Interactions on record — worth a quick check against your medications. Based on 7 of 10 ingredients. Check your meds →
Dietary supplement

ZzZeXX Ingredients & Drug Interactions

by Viatrexx Bio Incorporated

ZzZeXX label
See full label image
Liquid Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking ZzZeXX 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

The interaction bottom line Most serious interaction: Moderate

ZzZeXX is a dietary supplement by Viatrexx Bio Incorporated with 10 active ingredients. Its ingredients are commonly taken for trouble falling asleep (insomnia), jet lag, delayed sleep phase syndrome.Based on those ingredients, 1,545 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Melatonin, Chamomile, Valeriana officinalis. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against ZzZeXX by Viatrexx Bio Incorporated

Ask about any prescription or over-the-counter medication and we check it for interactions with ZzZeXX by Viatrexx Bio Incorporated — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of ZzZeXX by Viatrexx Bio Incorporated

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 10 active ingredients.
  • “Proprietary Micro Blend of Trace Amounts and Essences” is a proprietary blend — the label doesn't break down how much of each component you get.

ZzZeXX is a liquid supplement with 10 ingredients, several of which are active. The main ones are melatonin (a hormone that regulates sleep–wake cycles), valerian (Valeriana officinalis, an herbal sleep aid), lemon balm and chamomile (calming herbs), oats (used for cholesterol and heart health), Christmas Rose (black hellebore, a toxic plant in small amounts), pulsatilla (a homeopathic remedy), and pineal gland, serotonin, and phosphorus.

The product also contains a proprietary micro blend of trace amounts and essences. Inactive ingredients are alcohol and water.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: encourages a restful sleep.
  • We looked for evidence on: Insomnia, Delayed sleep phase syndrome (DSPS), Jet lag, Non-24-hour sleep wake disorder, Beta blocker-induced insomnia, Anxiety — and 4 related terms.
  • The strongest evidence on file: Melatonin is rated "Likely Effective" for Delayed sleep phase syndrome (DSPS) (Natural Medicines).
  • Also on file: Melatonin is rated "Likely Effective" for Non-24-hour sleep wake disorder.
  • Also on file: Valerian is rated "Possibly Effective" for Insomnia.

Melatonin is Likely Effective for non-24-hour sleep–wake disorder and delayed sleep phase syndrome (a condition where sleep comes much later than normal). It's Possibly Effective for reducing anxiety before medical procedures and for sunburn and high blood pressure.

Valerian is Possibly Effective for insomnia but has Insufficient Reliable Evidence for restless legs syndrome, anxiety before procedures, stress, or period pain. Lemon balm is Possibly Effective for cold sores (herpes labialis), stress, and depression.

Oats are Likely Effective for high cholesterol (dyslipidemia) and heart disease prevention. We hold no effectiveness data for chamomile, Christmas Rose, pulsatilla, pineal gland, serotonin, or phosphorus in this product.

The evidence, ingredient by ingredient Melatonin German Chamomile Black Hellebore Lemon Balm Oats Pulsatilla Valerian

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Melatonin is generally well tolerated short-term, but long-term safety is less certain and product quality varies. The most common side effects are dizziness, drowsiness, headache, and nausea.

Rarely, it may increase seizure risk. It can also affect mood (sadness, nervousness, depression), cause hallucinations or delusions, and in rare cases reduce sperm quality or cause breast tissue enlargement.

Melatonin is rated Possibly Unsafe in pregnancy. Valerian is generally well tolerated short-term; common side effects include dizziness, drowsiness, mental slowness, headache, and GI upset.

Long-term safety is not well studied, and it's rated Unsafe in pregnancy and lactation. Lemon balm is generally well tolerated short-term, with possible dizziness and sedation (though no more than placebo); long-term safety and high doses are not well studied.

It's rated to be avoided in pregnancy unless a doctor advises otherwise, and caution is advised while breastfeeding. Oats as food are generally safe in pregnancy and lactation; concentrated supplements are less studied.

Common side effects of oral oats include bloating, flatulence, and abdominal distension. Christmas Rose (black hellebore) is highly toxic—all parts are poisonous and can cause serious or fatal harm, GI irritation, irregular heartbeat, and symptoms like nausea, vomiting, diarrhea, dizziness, and difficulty breathing.

