Laurie asked
I recently started taking Qunol Liquid Turmeric with BioPerine, & read that it can interact with other drugs by increasing their absorption rate. I am taking 200 mg of Neurontin, a Smarty Pants women's Multivitamin along with 2000 mg of Vit D3, Zyrtec, VSL# 3 BID, Prometrium, & topical .02% Estrace. Will the turmeric & BioPerine have any interactions with these medications?
Answer
Turmeric and Bioperine supplements have a long list of potential interactions with prescription medication. However, many of the interactions are not well documented or studied. The severity of many of the interactions are not well known.
We have discussed drug interactions with both turmeric (curcumin) and BioPerine in related articles:
Below, we discuss both turmeric (curcumin) and Bioperine drug interactions in more detail.
Turmeric (Curcumin)
Curcumin is the active constituent of the turmeric root. It has been reported to have a variety of benefits and effects on the body, and has been used as an:
- Anti-inflammatory
- Anti-emetic/anti-nausea
- Analgesic (i.e. pain relieving)
- Anti-glycemic (i.e. lowers blood sugar levels)
- Antilipidemic (i.e. lowers cholesterol levels)
As turmeric (curcumin) has a wide range of effects on the body, it stands to reason that it could potentially interact with prescription medication.
Most significantly, it appears that turmeric (curcumin) can inhibit a major metabolizing enzyme in the body, CYP3A4, which could potentially increase the concentration of many drugs. Drugs that are metabolized by CYP3A4 include, but are not limited to:
- Calcium channel blockers (e.g. diltiazem, nicardipine, verapamil)
- Chemotherapeutic agents (e.g. etoposide, paclitaxel, vinblastine, vincristine)
- Cozaar (losartan)
- Allegra (fexofenadine)
Turmeric (curcumin) may also have blood thinning effects. This has the potential to increase the risk of bleeding in any patient that is on anticoagulant drugs, such as warfarin. However, data is inconclusive on how severe this interaction can be.
In terms of the medication you are taking, there are some studies that suggest that turmeric (curcumin) may interact with estrogen replacement therapies. Research shows that curcumin may displace the binding of estrogen to receptors. This has the potential to interfere with Estrace and other hormone replacement therapy. The study referenced above was only in a lab setting and more data is needed in humans to determine whether or not an interaction with turmeric and estrogen therapy.
BioPerine
Bioperine is a branded extract of black pepper and is commonly added to nutritional supplements to increase their absorption.
There is data that indicates that BioPerine does increase the absorption of the following:
- Turmeric (Curcumin)
- CoQ10
- Vitamin C
- Selenium
- Beta Carotene (Vitamin A)
- Resveratrol
Like turmeric (curcumin), BioPerine has the potential to interact with many medications due to inhibition of liver metabolizing enzymes according to studies, such as the liver enzyme CYP1A1.
In addition, BioPerine could increase the absorption of certain prescription medications, potentially leading to an increase in side effects.
Exactly which (and how many) medications are susceptible to the effects of black pepper extract is unknown as there have been few studies on the matter.
There are however, some known drug interactions that have been reported, which include:
- Amoxicillin: One animal study, in rats, showed the concomitant administration of black pepper extract and amoxicillin can result in increased levels of the amoxicillin.
- Anticoagulants: Lab tests show that black pepper can act as an anticoagulant, inhibiting blood platelet aggregation and increasing the risks of bleeds.
- Carbamazepine: Multiple studies have shown that taking black pepper extract with carbamazepine can significantly increase levels of the drug.
- Cyclosporine: One study showed that black pepper extracts can increase the bioavailability (i.e. rate and extent of absorption) of cyclosporine, an immunosuppressant. This could potentially potentially increase the risk of side effects with the medication.
- Phenytoin Multiple studies have reported that concomitant administration of phenytoin and black pepper extract increased absorption, slowed elimination, and increased levels of phenytoin.
If you plan on taking a turmeric (curcumin) and BioPerine supplement with your prescription medication, it is important to talk to your doctor regarding its use so you can be appropriately monitored for interactions and side effects.
Summary
- Turmeric (curcumin) and BioPerine have many potential interactions with medication, but few are well studied.
