Medication Side Effects

Nutrients connected to Medication Side Effects

A link means the body needs the nutrient for this, or that low intake is linked to it. It does not mean extra supplements help if your intake is already adequate; each link shows how strong the evidence is.

• Vitamin KDocumented risk

  Long-term antibiotic treatment can lead to deficiency, and vitamin K weakens the effect of warfarin.

• MagnesiumDocumented risk

  Some medicines lower magnesium, including diuretics, proton pump inhibitors and certain antibiotics and anti-cancer drugs. Magnesium products can also affect how other medicines are taken.

• AshwagandhaDocumented risk

  NCCIH says it might interact with diabetes, blood pressure, immunosuppressant, sedative, anti-seizure and thyroid hormone medicines. Ask a pharmacist.

• ChamomileDocumented risk

  Interactions have been reported with warfarin and some medicines processed by the liver; chamomile may also weaken birth control pills (preliminary). Ask a pharmacist first.

• GarlicDocumented risk

  NCCIH says garlic supplements may increase bleeding risk, with caution for anticoagulants, aspirin and other medicines that affect bleeding.

• St. John's wortDocumented risk

  NIH says it has clearly been shown to interact, sometimes dangerously, with many medicines, including some antidepressants, birth control pills, cyclosporine, anti-seizure drugs, HIV and cancer drugs, warfarin and some statins.

• RhodiolaDocumented risk

  Rhodiola can interact with some medicines (losartan, antidepressants, possibly warfarin and phenytoin). Ask a pharmacist first.

• BarberryDocumented risk

  Barberry and berberine affect liver enzymes that process many medicines (CYP2D6, CYP3A4), so interactions are possible. A related berberine herb lowered metformin levels.

• BoswelliaDocumented risk

  May raise bleeding risk with anticoagulant or antiplatelet drugs; lab studies show effects on drug transporters with unknown clinical meaning.

• AstragalusDocumented risk

  It may interact with immune-suppressing medicines; lab work suggests effects on drug-processing enzymes. Ask a prescriber.

• Licorice rootDocumented risk

  Licorice can counteract blood pressure medicines and add to the potassium-lowering effect of water pills, corticosteroids and some laxatives. It may also modestly change how CYP3A4-processed medicines are handled.

• SchisandraDocumented risk

  Schisandra may change blood levels of medicines handled by liver enzymes or P-glycoprotein, and raised tacrolimus levels in transplant patients. Check with a pharmacist or doctor first.

• American ginsengDocumented risk

  In a trial in 20 healthy volunteers it lowered warfarin's blood-thinning effect, and glucose lowering means diabetes medicines may need monitoring. Ask the prescriber or pharmacist before combining.

• GoldensealDocumented risk

  Goldenseal can lower or raise levels of some medicines (metformin lower, a CYP3A test drug higher) and may affect others cleared the same way. Check with a pharmacist.

• GymnemaDocumented risk

  With diabetes medicines, low blood sugar episodes were reported and doses were adjusted; animal data also suggest possible effects on drug-processing enzymes.

• Panax notoginsengDocumented risk

  Notoginseng may add to the effect of blood thinners (warfarin in rats, clopidogrel in platelet studies) and alters drug-handling enzymes. Ask a pharmacist before combining.

• BerberineDocumented risk

  Berberine can raise cyclosporine levels and may affect tacrolimus, liver-processed medicines and diabetes drugs, so it can change how prescribed medicines work.

• MangosteenDocumented risk

  MSK lists possible effects on drugs processed by P450 enzymes and additive immune suppression with cyclosporine or tacrolimus.

• Danshen (red sage root)Documented risk

  Case reports and a 2026 hospital-database study link danshen with bleeding when taken with warfarin and other oral anticoagulants. Avoid the combination unless a prescriber agrees. Danshen may also reduce clopidogrel's platelet effect.

• KannaDocumented risk

  Kanna acts on serotonin like SSRIs, and a medicine-information page lists antidepressants, triptans, antipsychotics and St. John's wort to discuss first. Not tested together; ask a pharmacist.

• MaitakeDocumented risk

  Maitake can raise bleeding risk with warfarin and add to the effect of diabetes medicines (MSK; a case report of raised INR).

• Almond mushroom (Agaricus subrufescens)Documented risk

  Lab data suggest mild inhibition of CYP3A4 and P-glycoprotein, and case reports describe liver injury in people receiving cancer treatment. Ask a pharmacist before combining with medicines.

• Mulberry leafDocumented risk

  May add to diabetes medicines and risk low blood sugar.

• YohimbeDocumented risk

  NCCIH and MSK list interactions with MAOIs, tricyclic antidepressants, bupropion, blood pressure medicines and others.

• Griffonia (5-HTP source)Documented risk

  Major interaction with antidepressants; further cautions with carbidopa, dextromethorphan, meperidine, pentazocine, tramadol and sedatives. Ask a pharmacist.

• Houttuynia (yu xing cao)Documented risk

  Injection reactions were 8.8 times more likely when given with macrolide antibiotics; many cases also involved penicillins and cephalosporins.

• Pleurisy rootDocumented risk

  Digoxin is a major interaction in a consumer reference, and PeaceHealth lists beta-blockers and calcium channel blockers; water pills and estrogen medicines are moderate interactions. Ask a pharmacist.

• Sutherlandia (cancer bush)Documented risk

  Sutherlandia may interact with HIV medicines (lower atazanavir levels in a small study) and with isoniazid for tuberculosis prevention (two cases in a trial). MSK advises avoiding these combinations.

• Citrus Fruits (overview)Documented risk

  Grapefruit can change blood levels of some medicines; Seville orange and pomelo might too; orange juice can lower absorption of some.

• GrapefruitDocumented risk

  Grapefruit juice can raise the blood level of some medicines (and lower it for fexofenadine); ask a pharmacist before eating it with regular medicines.

• Leafy Greens (overview)Documented risk

  Vitamin K-rich greens such as kale, collards and spinach can affect warfarin, so patient guidance says to keep intake steady and tell the clinic about changes; do not avoid greens on your own.

• SpinachDocumented risk

  Vitamin K in spinach can change how warfarin works; keep intake steady and ask the warfarin clinic. High potassium matters with ACE inhibitors, ARBs and potassium-sparing diuretics.

• KaleDocumented risk

  The high vitamin K content of kale can affect warfarin; keep intake steady and tell the clinic.

• Arugula (Rocket)Documented risk

  Arugula is high in vitamin K, which can weaken warfarin. People on warfarin should keep intake steady and ask their prescriber.

• Lettuce (Romaine & Leaf)Documented risk

  Vitamin K in lettuce can change how warfarin works; keep intake steady and tell the warfarin clinic.

• Swiss ChardDocumented risk

  Chard is very high in vitamin K, which can change warfarin's effect if intake changes suddenly; consistency is advised.

• Collard GreensDocumented risk

  Collards are very high in vitamin K, which can change how warfarin works; steady intake and clinic advice matter.

• WatercressDocumented risk

  Watercress is very high in vitamin K, which can change how warfarin works; keep intake steady and tell your clinic.

• Mustard GreensDocumented risk

  Mustard greens are very rich in vitamin K, which can change how warfarin works; the NHS says to ask the warfarin clinic rather than avoid leafy greens.

• Chicory, Endive & RadicchioDocumented risk

  Endive and radicchio are rich in vitamin K, which affects how warfarin works. MedlinePlus advises keeping vitamin K intake steady and asking the provider.

• BroccoliDocumented risk

  Broccoli is high in vitamin K, which affects how warfarin works; keep intake steady and tell the care team about big changes.

• Brussels SproutsDocumented risk

  Brussels sprouts are high in vitamin K, which affects warfarin. Keep intake steady and tell your clinic before big changes.

• Bok ChoyDocumented risk

  Vitamin K in bok choy can change how warfarin works if intake swings; keep intake steady and tell your clinic.

• Scotch broomDocumented risk

  Major interactions are listed with MAOI antidepressants, haloperidol and quinidine; moderate with lithium. Based on one consumer reference.

• Autumn crocus (colchicum)Documented risk

  Some antibiotics, antifungals, cyclosporine, protease inhibitors and statins can raise colchicine levels; fatal interactions with clarithromycin are described.

• AsparagusDocumented risk

  Vitamin K in asparagus can change how warfarin works, so keep intake steady and tell the prescriber.

• Wintergreen OilDocumented risk

  Case reports and a patient series describe raised INR and bleeding with topical methyl salicylate in people taking warfarin.

• Licorice Root TeaDocumented risk

  The EU monograph says licorice may counteract blood pressure medicines and should not be used with diuretics, heart glycosides, corticosteroids or stimulant laxatives.

• Ashwagandha TeaDocumented risk

  Possible interactions with sedatives, diabetes, blood pressure, thyroid, anticonvulsant and immunosuppressant medicines (NIH).

• Ginseng TeaDocumented risk

  Interactions with warfarin, insulin and sulfonylureas, and MAOIs (trial, MSK, NIH).

• Lapacho (Pau d'Arco) TeaDocumented risk

  May add to the effect of blood-thinning and antiplatelet medicines (lapachol, vitamin K-related enzymes); clinical relevance not known.

• Cat's Claw TeaDocumented risk

  Theoretical interaction with blood thinners, antiplatelets and blood pressure drugs; cell work shows CYP3A4 induction.

• Hawthorn TeaDocumented risk

  Possible interactions with anticoagulants, digoxin and blood-pressure medicines (LactMed); NIH raises a possible drug interaction in one heart failure study.

• Schisandra TeaDocumented risk

  Lab and animal work suggests effects on CYP enzymes and P-glycoprotein; a related-species capsule raised tacrolimus levels.

• Goji Berry TeaDocumented risk

  Case reports of high INR and bleeding with warfarin after goji juice, tea and wine; lab CYP enzyme effects.

• Kava, Kratom and Blue Lotus TeasDocumented risk

  Kava should not be combined with benzodiazepines or alcohol (NCCIH); kratom deaths usually involved other drugs (FDA).