It's Likely Unsafe in pregnancy and lactation. Pulsatilla (fresh plant) is toxic and irritating; only dried or diluted homeopathic forms are used.

It's Likely Unsafe in pregnancy and lactation. We hold no safety data for chamomile, pineal gland, serotonin, or phosphorus.

Side effects, ingredient by ingredient Melatonin German Chamomile Black Hellebore Lemon Balm Oats Pulsatilla Valerian

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 6 of the 7 matched ingredients can interact with medications — Black Hellebore, Lemon Balm, Oats, Valerian, Melatonin, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; seizure medications; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,546 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking ZzZeXX, double-check your medications with the tool on this page, particularly: seizure medications (anticonvulsants), heart rhythm or blood pressure drugs (especially extended-release nifedipine), blood thinners and antiplatelet drugs (especially warfarin), insulin and diabetes medications, thyroid hormone replacement, central nervous system depressants (sedatives, sleep aids, pain medications), immune-suppressing drugs, and alprazolam. Avoid alcohol while taking this product due to additive sedative effects from valerian.

The product contains black hellebore, a toxic ingredient—do not use without explicit medical guidance.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

ZzZeXX is marketed as a sleep and relaxation aid, so it may appeal to people struggling with insomnia or anxiety. However, before you start, it's essential to check your medications against the full interaction list on this page—especially if you take heart medications, blood thinners, seizure drugs, diabetes medications, thyroid replacements, or sleep aids.

The presence of black hellebore (Christmas Rose), a known poison, is a major safety concern; talk with your pharmacist or doctor before use.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 7 of 10 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 20, 2024.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about ZzZeXX, straight from the product label.

Brand Viatrexx Bio Incorporated
Barcode (UPC) 041910800502
Net contents 1.7 Ounce(s); 50 mL
Market status On market
Date entered into DSLD Jun 20, 2024
DSLD ID 309878
Product type Other Combinations
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
From the label
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 ZzZeXX by Viatrexx Bio Incorporated, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Spray(s)
Maximum serving Sizes:
5 Spray(s)
Servings per container
300
UPC/BARCODE
041910800502
IngredientAmount% DV
Phosphorus0 NP--
Melatonin0 NP--
Proprietary Micro Blend of Trace Amounts and Essences0 NP--
Chamomile0 NP--
Christmas Rose0 NP--
Lemon Balm0 NP--
Oat0 NP--
Pineal Gland0 NP--
Pulsatilla0 NP--
Serotonin0 NP--
Valeriana officinalis0 NP--

Other ingredients: Alcohol, Water

Tap any ingredient to jump to its full detail below.

Label statements
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.
Formulation

Encourages a restful sleep.

Organic alcohol used/Certified organic or wildcrafted sources used whenever possible.

Free of: Gluten, wheat, yeast, corn, dairy, soy, sugar & artificial colors/flavours.

Suggested/Recommended/Usage/Directions

Suggested use: As a dietary supplement, hold nozzle 1" from mouth: 1-5 spray(s) - 1-3 time(s) a day or as recommended by your healthcare practitioner.

Precautions

Caution: Do not exceed recommended dose.

Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult with a healthcare practitioner before taking this or any dietary supplement.

Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult with a healthcare practitioner before taking this or any dietary supplement. Keep out of reach of children.

Do not use if safety seal is damaged or missing.

Storage

Store in a cool, dry place.

FDA Disclaimer Statement

These statements have not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

FDA Statement of Identity

Dietary Supplement

General Statements

For more information visit: Viatrexx.com

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

ZzZeXX by Viatrexx Bio Incorporated label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

ZzZeXX label

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)
What’s inside

The Ingredients in ZzZeXX by Viatrexx Bio Incorporated

These are the 10 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Spray(s) Dosage formLiquid Servings per container300 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.

Proprietary Micro Blend of Trace Amounts and Essences

0 NP per serving

Other (inactive) ingredients: Alcohol, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

ZzZeXX by Viatrexx Bio Incorporated Drug Interactions

Want to check YOUR meds against ZzZeXX?

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.

