing zinc. U.S. Food and Drug Administration, June 16, 2009. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm (Accessed 16 June 2009)
- Dooren JC. FDA warns against use of Zicam. The Wall Street Journal, June 16, 2009. Available at: http://online.wsj.com/article/SB124516778692319231.html#mod=djemHL?mg=com-wsj (Accessed 16 June 2009).
- Alexander TH, Davidson TM. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. Laryngoscope 2006;116:217-20.
- Health Canada / GlaxoSmithKline Consumer Healthcare. Association of long-term, excessive use of zinc-containing Poli-Grip products with myeloneuropathy and blood dyscrasias. February 18, 2010. Available at: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medef
- GlaxoSmithKline Consumer Advisory. GlaxoSmithKline (GSK) warns about a potential health risk associated with long-term, excessive use of GSK's zinc-containing denture adhesives Super Polygrip Original, Ultra Fresh and Extra Care. February 18, 2010. Availa
- Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2012;184:E551-61. PubMed
- Castilla-Higuero, L., Romero-Gomez, M., Suarez, E., and Castro, M. Acute hepatitis after starting zinc therapy in a patient with presymptomatic Wilson's disease. Hepatology 2000;32(4 Pt 1):877. PubMed
- Sharquie, K. E., Najim, R. A., Farjou, I. B., and Al Timimi, D. J. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin.Exp.Dermatol. 2001;26(1):21-26. PubMed
- Dreno, B., Moyse, D., Alirezai, M., Amblard, P., Auffret, N., Beylot, C., Bodokh, I., Chivot, M., Daniel, F., Humbert, P., Meynadier, J., and Poli, F. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of
- Moore, R. Bleeding gastric erosion after oral zinc sulphate. Br.Med J 3-25-1978;1(6115):754. PubMed
- Jafek, B. W., Linschoten, M. R., and Murrow, B. W. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18(3):137-141. DOI
- Simonart, T. and de, Maertelaer, V. Systemic treatments for cutaneous warts: a systematic review. J Dermatolog.Treat. 2012;23(1):72-77. PubMed
- Cochran, R. J., Tucker, S. B., and Flannigan, S. A. Topical zinc therapy for acne vulgaris. Int.J Dermatol. 1985;24(3):188-190. DOI
- Morgan, A. A. Bleeding gastric erosion after oral zinc sulphate. Br.Med.J. 5-13-1978;1(6122):1283-1284. PubMed
- Murphy, J. V. Intoxication following ingestion of elemental zinc. JAMA 6-22-1970;212(12):2119-2120.
- Lang, C. J., Rabas-Kolominsky, P., Engelhardt, A., Kobras, G., and Konig, H. J. Fatal deterioration of Wilson's disease after institution of oral zinc therapy. Arch Neurol. 1993;50(10):1007-1008. PubMed
- Fjellner, B. Drug-induced lupus erythematosus aggravated by oral zinc therapy. Acta Derm.Venereol. 1979;59(4):368-370. DOI
- Varas Lorenzo, M. J. Zinc acexamate and ranitidine in the short- and mid-term management of gastroduodenal ulcers. Curr Ther Res 21986;39:19-29.
- Bosch, F. and Jimenez, E. Post-marketing surveillance of zinc acexamate in peptic ulcer treatment. Clin Trials J 1990;27:301-312.
- DeCook, C. A. and Hirsch, A. R. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
- Crown LA, May JA. Zinc toxicity: denture adhesives, bone marrow failure and polyneuropathy. Tenn Med. 2012 Feb;105(2):39-40, 42.