• Sweet Birch OilDocumented risk

  Methyl salicylate used on the skin has raised INR and caused bleeding in people on warfarin (a case series and a case report); Tisserand advises against sweet birch oil with blood thinners.

• Fenugreek TeaDocumented risk

  Fenugreek may lower blood sugar (diabetes medicines) and can interact with warfarin to cause bleeding, per EMA and LactMed.

• Dong Quai TeaDocumented risk

  Dong quai may add to the effect of warfarin and other blood thinners (case report, MSK, LactMed) and may change levels of drugs cleared by CYP3A4.

• Aged CheeseDocumented risk

  Tyramine in aged cheese can cause a serious reaction in people taking MAOI antidepressants.

• NattoDocumented risk

  Natto is high in vitamin K and warfarin users are told to keep vitamin K intake steady; ask the anticoagulation clinic before changing how much natto you eat.

• Salt Substitutes (Potassium Chloride)Documented risk

  ACE inhibitors, ARBs and spironolactone can raise potassium, adding to a salt substitute.

• Bone Health FormulasDocumented risk

  Vitamin K can weaken warfarin; calcium can reduce absorption of thyroid medicine.

• Multi-Ingredient Brain FormulasDocumented risk

  Ginkgo may raise bleeding risk with blood thinners; stimulants and undeclared drug ingredients can add to medicine effects. Ask a pharmacist.

• Greens PowdersDocumented risk

  Vitamin K from leafy greens can reduce how well warfarin works; ask a pharmacist or warfarin clinic. Supplements can also interact with other medicines.

• Vitamin ADocumented risk

  Vitamin A supplements may interact with isotretinoin, an acne medicine that can cause birth defects.

• Vitamin DDocumented risk

  Some statins, steroids and weight-loss medicines can affect vitamin D levels. Never stop a prescribed medicine on your own.

• Vitamin B9 (folate and folic acid)Deficiency link

  Some medicines, such as anticonvulsants and proton pump inhibitors, can lead to folate deficiency anaemia, and folic acid can interact with several others.

• Vitamin B12Documented risk

  Proton pump inhibitors, metformin and nitrous oxide can lower B12 levels. Do not stop a prescribed medicine without advice.

• PotassiumDocumented risk

  Some medicines, including diuretics, can lower or raise blood potassium. Ask a pharmacist or prescriber before changing anything.

• Fish oilDocumented risk

  Prescription omega-3 labels say omega-3 acids may prolong bleeding time and people on anticoagulant or antiplatelet drugs should be monitored. Ask a pharmacist before combining, and do not stop prescribed medicine on your own.

• Krill oilDocumented risk

  Prescription omega-3 labels warn of increased bleeding, especially with aspirin, clopidogrel or warfarin, and advise monitoring; no krill-specific data were found. Do not change medicines without asking the prescriber.

• Omega-3 fatty acids (ALA, EPA and DHA)Documented risk

  Prescribing information for omega-3 medicines notes longer bleeding time in some studies and higher bleeding risk with anticoagulants and antiplatelet drugs. Ask a clinician or pharmacist, especially before surgery.

• Evening primrose, borage and GLA oilsDocumented risk

  A study cited in the Cochrane eczema review suggests evening primrose oil may increase bleeding in people taking warfarin. Ask a pharmacist before combining.

• Green tea extract and EGCGDocumented risk

  Green tea or its extract lowered blood levels of nadolol and atorvastatin and interacted with raloxifene, so it may change how some medicines work.

• Grape seed extract and pine bark extract (oligomeric proanthocyanidins, OPC)Documented risk

  May increase bleeding risk with warfarin-type blood thinners, and grape seed extract affected liver drug-processing enzymes in the lab. Ask a pharmacist about your medicines.

• Lactobacillus and Bifidobacterium probioticsPreliminary or mixed

  Diarrhoea caused by antibiotics is the best-studied use; some strains reduced it in trials, though NCCIH calls the adult finding tentative.

• Lactobacillus rhamnosus GGClinically supported

  Diarrhoea caused by antibiotics: LGG is recommended for prevention in at-risk children by ESPGHAN (strong recommendation, moderate-quality evidence).

• Saccharomyces boulardiiClinically supported

  Diarrhoea caused by antibiotics is the best-studied use: ESPGHAN gave a strong recommendation in children with risk factors, and the AGA conditionally suggests it for C. difficile prevention, with low-quality evidence.

• HibiscusDocumented risk

  A hibiscus drink lowered simvastatin exposure in six volunteers; animal studies suggest an interaction with a water pill; added blood-pressure lowering with blood pressure drugs is a reasoned caution.

• LavenderDocumented risk

  NIH says lavender might theoretically interact with sedative drugs or herbs, which matters before surgery. The EU monograph reports no interactions; ask a pharmacist.

• SaffronDocumented risk

  A case report described acute bleeding in a man taking rivaroxaban with a saffron supplement; the authors advise caution with anticoagulant and antiplatelet medicines. Saffron has also been combined with antidepressants in trials, so ask a pharmacist about any combination.

• TurmericDocumented risk

  Turmeric may raise bleeding risk with blood thinners and may change the effect of some other medicines. Most evidence is lab, animal or single-case, so ask a pharmacist before combining.

• GingerDocumented risk

  Ginger supplements may add to the bleeding risk of warfarin, other blood thinners and NSAIDs, and may affect diabetes medicines, tacrolimus and cyclosporine. The EU summary reports no described interactions, so sources differ; ask a pharmacist.

• OreganoDocumented risk

  One case report describes a high clotting test (INR 6.42) in a woman on a blood thinner after about a week of daily oregano tea. One case cannot show how often this happens, but the authors say the interaction should be recognised and monitored.

• CranberryDocumented risk

  Evidence is conflicting about whether cranberry affects warfarin, so people on blood thinners should check with a prescriber.

• Aloe veraDocumented risk

  NCCIH says overuse of aloe latex may increase side effects of heart medicines called cardiac glycosides, such as digoxin. Ask a pharmacist before combining.

• FenugreekDocumented risk

  Its blood-sugar-lowering effect can add to diabetes medicines, so glucose should be monitored.

• EchinaceaDocumented risk

  Evidence is conflicting for interaction with some liver-processed drugs and theoretical for immunosuppressants and caffeine; ask a pharmacist.

• ArnicaDocumented risk

  Arnica may increase the effects of warfarin and other blood thinners and inhibits platelets in the lab; clinical importance is unknown, so ask a pharmacist.

• GoldenrodDocumented risk

  The EU monograph does not recommend using goldenrod together with synthetic diuretics (water pills).

• Saw palmettoDocumented risk

  Case reports describe extra bleeding with blood thinners and more side effects with NSAIDs. Lab work suggests it may affect liver enzymes that clear some medicines; the clinical meaning is unknown.

• SennaDocumented risk

  Can interact with heart medicines, diuretics, steroids and liquorice; low potassium adds to their effects.

• AmlaDocumented risk

  Amla extract reduced platelet aggregation and lengthened bleeding time, alone and with clopidogrel or aspirin, in a small study. Tell a clinician if you take blood thinners.

• Burdock rootDocumented risk

  The EU monograph does not recommend using burdock root with synthetic water tablets (diuretics), and the report notes lab findings about diabetes medicines with other plant parts. The report found no documented interactions otherwise.

• PassionflowerDocumented risk

  Might interact with anesthesia and other medicines used around surgery; ask a provider or pharmacist before combining with sedating medicines.

• ValerianDocumented risk

  Should not be combined with alcohol or sedatives; NIH advises checking with a provider about other medicines.

• Black seedDocumented risk

  Black seed may inhibit the liver enzymes CYP2D6 and CYP3A4 and could change levels of medicines cleared by them; thymoquinone inhibited warfarin activity in a lab study. Whether this matters in people is not known. Ask a pharmacist.

• HawthornDocumented risk

  Hawthorn may interact with digoxin and other heart medicines. One small trial found no change in digoxin levels, but a lab study found test interference and advised people on digoxin to avoid it; ask a pharmacist first.

• FeverfewDocumented risk

  May interact with some medicines, including some migraine drugs, and may add to the effect of blood thinners.

• BilberryDocumented risk

  Bilberry has been reported to lower blood glucose, so it may add to the effect of diabetes medicines. Ask a pharmacist.

• Gotu kolaDocumented risk

  Gotu kola itself can be the cause of a harmful reaction (liver injury) in case reports.

• NoniDocumented risk

  Noni may be unsafe with medicines that raise potassium, lower blood pressure or harm the liver, and case reports describe weaker effects of warfarin and phenytoin.

• Devil's clawDocumented risk

  A 2000 pharmacy review listed devil's claw among products with reports of possible interaction with warfarin; most herb-warfarin data come from lab, animal or single-case reports.

• Willow barkDocumented risk

  May add to the bleeding effects of warfarin and the stomach risk of NSAIDs.

• AndrographisDocumented risk

  Hypersensitivity reactions, including anaphylaxis, have been reported with andrographis products, and injectable derivatives caused life-threatening anaphylaxis. Tell a clinician if you take it.

• EleutheroDocumented risk

  May interfere with digoxin test results and, in lab studies, with some drug-handling enzymes. Reports of bleeding with antidepressants are not proof of cause.

• Asian ginsengDocumented risk

  Interacts with insulin, sulfonylureas, MAOIs, warfarin (mixed), aspirin, imatinib and raltegravir.

• Black cohoshDocumented risk

  It may interfere with tamoxifen and add toxicity with some chemotherapy drugs; clinical meaning is unknown. Ask a prescriber or pharmacist.

• Cat's clawDocumented risk

  NCCIH notes theoretical interactions with blood thinners, blood pressure drugs and other supplements; a cell study found extracts activate PXR, which was not shown in people.

• ChasteberryDocumented risk

  Lab studies suggest it may weaken hormone medicines and affect antipsychotic and Parkinson's medicines; clinical meaning is unknown, so check with a prescriber.