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1,545Drugs
1,545 Moderate

Ingredients driving the most interactions

Melatonin 1,461
Chamomile 960
Valeriana officinalis 902
Lemon Balm 264
Christmas Rose 133

Individual Drug Interactions

The ingredients in ZzZeXX interact with 1,545 drugs. Click any drug to see the details.

6 of the 10 ingredients in ZzZeXX interact with drugs. Each result below shows which ingredient is responsible. Melatonin Chamomile Valeriana officinalis Lemon Balm Christmas Rose Oat

Each ingredient & the kinds of drugs it affects

For each ingredient in ZzZeXX 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.

Melatonin18 drug types · 1,461 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There are isolated case reports of minor bleeding and decreased prothrombin activity in people taking melatonin with warfarin (Coumadin). The mechanism, if any, of this interaction is unknown. Taking melatonin orally seems to decrease coagulation activity within one hour of dosing in healthy men.

Likelihood Possible Evidence B
Anticonvulsants

Theoretically, melatonin may reduce the effects of anticonvulsants. Some clinical research suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological impairment.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Some clinical research shows that melatonin reduces levels of fasting blood glucose and improves glycemic control. However, other research suggests that melatonin might impair glucose utilization and increase insulin resistance, while other research has found no effect on glucose levels. Until more is known, use melatonin cautiously in combination with antidiabetes drugs.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Some clinical research suggests that taking melatonin decreases blood pressure in healthy adults. Also, melatonin seems to lower systolic and diastolic blood pressure in individuals with high blood pressure at nighttime or untreated essential hypertension. However, melatonin seems to worsen blood pressure in patients who are taking antihypertensive medications. Immediate-release melatonin 5 mg at night in combination with nifedipine GITS (Procardia XL) increases systolic blood pressure an average of 6.5 mmHg, diastolic blood pressure by an average of 4.9 mmHg, and heart rate by 3.9 bpm. Also, results from animal research suggest that melatonin reduces the effectiveness of certain antihypertensive drugs, including methoxamine and clonidine.

Likelihood Possible Evidence A
Caffeine

Theoretically, taking caffeine with melatonin might increase levels of melatonin.
Some evidence suggests that caffeine consumption can decrease endogenous melatonin levels, while other evidence suggests that caffeine increases endogenous melatonin levels. When administered in combination with melatonin supplements, caffeine seems to increase melatonin effects and levels. The reason for this discrepancy is not completely clear. Part of the discrepancy may result from the fact that caffeine can inhibit melatonin synthesis as well as inhibit melatonin metabolism. By functioning as an adenosine receptor antagonist, caffeine may indirectly inhibit the synthesis of melatonin. Conversely, because melatonin and caffeine are both metabolized by cytochrome P450 1A2 (CYP1A2) enzyme, concomitant use of melatonin and caffeine may reduce the metabolism of melatonin, resulting in higher serum levels.

Likelihood Probable Evidence B
Cns Depressants

Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Melatonin has sedative effects. Theoretically, concomitant use of melatonin with alcohol, benzodiazepines, or other sedative drugs might cause additive sedation.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, taking contraceptive drugs with melatonin might increase the effects and adverse effects of melatonin.
Contraceptive drugs can increase the levels of endogenous melatonin. Theoretically, these drugs may increase the effects and adverse effects of oral melatonin.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2. Also, other CYP1A2 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with drugs metabolized by the CYP1A2 enzyme might reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP1A2 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.

Likelihood Probable Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, melatonin might increase levels of drugs metabolized by CYP2C19. Also, other CYP2C19 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2C19 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP2C19 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.

Likelihood Probable Evidence D
Fluvoxamine (Luvox)

Theoretically, taking fluvoxamine with melatonin might increase levels of melatonin.
Fluvoxamine can significantly increase melatonin levels. In some cases, fluvoxamine might increase bioavailability of exogenously administered melatonin by up to 20 times. Some researchers think this might be a beneficial interaction and be potentially useful for cases of refractory insomnia. However, this interaction might also cause unwanted excessive drowsiness and possibly other adverse effects. Fluvoxamine is known to increase endogenous melatonin secretion. It seems to increase serum levels of exogenously administered melatonin possibly by decreasing melatonin metabolism by inhibiting cytochrome P450 (CYP450) 1A2 and 2C19 or by inhibiting melatonin elimination. This effect has been found in healthy people taking fluvoxamine 50-75 mg and melatonin 5 mg.

