Ginger rhizome • Blackberry leaf , Stevia leaf, Lemon Myrtle leaf.
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Below is general information about the effectiveness of the known ingredients contained in the product Ginger Aid. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
There is insufficient reliable information available about the effectiveness of blackberry.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of Madagascar periwinkle.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of periwinkle.
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Ginger Aid. 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 the fruit is used orally in amounts commonly found in foods (4912). There is insufficient reliable information available about the safety of blackberry fruit or leaf when used in medicinal amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in amounts greater than those found in foods.
LIKELY SAFE ...when used orally and appropriately. Ginger has been safely used in multiple clinical trials (721,722,723,5343,7048,7084,7085,7400,7623,11346)(12472,13080,13237,13244,17369,17928,17929,89889,89890,89894)(89895,89898,89899,90102,96252,96253,96259,96260,96669) (101760,101761,101762,103359,107903).
POSSIBLY SAFE ...when used topically and appropriately, short-term (89893,89897).
CHILDREN: LIKELY SAFE
when consumed in the amounts typically found in foods.
CHILDREN: POSSIBLY SAFE
when used orally and appropriately, short-term.
Ginger powder has been used with apparent safety at a dose of up to 750 mg daily for 4 days in girls aged 14-18 years (96255).
PREGNANCY: LIKELY SAFE
when consumed in the amounts typically found in foods.
Ginger is considered a first-line nonpharmacological treatment option for nausea in pregnancy by the American College of Obstetrics and Gynecology (ACOG) (111601). However, it should not be used long-term or without medical supervision and close monitoring.
PREGNANCY: POSSIBLY SAFE
when used for medicinal purposes.
Despite some early reports of adverse effects (721,7083) and one observational study suggesting that taking dried ginger and other herbal supplements during the first 20 weeks of pregnancy marginally increased the chance of stillbirth (96254), most research shows that ginger is unlikely to cause harm to the baby. The risk for major malformations in infants of parents who took ginger when pregnant does not appear to be higher than the baseline rate of 1% to 3% (721,1922,5343,11346,13071,13080,96254). Also, other research suggests that ginger intake during various trimesters does not significantly affect the risk of spontaneous abortion, congenital malformations, stillbirth, perinatal death, preterm birth, low birth weight, or low Apgar scores (18211,90103). Ginger use has been associated with an increase in non-severe vaginal bleeding, including spotting, after week 17 of pregnancy (18211).
LACTATION: LIKELY SAFE
when consumed in the amounts typically found in foods.
There is insufficient reliable information available about the safety of ginger when used for medicinal purposes; avoid amounts greater than those found in foods.
LIKELY UNSAFE ...when the plant or root are used orally. Madagascar periwinkle contains toxic vinca alkaloids, which can cause death (6). There is insufficient reliable information available about the safety of Madagascar periwinkle when used topically.
PREGNANCY: LIKELY UNSAFE
when used orally.
Madagascar periwinkle has abortifacient and teratogenic properties (19).
LACTATION: LIKELY UNSAFE
when used orally (6); avoid using.
POSSIBLY SAFE ...when myrtle berry is used orally, short term. Myrtle berry powder 2,250 mg daily has been used with apparent safety for up to 5 days (106778). ...when diluted myrtle leaf extract is used topically and appropriately, short term. A paste containing myrtle leaf extract 5% has been used with apparent safety for up to 6 days (98643). Other myrtle leaf extracts have been applied to the face for up to 16 weeks with apparent safety (106780). ...when myrtle leaf extract is used intravaginally and appropriately, short term. Vaginal suppositories containing myrtle leaf extract 10% and leaf essential oil 0.5% have been used with apparent safety for up to three menstrual cycles (98644).
LIKELY UNSAFE ...when the undiluted oil of myrtle leaf is used orally. Myrtle leaf contains cineole. Ingesting more than 10 grams of cineole can result in respiratory failure and collapse (18). There is insufficient reliable information available about the safety of myrtle leaf and branch when used orally. There is also insufficient reliable information available about the safety of myrtle berry when used topically or myrtle berry extract when used orally or topically.