• Coleus forskohlii (forskolin)Documented risk

  Forskolin may add to blood pressure medicines and may inhibit platelets (bleeding or bruising with blood thinners); it may also induce CYP3A enzymes. Clinical relevance is not determined, so ask a pharmacist.

• Dong quaiDocumented risk

  Dong quai can interact with medicines: it may raise bleeding risk with warfarin and may change how some drugs (such as clozapine) are processed.

• Guduchi (giloy)Documented risk

  Herb-induced liver injury is a recognised unwanted effect of guduchi products. One case was judged probable by a standard causality score, and symptoms eased after the product was stopped.

• GuggulDocumented risk

  Guggul lowered blood levels of propranolol and diltiazem in a small study, which could weaken those medicines. Ask a pharmacist.

• PeriwinkleDocumented risk

  Possible additive effects with blood thinners and blood pressure medicines, and laboratory evidence of P-glycoprotein inhibition.

• Red cloverDocumented risk

  May add to the effects of blood thinners, may affect drug-clearing enzymes and was linked to toxicity with methotrexate in a case report. Clinical relevance is not fully determined.

• Stinging nettleDocumented risk

  Nettle may add to blood sugar, diuretic and blood pressure medicines and may affect liver-processed drugs; clinical relevance is not yet determined.

• TribulusDocumented risk

  Possible added effects with diuretics, blood pressure and diabetes medicines; stent thrombosis reported with clopidogrel plus a tribulus-containing formula.

• PsylliumDocumented risk

  Psyllium can delay absorption of other medicines (for example digoxin and lithium) and needs spacing; diabetes and thyroid medicine may need adjusting.

• MyrrhDocumented risk

  MSK advises against myrrh with warfarin based on a case report in which warfarin's effect seemed weaker.

• KavaDocumented risk

  Kava should not be combined with alcohol, benzodiazepines or other sedatives, and may add to the liver effects of acetaminophen. Ask a pharmacist.

• SarsaparillaDocumented risk

  RxList rates two interactions as moderate: sarsaparilla might raise digoxin absorption, and its water-pill-like effect might raise lithium levels.

• LobeliaDocumented risk

  Lobelia may add to the effects of nicotine products and cause toxicity, according to MSK; no other specific drug interactions were listed.

• ArjunaDocumented risk

  Arjuna may add to or change the effects of heart, blood pressure, cholesterol, blood-thinning and heart-rhythm medicines; human research is insufficient to confirm it, so ask a pharmacist.

• Bitter orangeDocumented risk

  NCCIH advises talking to a health professional before combining bitter orange with medicines, and products often add caffeine and other stimulants. Specific interaction data were not found in the sources read.

• ChiaDocumented risk

  MSK says chia may add to blood pressure medicines and may lower blood sugar; ask a pharmacist.

• Yerba mateDocumented risk

  The EU monograph advises caution with MAO inhibitors and says caffeine can weaken sedatives and increase side effects of stimulant-type drugs.

• GuaranaDocumented risk

  Guarana may add to other stimulants, may raise bleeding risk with blood thinners (lab findings) and may lower amiodarone levels (rat study); clinical relevance is not known.

• RooibosDocumented risk

  Rooibos may lower levels of the transplant drug tacrolimus and may interfere with some chemotherapy; check with a pharmacist.

• Horny goat weedDocumented risk

  May affect CYP3A4-handled medicines and aromatase inhibitors; clinical relevance is unknown, so ask a pharmacist.

• FlaxseedDocumented risk

  Fiber such as linseed can delay absorption of other medicines (EMA), and NCCIH describes blood-thinner interactions as theoretical. Ask a pharmacist about timing.

• TriphalaDocumented risk

  MSK says triphala blocks the liver enzymes CYP3A4 and CYP2D6 and may raise levels of medicines they clear; monographs for Terminalia chebula also mention omeprazole, chlorzoxazone and diabetes medicines.

• MeadowsweetDocumented risk

  The EU monograph advises against using meadowsweet with salicylates or other NSAID medicines without medical advice. EU reviewers consider an interaction unlikely but found no clinical interaction data.

• Pau d'arcoDocumented risk

  Pau d'arco may add to the bleeding risk of blood-thinning and antiplatelet medicines (clinical relevance unknown); another source also lists NSAIDs. Ask a pharmacist.

• BupleurumDocumented risk

  Lab and animal findings suggest effects on liver enzymes that clear many medicines; the formula adds a pneumonitis risk with interferon. Clinical relevance is unknown.

• CorydalisDocumented risk

  WebMD says corydalis may add to sedating medicines and alcohol, may weaken dopamine-type medicines, and may slow the breakdown of some medicines. The evidence on interactions is incomplete.

• Reishi (lingzhi)Documented risk

  MSK flags possible interactions with blood thinners (bleeding risk, though one healthy-volunteer trial saw no clotting change) and immunosuppressants. Evidence is limited and mixed.

• CordycepsDocumented risk

  May add to blood thinners and to blood-sugar medicines (MSK).

• ChagaDocumented risk

  Chaga may add to the effect of blood thinners (animal data) and diabetes medicines (lab data); clinical importance is not known.

• Turkey tailDocumented risk

  No interaction list was found, but MSK notes overlap with chemotherapy side effects, so the care team should know about any product.

• BladderwrackDocumented risk

  Possible interactions with lithium, thyroid medicines, iodine-containing drugs, blood-pressure medicines and blood thinners are listed by the EU; a case report describes hyperthyroidism with lithium. Ask a pharmacist.

• KudzuDocumented risk

  MSK says not to combine kudzu with tamoxifen or methotrexate and that it may add to diabetes medicines; clinical relevance is not established.

• JujubeDocumented risk

  The seed formula may add to drowsiness from some medicines and may interact with SRIs and MAOIs (MSK). A consumer drug reference also flags blood sugar and antidepressants; sources disagree, so ask a pharmacist.

• Magnolia barkDocumented risk

  May add to drowsiness from sedatives and sleep medicines (consumer drug reference and lab authors' expectation); WebMD also advises against combining with blood thinners. No interaction trial was read; ask a pharmacist.

• PhellodendronDocumented risk

  Berberine, found in the bark, raised cyclosporine levels in transplant adults and lowers some liver-enzyme activity. No study of the bark itself was found, so ask a pharmacist.

• Coptis (goldthread)Documented risk

  Berberine raised cyclosporine levels in transplant recipients and may affect tacrolimus, diabetes medicines and liver-processed medicines; most other interactions are predicted from lab work.

• Isatis (ban lan gen)Documented risk

  MSK advises not to take isatis root or leaf with CYP3A4 medicines because indirubin may change their handling; the clinical importance is unknown.

• Prickly pear (nopal)Documented risk

  Consumer references report case reports of low blood sugar with diabetes medicines, though another lists no well-documented interactions; ask a pharmacist.

• Graviola (soursop)Documented risk

  MSK says graviola may add to the effects of diabetes and blood-pressure medicines; clinical relevance is unknown. Ask a pharmacist.

• HoodiaDocumented risk

  MSK says people taking medicines processed by CYP3A4 should not take hoodia (lab finding, clinical relevance not known); the human trial also showed raised blood pressure, pulse and some blood tests. Ask a pharmacist.

• GuayusaDocumented risk

  A consumer drug reference lists a major interaction with ephedrine and other stimulants.

• Long pepperDocumented risk

  Piperine from long pepper can change how medicines are absorbed and cleared, with possible harmful or reduced effects depending on the drug. Evidence is mostly from isolated piperine; ask a pharmacist.

• Rhubarb rootDocumented risk

  MSK lists possible interactions with digoxin, CYP450 medicines, melatonin, cyclosporine and methotrexate; clinical relevance is unclear for most.

• Garcinia cambogiaDocumented risk

  NCCIH says Garcinia may interact with medicines that affect the liver or serotonin; lab work suggests it blocks the enzyme CYP2B6. Ask a pharmacist.

• Mucuna pruriens (velvet bean)Documented risk

  The seed contains levodopa, so it can add to levodopa medicines and may share cautions with MAO inhibitors (inferred from levodopa medicine information). Ask a pharmacist.

• Green coffee beanDocumented risk

  Caffeine in some products can interact with many medicines; per a consumer drug reference. Ask a pharmacist.

• Irvingia (African mango seed)Documented risk

  Can add to the blood-sugar-lowering effect of diabetes medicines; a consumer reference also lists a testosterone interaction and MSK notes possible reduced absorption of other medicines.

• BergamotDocumented risk

  A 2025 review says interaction data with cholesterol medicines are lacking and suggests monitoring; a consumer reference also lists blood-sugar and sun-sensitivity cautions. Ask a pharmacist.

• CatuabaDocumented risk

  A consumer drug reference advises caution with SSRIs, SNRIs and MAOIs; research is incomplete, and some products reportedly held unlisted drugs.

• Cinchona barkDocumented risk

  Quinine from cinchona can cause serious reactions (heart rhythm, bleeding, allergy) and interacts with antacids; ask a pharmacist before any cinchona or quinine product.

• Betel nut (areca nut)Documented risk

  A consumer drug reference lists interactions with anticholinergic, cholinergic and MAO inhibitor medicines; not confirmed in an official page we read.

• Kola nutDocumented risk

  Caffeine in kola can interact with several medicines, including MAO inhibitors. Ask a pharmacist.

• SafflowerDocumented risk

  A consumer drug reference flags blood thinners and antiplatelet drugs as medicines to check with safflower flower; interactions are poorly understood. Ask a pharmacist.

• ChuanxiongDocumented risk

  In rats chuanxiong raised warfarin levels. No human study was found, so ask a prescriber before combining it with blood thinners.

• BugleweedDocumented risk

  May interfere with thyroid hormone medicines and radioisotope thyroid tests; ask a doctor or pharmacist.

• Wild cherry barkDocumented risk

  A consumer drug reference rates a moderate interaction: it may slow CYP3A4 breakdown of some medicines, raising their levels. Research is incomplete.

• Goat's rueDocumented risk

  LactMed advises caution with antidiabetic medicines because the leaves contain compounds that may lower blood sugar. Ask a pharmacist before combining.