Likelihood Probable Evidence B
Immunosuppressants

Theoretically, melatonin might interfere with immunosuppressive therapy.
Melatonin can stimulate immune function. Theoretically, melatonin might interfere with immunosuppressive therapy.

Likelihood Possible Evidence B
Methamphetamine (Desoxyn)

Theoretically, taking melatonin with methamphetamine may increase the adverse effects of methamphetamine.
Animal research suggests that melatonin exacerbates the adverse effects of methamphetamine, resulting in greater depression of tryptophan hydroxylase (TPH) and tyrosine hydroxylase (TH) activity, as well as a significant reduction in dopamine levels. This has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine Gits (Procardia Xl)

Theoretically, taking melatonin with extended release nifedipine reduces the effects of nifedipine.
Melatonin can decrease the effectiveness of extended release nifedipine (GITS). Immediate-release melatonin 5 mg at night in combination with nifedipine GITS 30-60 mg daily increases systolic and blood pressure by an average of 6.5 mmHg and 4.9 mmHg, respectively. Concomitant use with melatonin also increases heart rate by 3.9 bpm. The mechanism of this interaction is not known.

Likelihood Probable Evidence B
Seizure Threshold Lowering Drugs

Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Some clinical evidence suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological disabilities.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, melatonin may have antiplatelet effects and may increase the risk of bleeding with warfarin.
Three cases of increased prothrombin time have been reported for patients aged 48-72 years who took melatonin orally in combination with warfarin. However, three cases of decreased prothrombin time have also been reported for patients aged 51-84 years who took melatonin orally in combination with warfarin. Until more is known, use melatonin cautiously in patients taking warfarin.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, melatonin might increase levels of drugs metabolized by CYP2D6.
Laboratory research suggests that certain lots of melatonin inhibit CYP2D6. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2D6 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that certain lots of melatonin inhibit CYP3A4. Theoretically, combined administration of melatonin with certain drugs metabolized by CYP3A4 may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.

Likelihood Possible Evidence D
Flumazenil (Romazicon)

Theoretically, taking flumazenil with melatonin might reduce the effects of melatonin.
Animal research shows that flumazenil may inhibit the effect of melatonin.

Likelihood Possible Evidence D
Melatonin full monograph & interactions

Chamomile9 drug types · 960 drugs

Cns Depressants

Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, large amounts of German chamomile might reduce the effectiveness of oral contraceptives.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, concomitant use of large amounts of German chamomile might interfere with contraceptive drugs through competition for estrogen receptors.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.

Likelihood Possible Evidence D
Estrogens

Theoretically, large amounts of German chamomile might reduce the effectiveness of estrogens.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, large amounts of German chamomile might interfere with hormone replacement therapy through competition for estrogen receptors.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, large amounts of German chamomile might interfere with the activity of tamoxifen.
In vitro, German chamomile has demonstrated antiestrogenic activity.

Likelihood Possible Evidence D
Warfarin (Coumadin)

German chamomile might increase the effects of warfarin and increase the risk of bleeding.
In one case, a 70-year-old female taking warfarin developed retroperitoneal hematoma and bilateral recti muscle bleeding along with an INR of 7.9 following ingestion of German chamomile tea 4-5 cups daily and use of a topical chamomile-based lotion applied 4-5 times daily.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.

Likelihood Possible Evidence D
Chamomile full monograph & interactions

Valeriana officinalis6 drug types · 902 drugs

Alcohol (Ethanol)

Valerian can have additive sedative effects when used concomitantly with alcohol.
Valerian has sedative effects. Theoretically, valerian might have an additive sedative effect when combined with alcohol. Excessive sedation has been reported in an alcohol-abusing individual who took valerian and Gingko biloba. However, the potential interaction between valerian and alcohol has been disputed in other research. Limited evidence suggests that a combination of valerian 160 mg and lemon balm 80 mg (Euvegal) does not cause further deterioration in reaction ability and reaction rate when taken with alcohol as compared to the effects of alcohol alone.

