| Ingredients | Amount Per Serving |
|---|---|
|
Proprietary Extract Blend
|
1320 mg |
|
(Coix lachryma jobi )
(seed)
(Yi Yi Ren)
|
|
|
Stephania tetrandra
(Stephania tetrandra )
(root)
(Fang Ji)
|
|
|
(Prunus armeniaca )
(seed)
(Xing ren)
|
|
|
(Forsythia suspensa )
(fruit)
(Lian Qiao)
|
|
|
Achyranthes bidentata
(Achyranthes bidentata )
(root)
(Huai Niu Xi)
|
|
|
(Phellodendron chinense )
(bark)
(Huang bai)
|
|
|
(Atractylodes lancea )
(rhizome)
(Cang Zhu)
|
|
|
(Gardenia jasminoides )
(fruit)
(Zhi zi)
|
|
|
(Pinellia ternata )
(rhizome)
(Jiang ban xia)
(gingered)
(Pinellia ternata (Alt. Name: Jiang ban xia) PlantPart: rhizome Genus: Pinellia Species: ternata Note: gingered )
|
|
|
Akebia trifoliata
(Akebia trifoliata )
(stem)
(Mu tong)
|
activated Carbon, China Wax, Talcum
Below is general information about the effectiveness of the known ingredients contained in the product Xuan Bi Teapills Xuan Bi Wan. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Xuan Bi Teapills Xuan Bi Wan. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when purified apricot kernel oil is used orally in food amounts. Purified apricot kernel oil has Generally Recognized as Safe (GRAS) status in the US (4912,105943). ...when purified apricot kernel oil is applied topically (105943).
POSSIBLY SAFE ...when apricot kernel is used orally in the diet in small amounts. Consuming no more than 1-2 small kernels or half of a large kernel daily is considered safe by the European Food Safety Authority, the Food Safety Authority of Ireland, and Health Canada (105944,105945,105946).
LIKELY UNSAFE ...when apricot kernel is used orally in larger amounts. Apricot kernels provide approximately 0.5 mg cyanide per kernel, although exact cyanide content varies. The World Health Organization (WHO) and the European Food Safety Committee (EFSA) have set a tolerable daily intake of cyanide at 12 mcg/kg and 20 mcg/kg, respectively (105945,106501). To minimize the risk of cyanide toxicity, the EFSA, the Food Safety Authority of Ireland, and Health Canada recommend against consuming more than 2 small apricot kernels or more than half of a large apricot kernel daily (105944,105945,105946). There is insufficient reliable information available about the safety of using non-purified or virgin apricot kernel oil orally or topically. Partially processed apricot kernel oil may contain amygdalin and/or hydrogen cyanide in variable quantities (105943).
CHILDREN: LIKELY UNSAFE
when apricot kernel is used orally.
The European Food Safety Authority, the Food Safety Authority of Ireland, and Health Canada recommend against the use of apricot kernels in children. Consumption of only half of one small kernel can exceed safe levels in toddlers (105944,105945,105946).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when apricot kernels are taken orally.
The Hellenic Food Authority recommends that pregnant or breastfeeding patients avoid consumption of apricot kernels (4,12,105944,105945,105946).
There is insufficient reliable information available about the safety of atractylodes.
PREGNANCY: POSSIBLY UNSAFE
when used orally.
In animals, atractylodes has caused reproductive toxicity, including fetal death, as well as changes in gestation, growth, and skeletal formation (94304).
LACTATION:
There is insufficient reliable information available about the safety of atractylodes when used during breast-feeding.
There is insufficient reliable information available about the safety of gardenia.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when consumed orally and appropriately as a food. Job's tears has been safely eaten in amounts up to 60 grams daily for 4 weeks (15368). There is not enough information available to know if Job's tears extracts from the root or seed are safe when taken as a supplement.
PREGNANCY: POSSIBLY UNSAFE
when used orally.
In animal models, Job's tears seed extract induces embryo toxicity and increases uterine contractions during pregnancy (15373); avoid using during pregnancy.
LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when used orally and appropriately in combination with other ingredients, short-term. A specific product containing a combination of extracts of phellodendron plus magnolia (Relora, Next Pharmaceuticals) 250 mg 2-3 times daily has been used with apparent safety in clinical trials lasting up to 6 weeks (14349,94901,94904). Also, a specific product containing a combination of extracts of phellodendron plus sweet orange (Citrofen, Next Pharmaceuticals) 740 mg twice daily has been used with apparent safety for up to 8 weeks (94903). ...when used topically (97317). There is insufficient reliable information available about the safety of phellodendron when used orally as a single ingredient.
CHILDREN: LIKELY UNSAFE
when used orally in newborns.
The berberine constituent of phellodendron can cause kernicterus in newborns, particularly preterm neonates with hyperbilirubinemia (2589).