- Dadamio J, Van Tournout M, Teughels W, Dekeyser C, Coucke W, Quirynen M. Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial. J Clin Periodontol. 2013 May;40(5):505-13. PubMed
- Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug PubMed
- Zittel S, Ufer F, Gerloff C, Münchau A, Rosenkranz M. Severe myelopathy after denture cream use--is copper deficiency or excess zinc the cause? Clin Neurol Neurosurg. 2014 Jun;121:17-8. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescen
- Ding Y, Jia YY, Li F, et al. The effect of staggered administration of zinc sulfate on the pharmacokinetics of oral cephalexin. Br J Clin Pharmacol. 2012 Mar;73(3):422-7. PubMed
- Fallah R, Sabbaghzadegan S, Karbasi SA, Binesh F. Efficacy of zinc sulfate supplement on febrile seizure recurrence prevention in children with normal serum zinc level: A randomised clinical trial. Nutrition. 2015;31(11-12):1358-61. PubMed
- Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;12:CD005436. PubMed
- Mahmoud AM, Al-Alem U, Dabbous F, et al. Zinc intake and risk of prostate cancer: Case-control study and meta-analysis. PLoS One. 2016;11(11):e0165956. PubMed
- Nagraj SK, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A. Interventions for managing taste disturbances. Cochrane Database Syst Rev. 2017 Dec 20;12(12):CD010470. PubMed
- Yee BE, Richards P, Sui JY, Marsch AF. Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta-analysis. Dermatol Ther. 2020:e14252. PubMed
- Janyajirawong R, Vilaichone RK, Sethasine S. Efficacy of zinc supplement in minimal hepatic encephalopathy: A prospective, randomized controlled study (Zinc-MHE Trial). Asian Pac J Cancer Prev 2021;22(9):2879-2887. PubMed
- Nakano M, Nakamura Y, Miyazaki A, Takahashi J. Zinc pharmacotherapy for elderly osteoporotic patients with zinc deficiency in a clinical setting. Nutrients 2021;13(6):1814. PubMed
- Tolino E, Skroza N, Mambrin A, et al. An open-label study comparing oral zinc to lymecycline in the treatment of acne vulgaris. J Clin Aesthet Dermatol 2021;14(5):56-58.
- Hunter J, Arentz S, Goldenberg J, et al. Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2021;11(11):e047474. PubMed
- Yamazaki K, Kageyama H, Fujiyama T, Ito T, Urano S, Honda T. A case of systemic contact dermatitis due to zinc supplements. Int J Dermatol 2022. PubMed
- Magham K, Han J, Eilbert W, Bunney EB. Severe copper deficiency anemia caused by zinc supplement use. Am J Emerg Med 2023;72:222. PubMed
- Sivakumar RR, Chinnaiah Govindareddy D, Sahoo J, Bobby Z, Chinnakali P. Effect of daily zinc supplementation for 12 weeks on serum thyroid auto-antibody levels in children and adolescents with autoimmune thyroiditis - a randomized controlled trial. J Pedi PubMed
- AlDhasee O, AlMalki H, AlKharashi N, AlJeraisy N, Al Deeb M. Acute zinc sulfate overdose: clinical presentation and management. BMJ Case Rep 2025;18(1):e263899. PubMed
- US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.
Acerola 20 references
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- 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/.
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
- Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. 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
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Denadai R, Souza FM, Valle MR. Fecal impaction by rectal acerola bezoar. Indian J Pediatr 2013;80(5):432-3. PubMed
- Raulf-Heimsoth M, Stark R, Sander I, et al. Anaphylactic reaction to apple juice containing acerola: cross-reactivity to latex due to prohevein. J Allergy Clin Immunol 2002;109(4):715-6. PubMed
Marshmallow 5 references
- Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.
Elderberry 6 references
- Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6..
- Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
- European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).
- Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:6 PubMed
- Ramachandran A, Antala D, Pudasainee P, Panginikkod S, Gupta H. A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis. Cureus 2022;14(4):e24250. PubMed
- Agarwal N, Mangla A. Elderberry interaction with pazopanib in a patient with soft-tissue sarcoma: A case report and literature review. Mol Clin Oncol 2024;20(5):36. PubMed
Kudzu 21 references
- Woo J, Lau E, Ho SC, et al. Comparison of Pueraria lobata with hormone replacement therapy in treating the adverse health consequences of menopause. Menopause 2003;10:352-61. PubMed
- Akita H, Sowa J, Makiura M, et al. Maculopapular drug eruption due to the Japanese herbal medicine Kakkonto (kudzu or arrowroot decoction). Contact Dermatitis 2003;48:348-9. PubMed
- Luo ZR, Zheng B. [Effect of Puerarin on platelet activating factors CD63 and CD62P, plasminogen activator inhibitor and C-reactive protein in patients with unstable angia pectoris]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2001;21:31-3 .
- Lee KT, Sohn IC, Kim DH, et al. Hypoglycemic and hypolipidemic effects of tectorigenin and kaikasaponin III in the streptozotocin-lnduced diabetic rat and their antioxidant activity in vitro. Arch Pharm Res 2000;23:461-6.
- Yu Z, Zhang G, Zhao H. [Effects of Puerariae isoflavone on blood viscosity, thrombosis and platelet function]. Zhong Yao Cai 1997;20:468-9.