Likelihood Possible Evidence B
Alprazolam (Xanax)

Valerian can have additive sedative effects when used with alprazolam. Also, valerian in high doses might modestly increase alprazolam levels, though this is not likely to be clinically significant.
Valerian has sedative effects. Theoretically, valerian might cause additive sedation when combined with alprazolam. Also, a small pharmacokinetic study shows that taking valerian extract 1000 mg daily (providing 11 mg valerenic acid) might increase alprazolam levels by about 19%. This might be due to valerian's mild inhibition of cytochrome P450 3A4 (CYP3A4). Despite being statistically significant, this increase is not likely to be clinically significant.

Likelihood Possible Evidence B
Cns Depressants

Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Theoretically, concomitant use of valerian and drugs with sedative and anesthetic properties may cause additive therapeutic and adverse effects.

Likelihood Possible Evidence D
Glucuronidated Drugs

Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
In vitro research shows that methanolic valerian extract and valerenic acid might competitively inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1) and UGT2B7.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Although some in vitro evidence suggests that valerian affects CYP2D6, clinical pharmacokinetic (PK) studies show that valerian is unlikely to affect the CYP2D6 enzyme. In one PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days did not affect the metabolism of dextromethorphan, a CYP2D6 substrate. In another PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of debrisoquine, an accepted CYP2D6 probe-substrate.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Although some in vitro evidence suggests that valerian extract might inhibit or induce CYP3A4, clinical pharmacokinetic (PK) studies show that valerian does not have a clinically significant effect on the CYP3A4 enzyme. In one PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of midazolam, an accepted CYP3A4 probe-substrate. In another PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days modestly increases levels of alprazolam, a CYP3A4 substrate, suggesting mild inhibition of CYP3A4. However, this mild inhibition is unlikely to be clinically relevant.

Likelihood Possible Evidence B
Valeriana officinalis full monograph & interactions

Lemon Balm2 drug types · 264 drugs

Cns Depressants

Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Lemon balm seems to have CNS depressant activity in animals and in humans.

Likelihood Possible Evidence B
Thyroid Hormone

Theoretically, lemon balm might interfere with thyroid hormone replacement therapy.
In vitro, constituents of lemon balm extract bind to thyroid stimulating hormone (TSH), preventing TSH receptor-binding and leading to the inhibition of TSH-stimulated adenylate cyclase activity. In animals, lemon balm extract has been shown to decrease levels of circulating TSH and inhibit thyroid secretion.

Likelihood Possible Evidence D
Lemon Balm full monograph & interactions

Christmas Rose6 drug types · 133 drugs

Digoxin (Lanoxin)

Black hellebore contains cardiac glycosides. Using black hellebore in combination with digoxin might have additive effects and increase the risk of toxicity.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, concomitant use of potassium depleting diuretics and black hellebore can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.

Likelihood Possible Evidence D
Macrolide Antibiotics

Theoretically, concomitant use of macrolide antibiotics and black hellebore might increase risk of cardiac glycoside toxicity. Some of these drugs include erythromycin, azithromycin, and clarithromycin.

Likelihood Possible Evidence D
Quinine

Theoretically, concomitant use of quinine and black hellebore can increase the risk of cardiac glycoside toxicity.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, overuse or misuse of stimulant laxatives can increase the risk of cardiac glycoside toxicity due to potassium depletion.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Theoretically, concomitant use of tetracyclic antibiotics and black hellebore might increase the risk of cardiac glycoside toxicity.

Likelihood Possible Evidence D
Christmas Rose full monograph & interactions

Oat2 drug types · 86 drugs

Antidiabetes Drugs

Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.

Likelihood Possible Evidence D
Insulin

Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.

Likelihood Possible Evidence B
Oat full monograph & interactions
The maker

Brand information

Manufacturer and brand details for ZzZeXX, from the product label.