PREGNANCY: LIKELY UNSAFE
when used orally.
The berberine constituent of phellodendron is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine (2589).
LACTATION: LIKELY UNSAFE
when used orally.
The berberine constituent of phellodendron and other harmful constituents can be transferred to the infant through breast milk (2589).
POSSIBLY UNSAFE ...when used orally. Pinellia ternata contains ephedrine alkaloids and is banned in the US (12147). There is no reliable evidence available about the safety of Pinellia ternata in humans. Because it contains ephedrine alkaloids, it is likely that Pinellia ternata might potentially cause the adverse effects reported with ephedra, including heart attack, stroke, seizure, and other serious side effects.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
Below is general information about the interactions of the known ingredients contained in the product Xuan Bi Teapills Xuan Bi Wan. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, atractylodes might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.
 Details
Laboratory research suggests that atractylenolides II and III, constituents of atractylodes, reduce platelet activation (94299). So far, this has not been shown in humans.
|
Theoretically, atractylodes may have an additive effect when used with other aromatase inhibitors.
Details
Laboratory research suggests that atractylodes and its constituents exhibit aromatase inhibitor effects (94302).
|
Theoretically, atractylodes might decrease the levels of CYP1A2 substrates.
Details
In animals, atractylodes administered at high doses has been shown to induce CYP1A2 activity (112828). This effect has not been shown in humans.
|
Theoretically, atractylodes might increase the levels of CYP3A4 substrates.
Details
In animals, atractylodes administered at high doses has been shown to inhibit CYP3A1 activity, which is a homolog to the human CYP3A4 enzyme (112828). This effect has not been shown in humans.
|
Theoretically, taking atractylodes may prolong the therapeutic and adverse effects of hexobarbital.
Details
In animals, atractylodes has been shown to prolong the effects of hexobarbital (94303). These effects have not been shown in humans.
|
Theoretically, taking forsythia with anticoagulant or antiplatelet drugs might increase the risk of bleeding due to decreased platelet aggregation. Forsythia might reduce platelet aggregation by inhibiting platelet activating factor (12619). Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
|
Theoretically, taking forsythia with azithromycin might increase the risk of adverse effects. Animal research in rats shows that taking a single dose of forsythia with azithromycin decreases the clearance and increases the area under the curve of both forsythiaside, a constituent of forsythia, and azithromycin. The mechanism of this interaction is not well understood (106675).
|
Theoretically, gardenia might increase the effects and adverse effects of stimulant laxatives.
Details
Animal research shows that geniposide, a glucoside found in gardenia fruit, may function as a laxative and cause diarrhea when taken orally (26534).
|
Preliminary evidence shows that constituents of Job's tears might have hypoglycemic effects (15363). Theoretically, concomitant use with drugs that decrease blood glucose levels might increase the risk of hypoglycemia. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
|
Animal research suggests that Job's tears might enhance absorption of chlorzoxazone in the small intestine. Single dose and short-term oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing chlorzoxazone increases chlorzoxazone peak plasma concentration and area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver (106531). This effect has not been reported in humans.
|
Animal research suggests that Job's tears might enhance absorption of dextromethorphan in the small intestine. Single dose oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing dextromethorphan increases dextromethorphan area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver (106531). This effect has not been reported in humans.
|
Animal research suggests that Job's tears might enhance absorption of diltiazem in the small intestine. Single dose oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing diltiazem increases diltiazem peak plasma concentration and area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver (106531). This effect has not been reported in humans.
|
Animal research suggests that Job's tears might enhance absorption of theophylline in the small intestine. Single dose and short-term oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing theophylline increases theophylline peak plasma concentration and area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver (106531). This effect has not been reported in humans.
|
Theoretically, phellodendron might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Details
|
Theoretically, phellodendron may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
|
Theoretically, phellodendron might have additive effects with antihypertensive drugs.
Details
Phellodendron contains berberine. Animal research suggests that berberine can have hypotensive effects (33692,34308). Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone (91956). Theoretically, phellodendron might also reduce blood pressure.
|
Theoretically, phellodendron might increase the sedative effects of CNS depressants.
Details
|
Theoretically, phellodendron might increase blood levels of cyclosporine.
Details
Phellodendron contains berberine. Preliminary clinical research shows that berberine can reduce metabolism of cyclosporine and increase serum levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporine (13524). Theoretically, phellodendron might also reduce the metabolism of cyclosporine.
|
Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2C9.
Details
Phellodendron contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9 (34279). Theoretically, phellodendron might also inhibit CYP2C9.
|
Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2D6.
Details
|
Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP3A4.
Details
|
Theoretically, phellodendron may increase serum levels of dextromethorphan.
