Is Garlique Safe To Take With Blood Pressure Medication?

Answer

Thanks for reaching out! I want to start off by clarifying that there are two different 'Garlique' products, one marketed for blood pressure and the other for cholesterol. Since you mentioned that you are looking to take a dietary supplement to help with your blood pressure, I'll focus on that product.

I provide more details in the next sections, but Garlique contains garlic powder, which has been purported to lower blood pressure, and although evidence is mixed, some studies do report that garlic may have a modest effect in lowering blood pressure in some individuals.

In terms of drug interactions, it does have a few theoretical ones that are important to be aware of.

Additionally, although not a 'drug interaction' per se, you have to keep in mind that taking multiple agents that lower blood pressure could increase your risk of hypotension, or low blood pressure, which can cause some symptoms to be concerned about, such as dizziness and lightheadedness.

In other words, if you are taking a medication to lower blood pressure (like lisinopril and amlodipine for example), adding on another agent (like Garlique) could lower blood pressure more than intended, and cause hypotension.

Therefore, it's important to let your doctor know of all the medication you are taking so you can be appropriately monitored.

What Is In Garlique?

Garlique Healthy Blood Pressure Formula contains:

• Garlic Powder ([bulb] not less than 1800 mcg allicin)

It also contains various inactive ingredients, but those aren't of concern here.

Although garlic, being a natural product, contains a variety of constituents, most dietary supplements that contain it are standardized for their allicin content, a component of garlic thought to be responsible for a majority of its purported health benefits.

So, when we talk about potential drug interactions with Garlique, we are more talking about what drugs interact with garlic.

Garlic And Blood Pressure Medication

As mentioned, some studies have reported that garlic supplements can help to lower blood pressure in some individuals. Most studies report an average blood pressure lowering of systolic blood pressure (the top number) between 3 and 10 mmHg, depending on the study.

Aside from the general concern I spoke about in the previous section, that taking multiple medications intended to lower blood pressure could lead to hypotension, there are some specific drug interactions to know about.

CYP3A4 Substrates

CYP3A4 is a major metabolizing enzyme in the body and some studies have reported that garlic could either induce it (i.e., increase its effects) or inhibit it.

Therefore, any drug that is metabolized via this enzyme has a potential interaction with garlic dietary supplements, like Garlique.

For example, one study reported that garlic (among other supplements) reduced blood concentrations of several antiviral drugs due to the induction of the CYP3A4 enzyme. This potentially reduced the overall effectiveness of these drugs.

Conversely, another study, which was actually a case report, reported that a garlic supplement increased levels of tacrolimus (thought to be due to CYP3A4 inhibition).

Overall, the evidence here is quite mixed and it's unknown just how much of an effect garlic has on this enzyme and what doses of garlic need to be taken to alter the activity of the enzyme.

Regardless, if you take a blood pressure medication that is primarily metabolized by CYP3A4, you should know that it could potentially interact with garlic and have its effect increased or decreased.

Some blood pressure medications that are metabolized by CYP3A4 include:

• Amlodipine
• Diltiazem
• Verapamil
• Nifedipine
• Losartan
• Felodipine
• Propranolol
• Bisoprolol
• Carvedilol
• Eplerenone
• Indapamide
  

The 'calcium channel blocker' drug class is mostly metabolized by CYP3A4, and this includes amlodipine, a drug you stated you were taking. If garlic inhibits or induces CYP3A4 metabolism, which studies say may be the case, amlodipine could be affected.

What About ACE-Inhibitors And ARBs?

Two of the more common drug classes used to treat blood pressure are ACE-Inhibitors and ARBs (angiotensin receptor blockers). ACE-Inhibitors include:

• Lisinopril
• Benazepril
• Captopril
• Enalapril
• Fosinopril
• Moexipril
• Perindopril
• Quinapril

ARBs include:

• Azilsartan
• Candesartan
• Eprosartan
• Irbesartan
• Losartan
• Olmesartan
• Telmisartan
• Valsartan 
  

You stated you are taking lisinopril in your question, an ACE-Inhibitor.

Fortunately, none of these drugs (with the exception of losartan) are primarily metabolized by CYP3A4, so avoid a potential interaction with garlic. If you take losartan, that however, may be affected (it is metabolized by multiple enzymes, including CYP3A4). 

Pharmacist Thoughts

To sum up, we've got two types of potential interactions with Garlique.

The first is the concern that taking two medications intended to lower blood pressure could put you more at risk of it dropping too low and the second is the potential interaction with any drug that is metabolized by CYP3A4.

In regard to the first concern, the additive blood pressure lowering effects could be seen as a positive here, but I do think it is important that you are aware of the signs and symptoms of low blood pressure (i.e., hypotension).

If you monitor your blood pressure with a machine, be sure to take it consistently and make sure you are in the range you and your doctor would like to see. If it's dropping too low, you may need some medication adjustments.

In regard to the actual drug interactions with CYP3A4 drugs, I would say the clinical concern here is relatively low.

While garlic has been shown in some studies to have an effect on the CYP3A4 enzyme, it appears to be to a relatively mild degree, and for any effect it may have on a blood pressure drug, like amlodipine, dosage adjustments are always possible. If side effects occur, they can be dealt with fairly easily.

I would be far more concerned about the potential drug interaction that some studies have shown between garlic and antiviral drugs, which could lead to treatment failure in some cases.

Final Words

I hope you found this answer helpful! Please reach back out anytime.