- Hsu FL, Liu IM, Kuo DH, et al. Antihyperglycemic effect of puerarin in streptozotocin-induced diabetic rats. J Nat Prod 2003;66:788-92. PubMed
- Chiang HM, Fang SH, Wen KC, et al. Life-threatening interaction between the root extract of Pueraria lobata and methotrexate in rats. Toxicol Appl Pharmacol 2005;209:263-8.
- Zheng, J., Chen, B., Jiang, B., Zeng, L., Tang, Z. R., Fan, L., and Zhou, H. H. The effects of puerarin on CYP2D6 and CYP1A2 activities in vivo. Arch Pharm Res 2010;33(2):243-246. PubMed
- Hsu, H. H., Chang, C. K., Su, H. C., Liu, I. M., and Cheng, J. T. Stimulatory effect of puerarin on alpha1A-adrenoceptor to increase glucose uptake into cultured C2C12 cells of mice. Planta Med 2002;68(11):999-1003.
- Zheng, G., Zhang, X., Zheng, J., Meng, Q., and Zheng, D. [Estrogen-like effects of puerarin and total isoflavones from Pueraria lobata]. Zhong.Yao Cai. 2002;25(8):566-568.
- Qi, B. L. and Qi, B. M. [Effect of the purariae-isofiavones on estrogen level in normal and ovariectomized rats]. Zhongguo Zhong.Yao Za Zhi. 2002;27(11):850-852.
- Akita, H., Sowa, J., Makiura, M., Akamatsu, H., and Matsunaga, K. Maculopapular drug eruption due to the Japanese herbal medicine Kakkonto (kudzu or arrowroot decoction). Contact Dermatitis 2003;48(6):348-349. PubMed
- Manonai, J., Chittacharoen, A., Theppisai, U., and Theppisai, H. Effect of Pueraria mirifica on vaginal health. Menopause. 2007;14(5):919-924. PubMed
- Chandeying, V. and Sangthawan, M. Efficacy comparison of Pueraria mirifica (PM) against conjugated equine estrogen (CEE) with/without medroxyprogesterone acetate (MPA) in the treatment of climacteric symptoms in perimenopausal women: phase III study. J M
- Virojchaiwong, P., Suvithayasiri, V., and Itharat, A. Comparison of Pueraria mirifica 25 and 50 mg for menopausal symptoms. Arch.Gynecol.Obstet. 2011;284(2):411-419. PubMed
- Hou, Q., Ao, X., Li, G., and Zhang, Y. [Puerarin combined with avandia for diabetic nephropathy]. Zhong.Nan.Da.Xue Xue Bao Yi Xue Ban. 2012;37(1):73-77.
- Kim HJ, Kim H, Ahn JH, Suk JH. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern Complement Med 2015;21(3):180-5. PubMed
- Santosh N, Mohan K, Royana S, Yamini TB. Hepatotoxicity of tubers of Indian Kudzu (Pueraria tuberosa) in rats. Food Chem Toxicol. 2010 Apr;48(4):1066-71. PubMed
- Teschke R, Zhang L, Long H, Schwarzenboeck A, Schmidt-Taenzer W, Genthner A, Wolff A, Frenzel C, Schulze J, Eickhoff A. Traditional Chinese Medicine and herbal hepatotoxicity: a tabular compilation of reported cases. Ann Hepatol. 2015 Jan-Feb;14(1):7-19. DOI
- Wang D, Qiu L, Wu X, Wei H, Xu F. Evaluation of kudzu root extract-induced hepatotoxicity. J Ethnopharmacol. 2015 Dec 24;176:321-6. PubMed
- Warinsiriruk P, Tantitham C, Cherdshewasart W, Shobeiri SA, Manonai J. Effects of Pueraria mirifica on vaginal artery vascularization in postmenopausal women with genitourinary syndrome of menopause. Maturitas 2022;160:4-10. PubMed
Echinacea 51 references
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998;168:170-1. PubMed
- Mullins RJ. Allergic reactions to Echinacea. J Allergy Clin Immunol 2000;104:S340-341 (Abstract 1003).