• GingerDocumented risk

  Ginger supplements may add to the bleeding risk of warfarin, other blood thinners and NSAIDs, and may affect diabetes medicines, tacrolimus and cyclosporine. The EU summary reports no described interactions, so sources differ; ask a pharmacist.

• TurmericDocumented risk

  MSK lists possible interactions with blood thinners, tacrolimus and other drugs, mostly from lab or animal data.

• Albizia (mimosa tree bark)Documented risk

  Possible added drowsiness when combined with sedatives and sleep medicines (consumer drug reference rating: moderate).

• HaritakiDocumented risk

  Rat findings suggest effects on liver enzymes that clear medicines, and MSK advises against triphala with CYP3A4 or CYP2D6 medicines; not proven for haritaki alone in people.

• BibhitakiDocumented risk

  Bibhitaki might add to the blood-sugar drop of diabetes medicines, and triphala as a whole blocks liver enzymes that clear many medicines. Ask a pharmacist.

• Black pepperDocumented risk

  Isolated piperine can raise levels of some medicines, which may increase their effects.

• Sarpagandha (Indian snakeroot)Documented risk

  The label lists interactions with digoxin, quinidine, levodopa, MAO inhibitors, sedatives and beta-blockers. Ask a pharmacist about any rauwolfia product.

• White pepperDocumented risk

  Isolated piperine raised the blood levels of several drugs in studies, which could increase their effects. This is for piperine supplements, not shown for pepper on food.

• Tagara (Indian valerian)Documented risk

  Tagara may add to the effects of sedating medicines and alcohol; this is carried over from common valerian and has not been tested for tagara.

• Long pepperDocumented risk

  Piperine, found in long pepper, can change how some medicines are absorbed or cleared. This is mostly shown for isolated piperine; a case report links long pepper to a warfarin problem.

• Cayenne and chili pepperDocumented risk

  MSK lists possible interactions with blood pressure medicines, ACE inhibitors and cyclosporin, mainly for supplements.

• AllspiceDocumented risk

  A reference monograph rates a moderate interaction between medicinal allspice and blood thinners (bleeding). It concerns supplement amounts, not cooking.

• FenugreekDocumented risk

  The blood-sugar-lowering effect can add to diabetes medicines, and LactMed describes a warfarin interaction.

• Angelica dahurica (bai zhi)Documented risk

  In rats an extract raised levels of two medicines; human relevance is unknown, so ask a pharmacist.

• Black seed (nigella)Documented risk

  MSK says it inhibits liver enzymes CYP2D6 and CYP3A4 and thymoquinone weakened warfarin's action in a study; relevance for people unknown.

• Xanthium (cang er zi, cocklebur)Documented risk

  Interaction data were not found; because the fruit can injure liver and kidney, ask a pharmacist before combining it with other medicines.

• Grape seed extractDocumented risk

  Possible bleeding risk with blood thinners and lab-based effects on drug-processing enzymes; clinical relevance not determined.

• SaffronDocumented risk

  A bleeding case was reported with saffron supplements and rivaroxaban; mood medicines and mental health conditions call for caution.

• AlfalfaDocumented risk

  Alfalfa contains vitamin K, and LactMed says to avoid it with warfarin. MSK did not list a warfarin interaction, so ask a pharmacist.

• ChlorellaDocumented risk

  Chlorella's high vitamin K content may weaken warfarin. Other medicine interactions were not described in the sources read, so ask a pharmacist.

• Gravel root (Joe-Pye weed)Documented risk

  A consumer drug reference lists moderate interactions with lithium and with medicines that speed liver enzymes (carbamazepine, phenytoin, rifampin and others).

• Blue flagDocumented risk

  A consumer drug reference lists interactions with digoxin, warfarin and water pills because blue flag acts as a stimulant laxative. This comes from a consumer reference, not clinical studies.

• Bitter kolaDocumented risk

  The 2026 survey notes earlier reports of an interaction with quinine sulfate, but says the mechanism is unverified. Ask a pharmacist before combining bitter kola with medicines.

• African potatoDocumented risk

  Lab studies show African potato can affect drug-processing enzymes and a transporter, so it could change levels of some medicines, including HIV drugs. Small healthy-volunteer studies found no change in efavirenz or lopinavir levels, so the real-life effect is unsettled. Ask a pharmacist.

• AshitabaDocumented risk

  High rat doses lengthened clotting times and lowered platelets, so ask a pharmacist before using concentrated ashitaba with blood thinners. EFSA did not assess medicine interactions.

• Papaya leafDocumented risk

  Lab and animal studies suggest the leaf could change the effects or absorption of metformin, glimepiride, digoxin and ciprofloxacin; no clinical interaction studies exist. Ask a pharmacist.

• Mistletoe (European)Documented risk

  Injected extracts can cause injection-site reactions, fever, chills and rare allergic reactions, and may interfere with standard treatment.

• Japanese knotweed (hu zhang)Documented risk

  Resveratrol changed activity of several medicine-processing enzymes in healthy volunteers and may add to bleeding risk with blood thinners.

• Sophora flavescens (ku shen)Documented risk

  One Hong Kong patient developed a prolonged QT interval while taking ciprofloxacin after a Sophora alkaloid overdose; no systematic interaction data were found.

• Evodia (wu zhu yu)Documented risk

  Lab studies say the alkaloids affect CYP1A2 and CYP3A4, and in mice rutaecarpine made acetaminophen liver injury worse; the direction of effects is unclear and no human study was found. Ask a pharmacist.

• Fritillaria (chuan bei mu)Documented risk

  Traditional Chinese medicine lists Fritillaria and processed aconite as an incompatible pair, and a rat and cell study found Fritillaria raised absorption of an aconite toxin. Ask a pharmacist before combining.

• Bitter leafDocumented risk

  A rat study found a leaf extract altered metformin handling and blocked two liver enzymes; people may be exposed to unnoticed herb-drug interactions. Human relevance is not known.

• OrangesDocumented risk

  Seville oranges might act like grapefruit juice on some medicines, and orange juice may lower absorption of some (for example fexofenadine). Ask a pharmacist.

• AvocadoDocumented risk

  Avocado contains vitamin K, so people on warfarin should keep vitamin K foods steady and ask the prescriber.

• BananasDocumented risk

  MedlinePlus says some medicines can raise potassium, and a 2026 study of RAAS inhibitor users linked adding another potassium-raising drug to more hyperkalaemia. Ask a pharmacist; bananas themselves were not tested.

• BorageDocumented risk

  Memorial Sloan Kettering advises against borage oil with liver-toxic medicines and cautions about blood thinners and NSAIDs; most of this is reasoned rather than proven.

• WatercressDocumented risk

  One watercress meal slowed clearance of chlorzoxazone in a small trial, and the leaf is rich in vitamin K, relevant to warfarin. Ask a pharmacist.

• PersimmonsDocumented risk

  One case report links daily unripe persimmons with raised clotting tests in a person on warfarin; people on blood thinners should ask their prescriber.

• Sweet clover (melilot)Documented risk

  A case report links a melilot and Ruscus cream to a rise in INR in a person taking acenocoumarol, and spoiled sweet clover contains dicoumarol. The EU monograph lists no reported interactions, so sources differ; ask a pharmacist.

• DatesDocumented risk

  MedlinePlus says some medicines can raise potassium; dates are potassium-rich, so people on such medicines should ask a clinician.

• FigsDocumented risk

  Potassium-rich foods in general matter for people on ACE inhibitors, ARBs or potassium-sparing diuretics, or with kidney disease.

• Belladonna (deadly nightshade)Documented risk

  A German reference says tricyclic antidepressants, amantadine and quinidine may increase belladonna's anticholinergic effect. Secondary source, not independently confirmed.

• PomegranateDocumented risk

  A case report and a review raise a possible, unproven interaction with warfarin; laboratory work suggests effects on drug-processing enzymes. Ask a pharmacist.

• Stephania (fang ji)Documented risk

  Herbal product mix-ups can cause serious harm; the Belgian case came from a substituted ingredient in slimming pills. Sources for pure Stephania interactions were not found.

• Qin jiao (large-leaf gentian)Documented risk

  A 2025 review warns of possible interactions with medicines handled by the liver and with blood-sugar control; a consumer reference site lists heart medicines, diabetes medicines and sedatives. Not tested in people; ask a pharmacist.

• SalaciaDocumented risk

  May add to the effect of diabetes medicines, including insulin, so blood sugar could drop too low (consumer drug reference). Ask a pharmacist.

• Cruciferous Vegetables (overview)Documented risk

  Vitamin K-rich cruciferous vegetables can affect warfarin; the advice is to keep intake consistent and tell the clinic about big changes.

• Vijaysar (Indian kino)Documented risk

  Possible added blood-sugar lowering with diabetes medicines such as glibenclamide, based on an animal study; no human interaction study was read. Ask a pharmacist.

• Jamun (Java plum seed)Documented risk

  May add to the glucose-lowering of diabetes medicines (reasoned caution; no interaction study read). Ask a pharmacist.

• CauliflowerDocumented risk

  High in vitamin K: people taking warfarin should keep intake steady and ask their provider.

• CabbageDocumented risk

  Cabbage contains vitamin K, which can affect how warfarin works if intake changes suddenly; keep intake steady and ask your clinic.

• Cissus quadrangularisDocumented risk

  A consumer reference says it may add to the blood sugar lowering of diabetes medicines. Ask a pharmacist.

• Onions, Garlic & Allium Vegetables (overview)Documented risk

  Garlic supplements may raise bleeding risk with anticoagulants or aspirin; this applies to supplements, not to garlic in meals.

• LeeksDocumented risk

  Leeks contain vitamin K, which can change how warfarin works; MedlinePlus advises keeping vitamin K intake steady, so people on warfarin should tell their prescriber about big changes.

• Black horehoundDocumented risk

  RxList rates a moderate interaction with dopamine-type Parkinson's medicines; ask a pharmacist.

• CucumbersDocumented risk

  Vitamin K in cucumber can matter for people taking warfarin, because sudden changes in vitamin K intake can change how the medicine works.