Details
Phellodendron contains berberine. Preliminary clinical research shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan (34279). Theoretically, phellodendron may also inhibit the metabolism of dextromethorphan.
|
Theoretically, phellodendron might reduce the therapeutic effects of losartan by decreasing its conversion to its active form.
Details
Phellodendron contains berberine. Preliminary clinical research suggests that berberine can inhibit cytochrome P450 2C9 (CYP2C9) activity and reduce metabolism of losartan (34279). Theoretically, phellodendron might also inhibit the metabolism of losartan.
|
Theoretically, phellodendron might increase the therapeutic and adverse effects of metformin.
Details
Phellodendron contains berberine. In vitro and animal studies show that berberine can increase the systemic exposure and half-life of metformin, potentially increasing metformin's effects and side effects. This interaction seems to be most apparent when berberine is administered 2 hours prior to metformin. Taking berberine and metformin at the same time does not appear to increase systemic exposure to metformin (103195). It is unclear if phellodendron might have this same effect.
|
Theoretically, phellodendron might reduce metabolism of midazolam, which might increase the risk of severe adverse effects.
Details
Phellodendron contains berberine. Preliminary clinical research shows that berberine can inhibit cytochrome P450 3A4 (CYP3A4) activity and reduce metabolism of midazolam (34279). Theoretically, phellodendron might also inhibit the metabolism of midazolam.
|
Theoretically, phellodendron might increase the sedative effect of pentobarbital.
Details
Phellodendron contains berberine. Animal research shows that berberine can prolong pentobarbital-induced sleeping time (13519). Theoretically, phellodendron might increase the sedative effects of pentobarbital.
|
Theoretically, phellodendron might increase blood levels of tacrolimus.
Details
Phellodendron contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of the tacrolimus dose to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL (91954). It is unclear if phellodendron might have this same effect.
|
Evidence from animal research shows that a Pinellia ternata preparation decreases activity and increases sleeping time (102704). Theoretically, Pinellia ternata can potentiate the therapeutic effect of barbiturates. Some of these sedative medications include pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), and others.
|
Evidence from animal research shows that a Pinellia ternata preparation decreases activity and increases sleeping time (102704). Theoretically, Pinellia ternata can potentiate the therapeutic effect of benzodiazepines. Some benzodiazepines include lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), midazolam (Versed), and others.
|
Evidence from animal research shows that a Pinellia ternata preparation decreases activity and increases sleeping time (102704). Theoretically, Pinellia ternata can potentiate the therapeutic effect of CNS depressants. Some of these medications include antihistamines, barbiturates, benzodiazepines, tricyclic antidepressants, and others.
|
Below is general information about the adverse effects of the known ingredients contained in the product Xuan Bi Teapills Xuan Bi Wan. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, consuming more than 2 small apricot kernels or half of a large apricot kernel daily may precipitate acute or chronic cyanide toxicity in adults.
In children, apricot kernels can be toxic in any dose. Orally and topically, purified apricot kernel oil seems to be well tolerated.
Serious Adverse Effects (Rare):
Orally: Acute cyanide toxicity with large doses of apricot kernel. Chronic cyanide poisoning with long-term intake of apricot kernel.
Hepatic ...In one case report, a 58-year-old male receiving palliative chemotherapy developed elevated liver function enzymes without other signs of toxicity after consuming 70 chopped apricot kernels daily for 45 days. One week after discontinuing the use of apricot kernels, the patient still had a thiocyanate level of 71 mg/dL (94064).
Other
...Apricot kernel contains amygdalin, which is converted to cyanide in the body and can cause cyanide poisoning.
Signs of acute cyanide poisoning include abdominal pain, nausea, vomiting, diarrhea, dizziness, headache, hives, rash, itchy or swollen skin, cyanosis, light-headedness, confusion, weakness, drowsiness, palpitations, hyperpnea, seizures, hypotension, and trembling. Late symptoms include respiratory failure, paralysis, coma, and death (4,31757,65124,94064,94065). There are numerous documented reports of acute cyanide toxicity after ingestion of large quantities of apricot kernels and/or amygdalin (31757,31768,65124).
Long-term ingestion of apricot kernel can also cause chronic cyanide poisoning, with symptoms of goiter, thyroid cancer, optic nerve lesions, blindness, ataxia, hypertonia, and intellectual disability. Demyelinating lesions and neuromyopathies also occur secondary to chronic exposure. Lab values indicating chronic cyanide toxicity include increased blood thiocyanate, elevated liver enzymes, and low oxygen saturation (4,94064,97500). There are case reports of chronic cyanide toxicity after long-term consumption of apricot kernels and/or amygdalin (94064,97500).
General
...There is currently a limited amount of information on the adverse effects of atractylodes.
A thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Allergic reaction, dry mouth, nausea.
Gastrointestinal ...Orally, atractylenolide I, an isolated constituent of atractylodes, can cause bad taste, nausea, and dry mouth (15706).