- Chavez ML, Chavez PI. Echinacea. Hosp Pharm 1998;33:180-8.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43. PubMed
- Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.. PubMed
- Luettig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75. PubMed
- Stimpel M, Proksch A, Wagner H, et al. Macrophage activation and induction of macrophage cytotoxicity by purified polysaccharide fractions from the plant Echinacea purpurea. Infect Immun 1984;46:845-9. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141-3. PubMed
- Soon SL, Crawford RI. Recurrent erythema nodosum associated with echinacea herbal therapy. J Am Acad Dermatol 2001;44:298-9. PubMed
- Mullins RJ, Heddle R. Adverse reactions associated with echinacea: the Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51. PubMed
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9.
- Schulten B, Bulitta M, Ballering-Bruhl B, et al. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001;51:563-8.. PubMed
- Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
- Yale SH, Liu K. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2004;164:1237-41. PubMed
- Gorski JC, Huang S, Zaheer NA, et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2003;73 (Abstract PDII-A-8):P94. PubMed
- Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol 2004;140:723-7. PubMed
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004;29:75-83.
- Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine 2003;10:66-86. PubMed
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf 2005;28:387-400. PubMed
- Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea augustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e262-7.
- Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148. PubMed
- Barrett B, Brown R, Rakel D. et al. Echinacea for treating the common cold: a randomized trial. Ann Intern Med 2010;153:769-77. PubMed
- Press Release: Echinacea herbal products should not be used in children under 12 years old. Medicines and Healthcare Products Regulatory Agency (UK). August 20, 2012. Available at: www.mhra.gov.uk/NewsCentre/Pressreleases/CON180627. (Accessed 21 October
- Barrett B, Brown R, Rakel D, Rabago D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann.Fam.Med 2011;9:312-22. PubMed
- Haller J, Freund, TF, Pelczer, KG, et al. The anxiolytic potential and psychotropic side effects of an echinacea preparation in laboratory animals and healthy volunteers. Phytother.Res. 2013;27:54-61.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. PubMed
- Schapowal A, Berger D, Klein P, et al. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. Eur.J Med Res 9-1-2009;14:406-12. PubMed
- Bossaer JB and Odle BL. Probable etoposide interaction with Echinacea. J.Diet.Suppl 2012;9:90-5.
- Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
- Kemp, D. E. and Franco, K. N. Possible leukopenia associated with long-term use of echinacea. J Am Board Fam.Pract. 2002;15(5):417-419.
- Liatsos, G., Elefsiniotis, I., Todorova, R., and Moulakakis, A. Severe thrombotic thrombocytopenic purpura (TTP) induced or exacerbated by the immunostimulatory herb Echinacea. Am J Hematol. 2006;81(3):224.
- Penzak, S. R., Robertson, S. M., Hunt, J. D., Chairez, C., Malati, C. Y., Alfaro, R. M., Stevenson, J. M., and Kovacs, J. A. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy s
- Maskatia, Z. K. and Baker, K. Hypereosinophilia associated with echinacea use. South.Med J 2010;103(11):1173-1174. PubMed
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomed 1996;3:95-102. PubMed
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and darunavir-ritonavir in HIV-infected patients. Antimicrob Agents Chemother 2011;55(1):326-30.
- Goey AK, Meijerman I, Rosing H, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013;76(3):467-74.
- Moltó J, Valle M, Miranda C, et al. Herb-drug interaction between Echinacea purpurea and etravirine in HIV-infected patients. Antimicrob Agents Chemother 2012;56(10):5328-31. PubMed
- Lawrenson JA, Walls T, Day AS. Echinacea-induced acute liver failure in a child. J Paediatr Child Health 2014;50(10):841.
- Hansen TS, Nilsen OG. In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 2008;103:445-9.
- Gabranis I, Koufakis T1, Papakrivos I, Batala S. Echinacea-associated acute cholestatic hepatitis. J Postgrad Med. 2015;61(3):211-2. PubMed
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev.2014;(2):CD000530. doi: 10.1002/14651858.CD000530.pub3. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res. 2021 Apr 8;26(1):33. PubMed
- Lopresti AL, Smith SJ. An investigation into the anxiety-relieving and mood-enhancing effects of Echinacea angustifolia (EP107 ™): A randomised, double-blind, placebo-controlled study. J Affect Disord 2021;293:229-237.
- Weishaupt R, Buchkov A, Kolev E, Klein P, Schoop R. Reduction of viral load in patients with acute sore throats: Results from an observational clinical trial with Echinacea / Salvia lozenges [published online ahead of print, 2023 Mar 8]. Complement Med Re
- Sumer J, Keckeis K, Scanferla G, et al. Novel Echinacea formulations for the treatment of acute respiratory tract infections in adults-A randomized blinded controlled trial. Front Med (Lausanne) 2023;10:948787. PubMed
Astragalus 13 references
- Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-25.