• PumpkinDocumented risk

  ACE inhibitors, ARBs and potassium-sparing diuretics can raise blood potassium, so potassium-rich foods call for advice from a prescriber.

• Butternut SquashDocumented risk

  ACE inhibitors, ARBs and potassium-sparing diuretics can raise blood potassium; potassium-rich foods such as winter squash need clinician advice.

• Cinnamon twig (gui zhi)Documented risk

  Cinnamon taken with statins has been reported to cause hepatitis, and lab findings suggest it may raise side effects of some medicines. Twig-specific data were not found.

• Green BeansDocumented risk

  Vitamin K foods can change how warfarin works; MedlinePlus advises consistent amounts week to week and a talk with the prescriber.

• Green PeasDocumented risk

  Vitamin K can affect warfarin, and potassium-rich foods matter with ACE inhibitors and kidney disease.

• OkraDocumented risk

  Vitamin K in okra can matter for people on warfarin; keep intake consistent and tell the prescriber. No interaction with metformin was shown in sources read.

• CeleryDocumented risk

  Celery has vitamin K, which can change how warfarin works if intake changes suddenly; the NHS says to ask the warfarin clinic.

• Globe ArtichokesDocumented risk

  Vitamin K in artichoke can matter for people on warfarin; keep intake steady and ask the prescriber.

• Fennel BulbDocumented risk

  Vitamin K in the bulb can change how warfarin works, and potassium matters with ACE inhibitors, ARBs and potassium-sparing diuretics.

• KimchiDocumented risk

  Fermented foods may contain tyramine and histamine; MAOI antidepressant users should ask their prescriber or pharmacist.

• SauerkrautDocumented risk

  Fermented foods can contain tyramine, and MAOIs alter how the body handles it, so people taking an MAOI should ask their prescriber. Sauerkraut is not singled out in the sources read.

• Dried fenugreek leaf (kasuri methi)Documented risk

  The blood-sugar-lowering effect can add to diabetes medicines, and LactMed describes a warfarin interaction.

• Garlic powderDocumented risk

  Garlic supplements may add to the bleeding effect of anticoagulants and aspirin; NCCIH advises asking a provider.

• Safflower ("false saffron")Documented risk

  Blood thinners and antiplatelet drugs should be discussed with a prescriber before using safflower flower products; interactions are not well understood.

• Dried citrus peelDocumented risk

  Seville orange juice raised levels of one blood pressure drug in a trial, and FDA says Seville oranges might act like grapefruit; dried peel itself was not tested.

• Kola NutsDocumented risk

  Caffeine in kola may interact with MAO inhibitors and several other medicines; a rabbit study found lower blood levels of one medicine.

• Prunes (Dried Plums)Documented risk

  Vitamin K intake should stay steady for people on warfarin, and potassium-rich foods matter with medicines that raise potassium; prunes are high in both.

• Green TeaDocumented risk

  NCCIH reports nadolol blood levels fell with high-dose green tea and that it may interact with others; one warfarin case report exists.

• Rooibos TeaDocumented risk

  Case report of lower tacrolimus levels; animal CYP3A induction; possible interference with chemotherapy.

• Passionflower TeaDocumented risk

  NIH says passionflower might interact with some anesthesia drugs and medicines used around surgery; the EU monograph lists no reported interactions.

• Gynostemma (Jiaogulan) TeaDocumented risk

  Added glucose lowering with a sulfonylurea in an extract trial and one antidepressant adverse-event report; ask a pharmacist.

• Yerba MateDocumented risk

  The EU monograph advises caution with MAO-inhibitor medicines and says caffeine adds to side effects of stimulant-type medicines.

• Chamomile TeaDocumented risk

  A reported interaction with warfarin, possible effects on liver-processed medicines, sedatives and birth control pills.

• Lavender TeaDocumented risk

  Case report of serotonin toxicity with sertraline; theoretical sedative interaction.

• Hibiscus TeaDocumented risk

  Animal and small human signals for water pills and simvastatin; a warfarin case report.

• Red Clover TeaDocumented risk

  Listed in a pharmacy review as potentially adding to warfarin's effect, from mostly lab, animal and case-report data.

• Hops TeaDocumented risk

  Sedative action may add to sedative therapy and alcohol (EMA assessment).

• Marshmallow Root TeaDocumented risk

  The EU monograph says absorption of other medicines taken at the same time may be delayed; separate doses by half an hour to an hour.

• Valerian TeaDocumented risk

  NIH advises against combining valerian with alcohol or sedatives; the EU monograph reports no interactions, so sources differ.

• Ginger TeaDocumented risk

  LactMed says ginger can raise bleeding risk with warfarin; the EU monograph says no interaction is known. Ask a pharmacist.

• Senna Tea (Laxative Teas)Documented risk

  The EU monograph says senna can lower potassium, which matters for people on heart medicines, water pills, corticosteroids or licorice.

• Catnip TeaDocumented risk

  Databases warn of extra drowsiness with sedatives and a possible lithium interaction.

• Clove TeaDocumented risk

  Possible bleeding risk with blood thinners (theoretical, from lab data) and a falsely high phenytoin test. Not proven for tea.

• Horsetail TeaDocumented risk

  Case reports link diuretic herbal mixes with lithium toxicity and low potassium; the EU assessor could not draw a conclusion for field horsetail.

• Astragalus TeaDocumented risk

  NIH says astragalus may interact with immune-suppressing medicines; reviews describe effects on liver enzymes that process some medicines (mostly lab work). Ask a pharmacist.

• Mulberry Leaf TeaDocumented risk

  NIH says mulberry leaf may cause low blood sugar with diabetes medicines.

• Soy Sauce & TamariDocumented risk

  Fermented foods can contain tyramine; people on MAOI antidepressants are told to ask. One older lab study found high tyramine in a soy sauce.

• Fermented Tofu (Sufu)Documented risk

  Tyramine-rich fermented soy foods are a concern for people on MAOI antidepressants; fermented tofu amine levels vary by product.

• Soy Flour & Textured Soy ProteinDocumented risk

  Soy may affect levothyroxine absorption in some case reports and tyramine-rich soy products can interact with MAOIs.

• Alfalfa & Clover SproutsDocumented risk

  The vitamin K in alfalfa sprouts is relevant to warfarin; keep intake steady.

• Pomegranate JuiceDocumented risk

  A case report, a fruit-warfarin review and a lab/clinical review raise a possible interaction with warfarin and some other medicines. Not proven.

• Green & Vegetable JuicesDocumented risk

  Vitamin K in kale and spinach can change the effect of warfarin; keep intake steady and tell the prescriber.

• Goji BerryDocumented risk

  Case reports of raised INR and bleeding with warfarin; lab signs of enzyme effects.

• Korean Red GinsengDocumented risk

  Possible interactions with medicines, notably blood thinners and diabetes medicines.

• FucoidanDocumented risk

  May add to the effect of warfarin and heparin per MSK.

• Activated CharcoalDocumented risk

  Charcoal can bind medicines in the gut and reduce their absorption.

• Montmorillonite ClayDocumented risk

  Montmorillonite lowered a drug's exposure in rats when given soon after it; spacing is advised for the related clay diosmectite.

• Diosmectite (Smectite)Documented risk

  Adsorbs other oral drugs; spacing of 60 to 90 minutes is advised in a review.

• Zeolite (Clinoptilolite)Documented risk

  May reduce absorption of some medicines (MSK).

• Charcoal Toothpaste and Whitening PowderDocumented risk

  Swallowed activated charcoal can bind medicines; one small study saw a large drop in absorption of one medicine. Brushing amounts are not described.

• Bamboo CharcoalDocumented risk

  Activated charcoal can bind medicines in the gut; one small study saw a large drop in absorption of one medicine.

• Coconut Shell CharcoalDocumented risk

  Charcoal can bind some medicines in the gut, per a food-regulators' resolution.

• Baking Soda (Sodium Bicarbonate)Documented risk

  Take at least 2 hours apart from other medicines (drug label).

• Evening Primrose OilDocumented risk

  May increase bleeding with blood thinners, may raise blood pressure, and may raise levels of the HIV medicine lopinavir.

• MultivitaminsDocumented risk

  Supplements may interact with medicines; vitamin K can reduce the effect of warfarin. Ask a pharmacist before adding a multivitamin.

• Women's and Men's MultivitaminsDocumented risk

  NCCIH advises talking to a health care provider before taking a multivitamin that contains vitamin K if you use warfarin. Herbal add-ons in some formulas need a pharmacist check too.

• Multivitamins for Adults Over 50Deficiency link

  High-dose proton-pump inhibitor use was linked with lower B12 status in adults aged 60 and over.

• Fat Burners and Weight-Loss BlendsDocumented risk

  Green tea extract can lower blood levels of atorvastatin and nadolol, and hidden drugs can cause unexpected effects. Ask a pharmacist.

• Sleep Blends (Melatonin, Magnesium, L-Theanine, Herbs)Documented risk

  Melatonin needs medical supervision with blood thinners and in epilepsy; valerian should not be combined with alcohol or sedatives.

• Immune Support FormulasDocumented risk

  Echinacea has theoretical concerns with immune-suppressing medicines; ask a pharmacist.

• Joint Formulas (Glucosamine, Chondroitin, MSM, Turmeric)Documented risk

  Possible bleeding-risk interaction with warfarin; unsettled evidence.

• Hair, Skin and Nails FormulasDocumented risk

  Biotin can distort lab results, including thyroid tests, and clinicians are advised to account for it.

• Energy and Focus BlendsDocumented risk

  MedlinePlus lists stimulants, certain antibiotics, asthma and heart medicines as possible interactions with caffeine.

• Proprietary BlendsDocumented risk

  Hidden amounts or hidden ingredients make it harder to check a product against medicines. NCCIH says supplements can interact with medicines, and FDA says hidden drugs can cause serious side effects.

• Vitamin B1 (thiamin)Deficiency link

  High doses of water pills (diuretics) can raise the risk of thiamin deficiency.