Immunologic ...Atractylodes can cause an allergic reaction in people sensitive to the Asteraceae/Compositae family (12450). Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs.
General ...Adverse effects of forsythia have not been reported. However, a thorough evaluation of safety outcomes has not been conducted.
General
...There is currently a limited amount of information on the adverse effects of gardenia.
Most Common Adverse Effects:
Topically: Allergic contact dermatitis in sensitive individuals.
Dermatologic
...Topically, exposure to gardenia fruit extract or the whole plant has been associated with allergic contact dermatitis (26518,49078).
Orally, there is a case report of blue-gray skin pigmentation associated with taking a product containing the extracts of gardenia fruit, phellodendron bark, and licorice for 7 years in a 77-year-old female. The pigmentation was thought to be due to melanin deposition enhanced by genipin, a constituent of gardenia. The patient gradually improved over 9 months after stopping this treatment (102698).
Gastrointestinal ...Orally, there are case reports of mesenteric phlebosclerosis, a thickening of the walls of the intestine and mesenteric veins, which can lead to obstruction and occlusion. Typical presenting symptoms are paroxysmal abdominal pain with nausea and vomiting, and imaging studies reveal thickening and stiffening of the walls of the ascending and transverse colon, with dark purple discoloration of the colonic and rectal mucosa, and linear calcification of the mesenteric veins. Treatment is supportive and conservative, leading to a slow resolution of signs and symptoms. In one case a 61-year-old female had been taking a Chinese herbal combination containing extracts of gardenia fruit, Baikal skullcap root, goldthread, phellodendron bark, honeysuckle, rhubarb, anemarrhenae, and trichosanthis root for 8 years (112954). In another case, a 77-year-old female took a product containing extracts of gardenia fruit, phellodendron bark, and licorice for 7 years. Mesenteric phlebosclerosis is thought to be caused by genipin, formed from geniposide after hydrolysis by intestinal bacteria. It is absorbed from the intestine, reacting with proteins in mesenteric veins, leading to progressive fibrosis, calcification, and venous occlusion (102698,112954).
Immunologic ...Topically, exposure to gardenia fruit extract or the whole plant has been associated with allergic contact dermatitis (26518,49078).
General ...Orally, Job's tears is generally well tolerated when consumed as a food (15368). There is no good scientific evidence on the safety and adverse effects of Job's tears taken orally in medicinal amounts.
Dermatologic ...Oral use of Job's tears has been associated with Baboon syndrome -- a condition characterized by a red and itchy rash most often located on the buttocks. In one case report, a 53-year-old woman taking a specific Job's tears-containing supplement (Ibane, JW Pharm) from South Korea experienced severe red and itchy skin around her trunk and groin area. While the supplement also contains riboflavin, pyridoxine, ascorbic acid, nicotinamide, biotin, and L-cysteine, Job's tears was thought to be the cause of this patient's reaction. After two weeks of not taking the supplement the patient's skin returned to normal (95438).
General ...Orally, phellodendron seems to be well tolerated.
Endocrine ...Orally, a combination product containing extracts of phellodendron plus magnolia has been associated with one report of thyroid dysfunction in one clinical trial (14349,94901). However, it is unknown if this is related to phellodendron or some other factor.
Gastrointestinal ...Orally, a combination product containing extracts of phellodendron plus magnolia has been associated with one report of heartburn in one clinical trial (14349,94901). However, it is unknown if this is related to phellodendron or some other factor.
Genitourinary ...Orally, a combination product containing extracts of phellodendron plus magnolia has been associated with one report of sexual dysfunction in one clinical trial (14349,94901). However, it is unknown if this is related to phellodendron or some other factor.
Neurologic/CNS ...Orally, a combination product containing extracts of phellodendron plus magnolia has been associated with single reports of shaking hands, perilabial numbness, fatigue, and headache in clinical research (14349,94901). However, it is unknown if this is related to phellodendron or some other factor.
General ...Orally, raw Pinellia ternata tuber can cause severe gastrointestinal irritation. Pinellia ternata is banned from use in dietary supplements in the US due to its ephedrine content. Ephedrine can cause serious cardiovascular and neurologic side effects (12147,98007).
Cardiovascular ...Pinellia ternata contains ephedrine alkaloids, which may potentially cause hypertension, tachycardia, and heart attack when used orally (12147).
Gastrointestinal ...Orally, raw, unprocessed Pinellia ternata tuber can cause severe irritation of the mouth, throat and gastrointestinal tract due to the presence of needle-like crystals of calcium oxalate (98007).
Neurologic/CNS ...Pinellia ternata contains ephedrine alkaloids, which may potentially cause stroke and seizures when used orally (12147).
Pulmonary/Respiratory ...If Pinellia ternata preparations are inhaled they can cause IgE-mediated occupational asthma (12145).