- Khoo KS, Ang PT. Extract of astragalus membranaceus and ligustrum lucidum does not prevent cyclophosphamide-induced myelosuppression. Singapore Med J 1995;36:387-90.
- Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;25:125-9.
- Sun Y, Hersh EM, Lee SL, et al. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod 1983;2:227-37..
- Ma J, Peng A, Lin S. Mechanisms of the therapeutic effect of astragalus membranaceus on sodium and water retention in experimental heart failure. Chin Med J (Engl) 1998;111:17-23.
- Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;24:175-81.
- Zhang, J. G., Yang, N., He, H., Wei, G. H., Gao, D. S., Wang, X. L., Wang, X. Z., and Song, G. Y. [Effect of Astragalus injection on plasma levels of apoptosis-related factors in aged patients with chronic heart failure.]. Chin J Integr.Med 2005;11(3):18 PubMed
- Chen, H. W., Lin, I. H., Chen, Y. J., Chang, K. H., Wu, M. H., Su, W. H., Huang, G. C., and Lai, Y. L. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest PubMed
- Tian H, Lu J, He H, et al.The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis. J Ethnopharmacol. 2016;191:206-215. doi: 10.1016/j.jep.2016.05.062. PubMed
- Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Integr Complement Med 2023. PubMed
- Chan KW, Kwong ASK, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine 2024;130:155457. PubMed
- Han X, Yu T, Chen X, Du Z, Yu M, Xiong J. Effect of Astragalus membranaceus on left ventricular remodeling in HFrEF: a systematic review and meta-analysis. Front Pharmacol 2024;15:1345797. PubMed
- Jing P, Hongzheng H, Zhenqi WU, Meijuan Z, Zuojing LI, Gang C. Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials. J Tradit Chin Med 2024;44(2):
Beta-glucans 11 references
- Katz, D. L., Nawaz, H., Boukhalil, J., Giannamore, V., Chan, W., Ahmadi, R., and Sarrel, P. M. Acute effects of oats and vitamin E on endothelial responses to ingested fat. Am.J.Prev.Med. 2001;20(2):124-129. PubMed
- Keenan, J. M., Pins, J. J., Frazel, C., Moran, A., and Turnquist, L. Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. J.Fam.Pract. 2002;51(4):369.
- Maki, K. C., Galant, R., Samuel, P., Tesser, J., Witchger, M. S., Ribaya-Mercado, J. D., Blumberg, J. B., and Geohas, J. Effects of consuming foods containing oat beta-glucan on blood pressure, carbohydrate metabolism and biomarkers of oxidative stress i
- Bergendiova, K., Tibenska, E., and Majtan, J. Pleuran (beta-glucan from Pleurotus ostreatus) supplementation, cellular immune response and respiratory tract infections in athletes. Eur.J.Appl.Physiol 2011;111(9):2033-2040.
- Talbott S, Talbott J. Effect of beta 1,3/1,6 glucan on respiratory tract infection symptoms and mood state in marathon athletes. J Sports Sci Med 2009;8(4):509-515.
- Feldman S, Schwartz HI Kalman DS Mayers A Kohrman HM Clemens R Krieger DR. Randomized phase II clinical trials of Wellmune WGP® for immune support during cold and flu season. The Journal of Applied Research 2009;9(1-2):30-42.
- McFarlin BK, Carpenter KC, Davidson T, McFarlin MA. Baker's yeast beta glucan supplementation increases salivary IgA and decreases cold/flu symptomatic days after intense exercise. J Diet Suppl. 2013;10(3):171-83. PubMed
- Jesenak M, Urbancek S, Majtan J, Banovcin P, Hercogova J. ß-Glucan-based cream (containing pleuran isolated from pleurotus ostreatus) in supportive treatment of mild-to-moderate atopic dermatitis. J Dermatolog Treat 2016;27(4):351-4.