• Vitamin B3 (niacin)Deficiency link

  Some medicines (isoniazid, 5-fluorouracil, azathioprine) are listed as possible causes of pellagra. Conversely, high-dose niacin itself can cause side effects.

• Vitamin B7Preliminary or mixed

  In the 2017 review, some reported biotin deficiency cases involved valproic acid or isotretinoin. These were case reports only.

• PhosphorusDocumented risk

  Some medicines change blood phosphate: long-term aluminium hydroxide or calcium carbonate antacids and certain diuretics are linked to low levels; steroids, laxatives and phosphate enemas to high levels. Ask a clinician before changing any medicine.

• Lactobacillus acidophilus and the acidophilus groupPreliminary or mixed

  One specific mixture (L. acidophilus CL1285 plus L. casei LBC80R) lowered C. difficile diarrhoea in people taking antibiotics (low certainty). It does not apply to other acidophilus products.

• Caffeine supplementsDocumented risk

  MedlinePlus advises checking with a health professional about interactions between caffeine and medicines or supplements, including stimulants, certain antibiotics, asthma medicines and heart medicines.

• CinnamonDocumented risk

  NCCIH says cinnamon components may theoretically interact with an anticancer medicine or nicotine. Ask a pharmacist about any medicine.

• PeppermintDocumented risk

  Acid-reducing medicines may make the capsule coating dissolve too early. No other medicine interactions were described in the sources read.

• MacaDocumented risk

  One adverse-event report linked maca with the antidepressant mianserin and restless legs syndrome. These are reports, not trials.

• CodonopsisDocumented risk

  No interaction with medicines was documented in the sources read; this is not the same as safe. Ask a pharmacist, especially for anticoagulants.

• HorsetailDocumented risk

  The EU monograph reports no interactions, but a case report describes lithium toxicity with a mixed herbal diuretic containing another horsetail species. Ask a pharmacist if on lithium or water pills.

• JiaogulanDocumented risk

  One report of back pain with duloxetine and one case of very low platelets are on record; both are single reports.

• Lemon verbenaDocumented risk

  No interaction study was found, but because the extract lowered blood pressure on average in trials, check with a pharmacist if you take blood pressure or diabetes medicines.

• NeemDocumented risk

  A neem extract inhibited several liver drug-clearing enzymes in the lab; clinical relevance is unknown, so ask a pharmacist if you take medicines.

• Oregon grapeDocumented risk

  Cell studies show Oregon grape root extracts can change a drug transporter, which may alter how some medicines are absorbed. This has not been shown in people.

• Peony (white peony root)Documented risk

  Data on peony and medicines are very limited; a pharmacist should be asked before combining it with epilepsy or other prescription drugs.

• MoringaDocumented risk

  Lab data suggest moringa may affect a liver enzyme (CYP3A4) and an animal study found it reduced the effect of sitagliptin; clinical relevance is not known. Ask a pharmacist, especially with diabetes medicine.

• AcaiDocumented risk

  Acai may raise or lower fasting blood sugar and so could interfere with diabetes medicines; early research only.

• EucalyptusDocumented risk

  Cineole may speed up liver enzymes that process some medicines (animal, lab and one very small human study). The EMA monograph lists no interactions reported; ask a pharmacist.

• DamianaDocumented risk

  A lab study found a damiana extract strongly blocked liver enzymes that process many medicines (CYP3A4, CYP1A2); relevance in people is unknown. Ask a pharmacist.

• BhringrajDocumented risk

  No interaction studies were found. Because there is no human safety data, ask a pharmacist before combining it with medicines.

• Blue cohoshLab or animal research only

  A lab test found alkaloids from the root block several medicine-processing enzymes, so interactions are possible; not tested in people.

• Wild lettuceDocumented risk

  A consumer article says wild lettuce may interact with medicines but names none; ask a pharmacist, especially with sedatives.

• Muira puamaDocumented risk

  A 2020 review says interactions with medicines are the main worry with herbal sexual enhancers in general. No specific muira puama interaction was found in the sources we read, so ask a pharmacist.

• ForsythiaDocumented risk

  A clinical monograph lists a moderate interaction with anticoagulant and antiplatelet drugs and a minor one with azithromycin. Based on one secondary source.

• Honeysuckle (Lonicera)Preliminary or mixed

  Meta-analysis suggests honeysuckle products may reduce the rash caused by EGFR-inhibitor cancer drugs. Interactions with medicines were not found in sources read.

• Blessed thistleDocumented risk

  No interactions are reported, but EMA notes a theoretical chance of weakening stomach-acid medicines and of added bleeding risk; neither is proven. Ask a pharmacist.

• Lion's maneDocumented risk

  MSK says lion's mane can interact with some medicines but names none; the review did not discuss interactions. Ask a pharmacist.

• HorehoundDocumented risk

  A consumer reference says horehound may add to diabetes and blood-pressure medicines. No agency source confirms this; ask a pharmacist.

• AgrimonyDocumented risk

  The EU monograph reports no known interactions, but data are limited; ask a pharmacist.

• Wood betonyDocumented risk

  No interaction data were found in the sources read; this is a precaution, because safety in people has not been studied. Ask a pharmacist.

• Corn silkDocumented risk

  No human interaction study was found, but diuretic and potassium findings in rats and blood sugar findings in small trials are reasons to ask a pharmacist if you take water pills or heart or diabetes medicines.

• Ligustrum (glossy privet)Documented risk

  Interactions with medicines were not covered by the sources read, so absence of a known interaction is not proof of safety. Discuss use with a pharmacist, especially during cancer treatment.

• Chanca piedraDocumented risk

  A consumer drug reference lists diuretics and magnesium or potassium supplements to discuss with a provider; interaction research is incomplete.

• Dragon's blood (sangre de grado)Documented risk

  Memorial Sloan Kettering advises against combining crofelemer with dacomitinib (animal-based warning). Other interaction data for raw sap were not found.

• BaelDocumented risk

  A possible additive effect with diabetes medicines is a reasoned caution; no documented interaction was found.

• KutkiDocumented risk

  No specific drug interactions are listed in the review read, but safety data are limited; tell a pharmacist about kutki if you take medicines. This is a caution from lack of data.

• AjwainPreliminary or mixed

  Ajwain cream was tested for nerve symptoms caused by taxane chemotherapy and showed no significant benefit.

• BonesetDocumented risk

  A consumer drug reference gives a moderate interaction rating with CYP3A4-inducing medicines; not checked against a primary source.

• ColtsfootDocumented risk

  The EU statement says other liver-damaging agents can add to PA liver damage; no coltsfoot-specific medicine interaction was read, so ask a pharmacist.

• PennyroyalDocumented risk

  MSK describes a case of liver failure possibly caused by an interaction with pennyroyal tea and says it may cut iron absorption; evidence is limited.

• TansyDocumented risk

  Only one consumer-reference interaction was found (alcohol, drowsiness); no medicine interactions were found.

• Sweet wormwood (Artemisia annua)Lab or animal research only

  Lab studies show extracts increase two drug-processing liver enzymes; clinical relevance is not known.

• Uncaria (gou teng)Documented risk

  Lab work suggests gou teng alkaloids may affect liver enzymes that handle some medicines, and animals show a blood pressure fall. These are theoretical concerns, not confirmed human interactions; ask a pharmacist.

• Imperata (bai mao gen)Documented risk

  No interaction data were found; because it is traditionally used to increase urine, ask a pharmacist about water pills and blood-pressure medicines.

• Ophiopogon (mai dong)Documented risk

  Allergy-like reactions are described for Shenmai injection; no tested drug interaction was found, and a chemotherapy-enhancing idea is only a computer hypothesis. Ask a pharmacist.

• Job's tears (coix seed)Documented risk

  A consumer reference lists a possible blood-sugar-lowering interaction with diabetes medicines, and advises stopping 2 weeks before surgery; pregnancy caution also applies. Other interactions not found.

• Calamus (sweet flag)Documented risk

  EMA notes blood-clot-slowing effects of asarone in rodents; no human interaction studies were found, so tell a pharmacist if you take blood thinners.

• Safed musliDocumented risk

  No specific medicine interaction was found in the sources we read, so this is a precaution only: ask a pharmacist, especially with diabetes or blood pressure medicines.

• Yerba santaDocumented risk

  It is not known whether yerba santa interacts with medicines; ask a pharmacist, as no interaction study was found.

• Self-healDocumented risk

  Interactions with medicines are not well characterized; used in studies only alongside standard thyroid drugs.

• Antrodia camphorataDocumented risk

  No interaction study found; effects on blood pressure and cholesterol and a platelet fall in one trial are reasons to ask a pharmacist.

• Usnea (old man's beard lichen)Documented risk

  Possible additive effects with blood thinners and animal evidence of CYP3A4 induction; clinical relevance not known.

• Nut grass (mustaka, xiang fu)Documented risk

  No interaction data were found in the sources we read; the trial extract included piperine and interactions were not studied. Ask a pharmacist.

• Asafoetida (hing)Documented risk

  No interaction data were found in the sources read; ask a pharmacist before combining with medicines.

• CinnamonDocumented risk

  NCCIH notes theoretical interactions with an anticancer drug and nicotine; ask about diabetes medicine because supplements lowered glucose markers in trials.

• ClovesDocumented risk

  A theoretical bleeding interaction with blood thinners is noted for clove oil; not shown in people in the sources read.

• Bakuchi (babchi)Documented risk

  One review lists a possible interaction with medicines handled by CYP3A4; details not read.

• Cuscuta seed (tu si zi)Documented risk

  The review raises possible interactions with hormone, diabetes, immune-suppressing and enzyme-processed medicines; these are theoretical.

• VanillaDocumented risk

  Real vanilla has no interaction described in the sources we read. Fake 'vanilla' containing coumarin could raise bleeding risk for people on warfarin-type drugs, per an FDA warning reported in 2008.

• Morinda root (ba ji tian)Documented risk

  A consumer drug reference warns of possible effects on blood sugar and diabetes medicines; not confirmed by a clinical source we read.