Viatrexx Bio Incorporated

See all Viatrexx Bio Incorporated products
Name
Viatrexx Bio Incorporated
City
Newark
State
DE
ZipCode
19713
Phone Number
1.888.743.6652
Web Address
Viatrexx.com
Pharmacist Counseling Corner

ZzZeXX by Viatrexx Bio Incorporated: Common Questions

Does ZzZeXX by Viatrexx Bio Incorporated interact with any medications?
Yes. Based on its ingredients, ZzZeXX has a known interaction with 1,545 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
ZzZeXX contains 10 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take ZzZeXX while pregnant or breastfeeding?
No. Melatonin is rated Possibly Unsafe in pregnancy. Black hellebore (Christmas Rose) and pulsatilla are Likely Unsafe in both pregnancy and lactation. Valerian is Unsafe in both. Lemon balm should be avoided in pregnancy unless a doctor advises otherwise, and caution is advised while breastfeeding. Talk with your doctor or pharmacist for personalized advice before using this product if you're pregnant or nursing.
What are the most common side effects of ZzZeXX?
The main ingredients—melatonin, valerian, and lemon balm—can cause dizziness, drowsiness, headache, and nausea. Valerian may also cause mental slowness and GI upset. Oats can cause bloating, flatulence, and abdominal distension. These tend to improve with continued use or lower doses.
Does ZzZeXX actually help with sleep and anxiety?
Melatonin is Likely Effective for two specific sleep disorders: non-24-hour sleep–wake disorder and delayed sleep phase syndrome. For general insomnia, valerian is Possibly Effective. Melatonin is also Possibly Effective for anxiety before medical procedures. For everyday stress and mood, lemon balm is Possibly Effective. Keep in mind that "possibly" means the evidence supports some benefit, but it's not as robust as "likely" effective.
Is it safe to drink alcohol while taking ZzZeXX?
No. Valerian in this product can have additive sedative effects when combined with alcohol, which may lead to excessive drowsiness or impaired judgment. Avoid alcohol while using this supplement.
Why does ZzZeXX contain black hellebore if it's toxic?
The product facts indicate black hellebore is a component, and the data clearly warns that all parts are poisonous and can cause serious, potentially fatal harm. This ingredient carries significant safety risks, including GI irritation and irregular heartbeat. You should talk with a pharmacist or doctor before using any product containing this ingredient.
Do I need to taper off ZzZeXX if I stop taking it?
Yes, if you've used it for an extended period. Valerian, one of the main ingredients, can cause withdrawal symptoms like anxiety, irritability, insomnia, and vivid dreams if stopped abruptly after long-term use. Taper your dose slowly under the guidance of your pharmacist or doctor.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

ZzZeXX label
Go deeper

The Full Monographs Behind ZzZeXX’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Melatonin

Interacts with 1,461 drugs

Melatonin is a hormone your body makes naturally to help control your sleep-wake cycle, and the supplement form is widely used to help with sleep timing problems and jet lag. The evidence is...

Read the full Melatonin monograph → Herb & supplement monograph

German Chamomile

Interacts with 960 drugs

German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin o...

Read the full German Chamomile monograph → Herb & supplement monograph

Black Hellebore

Interacts with 133 drugs

Black Hellebore is a highly toxic plant that was used in old folk medicine but has no proven, safe modern use. Because even small amounts can cause severe poisoning and dangerous heart rhyth...

Read the full Black Hellebore monograph → Herb & supplement monograph

Lemon Balm

Interacts with 264 drugs

Lemon balm is a gentle, lemon-scented mint-family herb traditionally used to ease stress, support sleep, and calm digestion, and topically for cold sores. Early studies are promising but gen...

Read the full Lemon Balm monograph → Herb & supplement monograph

Oats

Interacts with 86 drugs

Oats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...

Read the full Oats monograph → Herb & supplement monograph

Pulsatilla

Pulsatilla is a flowering plant in the buttercup family that is most often used today in homeopathic (highly diluted) preparations. The fresh plant is toxic and irritating, so it must never...

Read the full Pulsatilla monograph → Herb & supplement monograph

Valerian

Interacts with 902 drugs

Valerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some people sleep but does not work reliably...

Read the full Valerian monograph →
Sources

Sources & How We Checked

ZzZeXX'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.

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 203 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.

Melatonin 118 references
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German Chamomile 15 references
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Black Hellebore 5 references
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Lemon Balm 12 references
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Oats 13 references
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Pulsatilla 3 references
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Valerian 37 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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