- Mah E, Kaden VN, Kelley KM, Liska DJ. Beverage containing dispersible yeast ß-glucan decreases cold/flu symptomatic days after intense exercise: a randomized controlled trial. J Diet Suppl 2020;17(2):200-10. PubMed
- Zhong K, Liu Z, Lu Y, Xu X. Effects of yeast ß-glucans for the prevention and treatment of upper respiratory tract infection in healthy subjects: a systematic review and meta-analysis. Eur J Nutr. 2021. PubMed
- Cardenas FI, Mauguen A, Cheung IY, et al. Phase I trial of oral yeast-derived ß-glucan to enhance anti-GD2 immunotherapy of resistant high-risk neuroblastoma. Cancers (Basel) 2021;13(24):6265. PubMed
Maitake Mushroom 8 references
- Kabir Y, Kimura S. Dietary mushrooms reduce blood pressure in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol (Tokyo) 1989;35:91-4. PubMed
- Kabir Y, Yamaguchi M, Kimura S. Effect of shiitake (Lentinus edodes) and maitake (Grifola frondosa) mushrooms on blood pressure and plasma lipids of spontaneously hypertensive rats. J Nutr Sci Vitaminol (Tokyo) 1987;33:341-6. PubMed
- Konno S, Tortorelis DG, Fullerton SA, et al. A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients. Diabet Med 2001;18:1010. PubMed
- Chen JT, Tominaga K, Sato Y, et al. Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: a possible monotherapy and a combination therapy after failure with first-line clomiphene citrate. J Altern Compl
- Hanselin MR, Vande Griend JP, Linnebur SA. INR elevation with maitake extract in combination with warfarin. Ann Pharmacother 2010;44:223-4. PubMed
- Talpur, N. A., Echard, B. W., Fan, A. Y., Jaffari, O., Bagchi, D., and Preuss, H. G. Antihypertensive and metabolic effects of whole Maitake mushroom powder and its fractions in two rat strains. Mol.Cell Biochem. 2002;237(1-2):129-136. PubMed
- Deng, G., Lin, H., Seidman, A., Fornier, M., D'Andrea, G., Wesa, K., Yeung, S., Cunningham-Rundles, S., Vickers, A. J., and Cassileth, B. A phase I/II trial of a polysaccharide extract from Grifola frondosa (Maitake mushroom) in breast cancer patients: i
- Wesa KM, Cunningham-Rundles S, Klimek VM, et al. Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunol Immunother 2015;64(2):237-47. PubMed
Cassia Cinnamon 20 references
- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
- Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. PubMed
- De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis 1999;40:165. PubMed
- Drake TE, Maibach HI. Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste. Arch Dermatol 1976;112:202-3.
- Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
- Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
- Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. PubMed
- Akilen, R., Tsiami, A., Devendra, D., and Robinson, N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet.Med. 2010; PubMed
- Lu T, Sheng H Wu J Cheng Y Zhu J Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012;32(6):408-412. PubMed
- Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
- Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM. The effect of cinnamon on A1C among adolescents with type 1 diabetes. Diabetes Care 2007;30(4):813-6. PubMed
- Stoecker BR, Zhan Z, Luo R, et al. Cinnamon extract lowers blood glucose in hyperglycemic subjects. FASEB J. 2010;22:722.1 (Abstract only). DOI
- Admani S, Hill H, Jacob SE. Cinnamon Sugar Scrub Dermatitis: "Natural" Is Not Always Best. Pediatr Dermatol. 2017;34(1):e42-e43. PubMed
- Isaac-Renton M, Li MK, Parsons LM. Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis. 2015;26(3):116-21. PubMed
- Vandersall A, Katta R. Eyelid dermatitis as a manifestation of systemic contact dermatitis to cinnamon. Dermatitis. 2015 Jul-Aug;26(4):189. PubMed
- Wickenberg J, Lindstedt S, Nilsson J, Hlebowicz J. Cassia cinnamon does not change the insulin sensitivity or the liver enzymes in subjects with impaired glucose tolerance. Nutr J 2014 Sep 24;13:96. PubMed
- Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep 2015;16:250-4. PubMed
- Shekarchizadeh-Esfahani P, Heydarpour F, Izadi F, Jalili C. The effect of cinnamon supplementation on liver enzymes in adults: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2021;58:102699. PubMed
- Bernaola J, Valverde-Monge M, Otal-Buesa M, Cullen D, Heras-Mendaza F. Cinnamon allergic contact cheilitis. Contact Dermatitis 2023;88(5):418-419. PubMed
- Patel K, Howard M, Tate B. Cheilitis caused by allergic contact dermatitis to cinnamon in chai tea: A case report. Contact Dermatitis 2023;88(3):239-240. PubMed
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