• Caterpillar fungusDocumented risk

  MSK describes possible interactions with blood thinners and blood-sugar medicines for cordyceps in general.

• Moutan (tree peony root bark, mu dan pi)Documented risk

  No specific medicine interactions were described in the sources read, and none were checked for blood thinners; ask a pharmacist, especially with blood thinners, in pregnancy or before surgery.

• Angelica pubescens (du huo)Documented risk

  No interaction study was found; lab platelet effects and liver or kidney findings in animals are reasons to ask a pharmacist when on medicines.

• Notopterygium (qiang huo)Documented risk

  In a laboratory test with human enzymes, notopterol from the root blocked CYP2D6 irreversibly and may cause drug interactions. No human interaction study was found; ask a pharmacist.

• King tuber mushroomDocumented risk

  No interaction study exists; blood-sugar and immune effects in animals raise a question for people on diabetes or immune-suppressing medicine.

• Pinellia (ban xia)Documented risk

  A laboratory study found a pinellia-containing formula inhibited a drug-handling liver enzyme, and a combination with processed aconite is reported to be restricted in China. No human interaction study was read; ask a pharmacist.

• Celery seedDocumented risk

  Because celery preparations lowered blood pressure in trials, people on blood pressure medicine should ask a pharmacist before using supplements. This is a precaution, not a documented interaction.

• Alpinia oxyphylla (yi zhi ren)Documented risk

  No interaction or safety data were found for medicines; this is an unknown, so ask a pharmacist.

• Chinese asparagus root (tian men dong)Documented risk

  In animal studies the herb switched on two liver enzymes that clear many medicines, and Memorial Sloan Kettering advises against use with medicines cleared by them. Importance in people is unknown; ask a pharmacist.

• Ajwain (carom seed)Documented risk

  Wikipedia says an anti-clotting action may matter with antiplatelet or anti-inflammatory medicines. We found no official statement; ask a pharmacist.

• TamarindDocumented risk

  A very small 1991 study found tamarind extract raised aspirin absorption; ask a pharmacist before large amounts.

• Stone rootDocumented risk

  Possible interaction with blood thinners, blood pressure medicines and diuretics according to non-agency sources; no interaction study found.

• Orange cordyceps (Cordyceps militaris)Documented risk

  MSK's cautions on blood thinners and blood-sugar medicines concern the wild species; they are unresolved for C. militaris, so treat them as possible.

• Hydrangea rootDocumented risk

  A consumer drug reference lists a moderate interaction with lithium; hydrangea may act like a diuretic and raise lithium levels. Ask a pharmacist.

• Cs-4 and cultured Cordyceps myceliumDocumented risk

  Cordyceps in general may add to blood-thinner and blood-sugar medicines (lab studies, MSK); not tested for Cs-4.

• YaconDocumented risk

  Yacon could add to the effect of diabetes medicines on blood sugar in theory; we found no source that tested this, so ask a pharmacist.

• Guava leafDocumented risk

  Trial authors say interactions with diabetes and other common medicines are not well studied; people on glucose-lowering medicines should monitor blood sugar and ask their clinician.

• Oat straw (milky oats)Documented risk

  No interaction data were found in the sources read; the EU monograph's precautions could not be read, so ask a pharmacist.

• BoldoDocumented risk

  The EMA cites single case reports of a raised INR with warfarin and low tacrolimus levels; cause could not be confirmed.

• Lily bulb (bai he)Documented risk

  Proper evidence on interactions was not found; the formula is usually studied alongside antidepressants, so a prescriber should be told.

• African wormwoodDocumented risk

  A lab study found an extract weakened several antibiotics in test tubes. No human interaction data were found, so ask a pharmacist.

• ChuchuhuasiDocumented risk

  Whether it interacts with medicines is unknown (consumer reference); this is a caution, not a known interaction.

• Yerba mansaDocumented risk

  A consumer drug reference warns of added drowsiness with sedative medicines; this is a theoretical caution. Ask a pharmacist.

• Prickly ash (northern)Documented risk

  A consumer drug reference lists minor interactions with acid-reducing medicines (antacids, H2 blockers, proton pump inhibitors). No blood thinner interaction is listed.

• ApricotsDocumented risk

  Raw kernel products and laetrile can cause cyanide toxicity; this is a safety caution, not a medicine interaction with the fruit.

• MayappleDocumented risk

  Podophyllin resin used for warts has caused severe whole-body toxicity when applied to large or fragile areas (CDC, IPCS). No herb-drug interaction data were found.

• BloodrootDocumented risk

  MSK does not discuss medicine interactions, but notes antiplatelet and heart-rhythm effects of sanguinarine in lab studies. Ask a pharmacist.

• PipsissewaDocumented risk

  No interaction studies were found; safety with regular medicines is unknown, so ask a pharmacist. This is a data gap, not a proven interaction.

• LovageDocumented risk

  The EU monograph reports no interactions, which is not proof of safety; ask a pharmacist, especially if taking diuretics or heart or kidney medicines.

• Nasturtium (garden)Documented risk

  No medicine interactions are described in the sources we read; ask a pharmacist, especially with kidney or stomach conditions.

• Iceland mossDocumented risk

  The EU advises spacing it from other medicines because the gel-like fibre might delay their absorption; no interaction has been confirmed.

• JackfruitDocumented risk

  Some medicines raise potassium (MedlinePlus); no source read tests jackfruit with them, so people on such medicines should ask a pharmacist.

• Garam masalaDocumented risk

  Piperine from black pepper, in isolated bolus form, raised levels of some drugs; the finding is not for pepper in food and not for the blend.

• Bee balm (Monarda)Documented risk

  It is unknown whether bee balm interacts with medicines (consumer reference), so a pharmacist should be asked.

• CantaloupeDocumented risk

  MedlinePlus says some medicines raise potassium, so potassium-rich foods can matter for those users; ask a pharmacist.

• Herbes de ProvenceDocumented risk

  One case report links regular oregano tea to a raised blood-thinner test; one case cannot show how common this is, and it concerns tea, not a pinch in cooking.

• BaharatDocumented risk

  Piperine from black pepper can change drug levels. This is shown for isolated piperine; the effect of baharat in food is not described.

• RaisinsDocumented risk

  Some medicines raise potassium levels (MedlinePlus), and raisins are potassium-rich; ask a pharmacist if this applies.

• BerbereDocumented risk

  MSK says cayenne supplements may affect blood pressure medicines and cyclosporine; it does not state this for food.

• Panch phoronDocumented risk

  NCCIH advises talking with a provider before using fenugreek with any medicine. No source on the blend and medicines was found.

• Shichimi togarashiDocumented risk

  For chili, animal data suggest changed drug absorption and MSK advises avoiding cayenne with cyclosporin. Clinical relevance is unknown and shichimi was not studied.

• KokumDocumented risk

  NCCIH reports Garcinia cambogia may interact with drugs that affect the liver or serotonin; no kokum interactions were described in the sources read.

• FigwortDocumented risk

  No specific drug interaction was verified; a practitioner source advises asking a pharmacist, especially with heart medicines.

• Grains of SelimDocumented risk

  In mice, the extract changed how three antidepressants acted and lowered imipramine blood levels; unknown in people.

• Ancho chileDocumented risk

  MSK lists possible interactions of capsicum supplements with cyclosporine, ACE inhibitors and antiplatelet drugs, mostly from animal data.

• Chipotle (smoked jalapeno)Documented risk

  MSK lists possible effects of capsaicin supplements on blood pressure medicines, ACE inhibitors and cyclosporine; not stated for chili in food.

• Aleppo pepperDocumented risk

  MSK describes possible interactions of cayenne supplements with blood pressure medicines, ACE inhibitors and cyclosporin; not stated for food.

• Kashmiri chiliDocumented risk

  MSK lists possible interactions of capsaicin with blood pressure drugs, theophylline and cyclosporine, mainly for supplements.

• Sariva (Indian sarsaparilla)Documented risk

  No human interaction data were found. Because extracts lowered glucose in rats and enhanced chemotherapy drugs in cells, ask a clinician before combining with diabetes or cancer medicines; this is a precaution, not a documented interaction.

• Cubeb pepperDocumented risk

  Lab assays show compounds from cubeb block a liver enzyme that processes many medicines. It is not shown in people or at food amounts.

• ChirataDocumented risk

  Animal studies show glucose lowering, so a drop in blood sugar with diabetes medicines is a theoretical concern; no confirmed human case was found. Specific interaction data for chirata are lacking.

• Patha (velvetleaf)Documented risk

  No interaction studies were found; possible effects around anesthesia and muscle relaxants are unknown, so tell the surgical team.

• TurnipsDocumented risk

  Turnip greens are a leafy green: people on warfarin are advised to keep vitamin K foods steady and ask their doctor. The root has almost no vitamin K.

• Dhataki (fire-flame bush)Documented risk

  No herb-medicine interaction study was found, but lab findings on clot dissolving and starch-digesting-enzyme blocking make it worth asking a pharmacist if you take blood thinners or diabetes medicines. Not shown to matter in people.

• KohlrabiDocumented risk

  Some medicines raise potassium; potassium-containing foods may matter for those users, so ask a prescriber.

• SilverweedDocumented risk

  For the related tormentil, the EU advises separating it from other medicines by an hour or more because absorption may be delayed. Not studied for silverweed; ask a pharmacist.

• BeetsDocumented risk

  People on blood pressure medicine should ask a prescriber or pharmacist before making concentrated beet juice a regular habit. No source read describes a specific interaction.

• Heather (ling)Documented risk

  Whether heather interacts with medicines is not known, and safety data are limited; ask a pharmacist.

• PotatoesDocumented risk

  Potatoes are high in potassium; ACE inhibitors, ARBs and potassium-sparing diuretics can raise blood potassium, so ask your care team about high-potassium foods.

• Ground ivyDocumented risk

  No specific interactions are described in the sources read, but safety data are scarce, so ask a pharmacist before combining it with medicines.

• Sweet violetDocumented risk

  A plant database lists a possible added effect with laxatives; no other interaction data were found, so ask a pharmacist.

• Sweet woodruffDocumented risk

  A consumer drug reference rates a moderate interaction with blood thinners and advises stopping before surgery; BfR and AGES describe no such interaction, so sources differ. Ask a pharmacist.

• Eggplant (Aubergine)Documented risk

  ACE inhibitors, ARBs and potassium-sparing diuretics can raise blood potassium, so potassium-rich foods are a question for a clinician. No eggplant-specific interaction was found.

• Zucchini (Courgette)Documented risk

  With ACE inhibitors, ARBs or potassium-sparing diuretics, blood potassium can rise; ask a clinician about potassium-rich foods.

• Lycium root bark (di gu pi)Documented risk

  Animal results on blood sugar and pressure are a reason to ask about diabetes and blood pressure medicines; the combination was not tested in the sources read.

• Curculigo (kali musli)Documented risk

  No interaction data were found, and human safety is unstudied, so treat combinations with medicines (especially hormone medicines) as unknown and ask a pharmacist.

• Pueraria mirifica (kwao krua)Documented risk

  Because it is estrogen-like, ask a pharmacist before combining it with hormone medicines; interaction data were not found.

• Nopales (Prickly Pear Pads)Documented risk

  The sources we read do not say what lower blood sugar after nopales means for people on diabetes medicines; ask a pharmacist.

• Dried black lime (loomi)Documented risk

  Lime juice blocked a medicine-processing enzyme in the lab and raised one medicine's level in two people; dried lime in cooking is untested.

• Lovage seedDocumented risk

  One consumer reference says root might add to water pills and cause too much fluid loss; a reference text lists no known interactions.

• Chia SeedsDocumented risk

  MSK says chia may add to the effect of blood pressure medicines, because chia flour lowered blood pressure in treated and untreated people. Ask a pharmacist.

• FlaxseedDocumented risk

  NCCIH: flaxseed might theoretically interact with blood thinners (anticoagulant or antiplatelet drugs); WebMD says interactions are not fully understood.

• Juniper Berry OilDocumented risk

  Combining with diuretics is not recommended; no interaction reports exist. Ask a pharmacist.

• Cinnamon Oil (Leaf and Bark)Documented risk

  NCCIH describes theoretical interactions with an anticancer medicine or nicotine; Poison Control warns oils may interact with medications.

• MatchaDocumented risk

  NCCIH reports green tea interactions with nadolol and possibly others; matcha-specific data not found.

• Red Raspberry Leaf TeaDocumented risk

  One case report of low blood sugar needing less insulin in gestational diabetes after raspberry leaf tea; the EU monograph lists no reported interactions. One case cannot show how common it is.

• Burdock Root TeaDocumented risk

  The EU monograph does not recommend combining burdock root with synthetic diuretics; other interactions are not reported.

• Rose Hip TeaDocumented risk

  A 2014 paper title links hibiscus and rose hip tea to false-positive digoxin blood tests; only the title was read.

• Milk Thistle TeaDocumented risk

  NIH says to check with a health professional before using milk thistle with medicines; the EU lists no reported interactions, and a small extract study found no change in four drug-processing enzymes. This is a precaution, not a known interaction.

• Turmeric TeaDocumented risk

  The EU monograph reports no interactions; NCCIH advises asking a provider with any medicine. Not described for blood thinners.

• Cinnamon TeaDocumented risk

  Theoretical interactions (NCCIH); ask a pharmacist, especially with diabetes medicines.

• Pennyroyal Tea (Dangers)Documented risk

  MSK describes possible CYP450-related interaction and a possible case with other medicines.

• Cassia OilDocumented risk

  NCCIH describes theoretical interactions of cinnamon parts with an anticancer medicine and nicotine; Poison Control says oils may interact with medicines.

• Black Seed Oil (Nigella)Documented risk

  One case report links black seed oil capsules to a large bruise in a person on blood thinners and chemotherapy; one case only.

• SenchaDocumented risk

  NCCIH says high doses of green tea lowered blood levels of the beta-blocker nadolol, an extract lowered atorvastatin levels, and an NCCIH-funded study showed an interaction with raloxifene. Those findings are for green tea in general.

• GyokuroDocumented risk

  NCCIH says high doses of green tea lowered blood levels of the beta-blocker nadolol, an extract lowered atorvastatin levels, and an NCCIH-funded study showed an interaction with raloxifene. Those findings are for green tea in general.

• Moroccan Mint TeaDocumented risk

  NCCIH says high doses of green tea lowered blood levels of nadolol, and a case report describes warfarin becoming less effective with very large amounts. Ask a pharmacist.

• Olive Leaf TeaDocumented risk

  The EU monograph reports no interactions, but blood pressure and glucose measures moved in tea studies; tell a prescriber.

• Damiana TeaDocumented risk

  A lab screen found strong blocking of two liver enzymes that process many medicines by a damiana extract; no interaction in people is documented in the sources read.

• Soy Foods (Soybeans)Documented risk

  NCCIH reports tyramine-rich soy foods such as tofu and soy sauce linked to dangerously high blood pressure with MAOI antidepressants; a 2023 review found thin evidence on soy and levothyroxine tablets.

• Edamame (Green Soybeans)Documented risk

  A 2023 review found mainly case reports of soy affecting levothyroxine tablets and one crossover trial with no difference. NCCIH names tofu and soy sauce, not edamame, for the MAOI tyramine warning.

• TofuDocumented risk

  NCCIH reports tyramine-rich soy foods such as tofu linked with dangerously high blood pressure in people taking MAOI antidepressants. A 2023 review found thin evidence on soy and levothyroxine tablets.

• Bean Sprouts (Mung & Lentil Sprouts)Documented risk

  Vitamin K in sprouts can matter for people taking warfarin. Keep intake steady and ask a doctor.

• MisoDocumented risk

  Fermented soy foods can contain tyramine; people on MAOI antidepressants are told to ask. No miso-specific value was read.

• Gochujang & DoenjangDocumented risk

  Fermented soy foods can contain tyramine and histamine; people on MAOI antidepressants should ask. No paste-specific tyramine source for gochujang was read.

• Flaxseed OilDocumented risk

  Theoretical interaction with anticoagulant and antiplatelet drugs.

• Soybean & Vegetable OilDocumented risk

  Vitamin K in soybean oil can work against warfarin; steady intake is advised.

• MCT OilDocumented risk

  WebMD lists interactions with valproate medicines, triheptanoin and orlistat.

• Margarine & Plant-Oil SpreadsDocumented risk

  Vitamin K from plant-oil foods matters for people on warfarin, who are advised to keep intake steady.

• MayonnaiseDocumented risk

  Vitamin K in mayonnaise matters for people on warfarin, who are advised to keep intake steady.

• Coconut WaterDocumented risk

  MedlinePlus says some medicines raise potassium, so a high-potassium drink may add to that effect; ask a pharmacist.

• Soy MilkDocumented risk

  Foods with soybeans may affect levothyroxine; the evidence is mostly case reports.

• Orange JuiceDocumented risk

  FDA says fexofenadine may be less effective with orange or apple juice. Ask a pharmacist about your own medicines.

• Apple JuiceDocumented risk

  FDA says fexofenadine may be less effective with apple or orange juice; a small study found apple juice lowered elvitegravir levels.

• Cranberry JuiceDocumented risk

  The NHS says to avoid cranberry products on warfarin; NCCIH calls the evidence conflicting. Ask a prescriber or pharmacist.

• Prune JuiceDocumented risk

  MedlinePlus lists medicines that can raise potassium (ACE inhibitors, ARBs, potassium-sparing diuretics) and the NKF lists prune juice among higher-potassium juices; together this is a reason to ask a clinician.

• SmoothiesDocumented risk

  Greens added to a smoothie add vitamin K, which can change the effect of warfarin; keep intake steady and tell the prescriber.

• ZamanihaDocumented risk

  A mouse study found altered liver drug-metabolising enzyme activity with one extract; no human interaction data.

• Withania Coagulans (Indian Cheesemaker)Documented risk

  In rats the fruit extract added to the effect of the diabetes drug glipizide; no human interaction study found.

• Nori (Laver)Documented risk

  The Hong Kong Consumer Council advised people on warfarin to ask a clinician before eating seaweed.

• Sea Moss (Eucheuma & Gracilaria)Documented risk

  High iodine can add to the effect of anti-thyroid medicines and cause hypothyroidism.

• Seaweed Snacks (Roasted Nori)Documented risk

  Council advice: ask a clinician before eating seaweed if you take warfarin.

• Bentonite ClayDocumented risk

  Clays can bind substances in the gut; specific interactions were not described in sources we read.

• Epsom Salt (Magnesium Sulfate)Documented risk

  Chemotherapy nerve symptoms were the setting of the one foot-bath trial; this is not a claim of prevention.

• Royal JellyDocumented risk

  One case report links royal jelly with a raised INR and bleeding in a person taking warfarin.

• Black Seed Oil (Nigella)Documented risk

  One case report of a large bruise with blood thinners and chemotherapy; average blood sugar and blood pressure effects in trials. Ask a pharmacist.

• Creatine HCl (Hydrochloride)Documented risk

  The HCl sources gave no medicine-interaction list; ask a pharmacist, especially about kidney-affecting medicines.

• Creatine NitrateDocumented risk

  Possible low blood pressure with nitrate and blood pressure medicines is a concern raised by a review; not tested in a trial we read.

• Prenatal and Postnatal VitaminsDocumented risk

  MedlinePlus says to tell your doctor and pharmacist about all medicines, because doses of other medicines may need adjusting. It lists no specific interactions.

• Gut Health Blends (Probiotic, Fiber, Enzymes)Documented risk

  Antibiotics change gut bacteria and probiotics are studied for antibiotic-associated diarrhea, with strain-specific results; immunosuppressant users should ask a clinician first (NCCIH, NHS).

• Mushroom Blends and Mushroom CoffeeDocumented risk

  Supplements can interact with medicines; caffeine also interacts with stimulants, some antibiotics, asthma and heart medicines.

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