CHILDREN: LIKELY UNSAFE
when myrtle oil is used orally.
Avoid facial contact with myrtle oil preparations which may cause glottal spasm, bronchospasm, asthma-like attacks, or respiratory failure in infants or small children (18).
There is insufficient reliable information available about the safety of myrtle berry or myrtle berry extract when used orally in children.
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally (18); avoid using.
LIKELY SAFE ...when certain stevia constituents, including stevioside and rebaudiosides A, D, and M, are used orally as sweeteners in foods. These constituents have generally recognized as safe (GRAS) status in the US for this purpose (16699,16700,16702,16705,16706,108049). The stevia constituent stevioside has been safely used in doses of up to 1500 mg daily for 2 years (11809,11810,11811). There is insufficient reliable information available about the safety of whole stevia or stevia extracts when used orally. The European Food Safety Authority (EFSA) has determined that the acceptable intake of steviol glycosides is 4 mg/kg daily (106456); however, it is unclear how this relates to the use of whole stevia or stevia extract.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
Below is general information about the interactions of the known ingredients contained in the product Ginger Aid. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Details
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation (7622,12634,20321,20322,20323,96257). However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials (96257). Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
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Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
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Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
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Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects (12633). Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone (107901).
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Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
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In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time (20401).
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Theoretically, ginger might increase the levels of CYP1A2 substrates.
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In vitro research shows that ginger inhibits CYP1A2 activity (111544). However, this interaction has not been reported in humans.
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Theoretically, ginger might increase the levels of CYP2B6 substrates.
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In vitro research shows that ginger inhibits CYP2B6 activity (111544). However, this interaction has not been reported in humans.
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Theoretically, ginger might increase the levels of CYP2C9 substrates.
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In vitro research shows that ginger inhibits CYP2C9 activity (111544). However, this interaction has not been reported in humans.
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Ginger might increase or decrease the levels of CYP3A4 substrates.
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In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity (111544,111644). Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration (111644).
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates (111404). However, this interaction has not been reported in humans. |
Theoretically, ginger might increase levels of losartan and the risk of hypotension.
Details
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan (102459). It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.
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Theoretically, ginger might increase levels of metronidazole.
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In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced (20350).
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Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Details
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone (20324).
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Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Details
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates (111544,111644). Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration (111644).
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Ginger might increase the risk of bleeding with phenprocoumon.
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Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea (12880).
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Ginger might increase the risk of bleeding with warfarin.
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Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation (7622,12634,20321,20322,20323). In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin (12880). In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen (20349). A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months (20348). However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin (12881,15176). Until more is known, monitor INRs closely in patients taking large amounts of ginger.
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Animal research shows that Madagascar periwinkle lowers blood glucose levels in diabetic rats (104764). Theoretically, using Madagascar periwinkle in combination with antidiabetes drugs might increase the risk of hypoglycemia; monitor blood glucose closely.
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Madagascar periwinkle is thought to have diuretic properties (6). Theoretically, due to these potential diuretic effects, Madagascar periwinkle might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Theoretically, taking periwinkle may increase the effects of antihypertensive drugs due to the hypotensive activity of vincamine, a constituent of periwinkle (12,19).
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Theoretically, stevia might increase the risk for hypoglycemia when combined with antidiabetes drugs.
Details
Preliminary clinical research in patients with type 2 diabetes suggests that taking a single dose of stevia extract 1000 mg reduces postprandial blood glucose levels when taken with a meal (11812). However, other clinical research in patients with type 1 or type 2 diabetes suggests that taking stevioside 250 mg three times daily does not significantly affect blood glucose levels or glycated hemoglobin (HbA1C) after three months of treatment (16705).
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Theoretically, combining stevia or stevia constituents with antihypertensive agents might increase the risk of hypotension.
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Theoretically, stevia might decrease clearance and increase levels of lithium.
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Below is general information about the adverse effects of the known ingredients contained in the product Ginger Aid. 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 ...Blackberry fruit is commonly consumed as a food without reports of adverse effects. However, a thorough evaluation of safety outcomes for blackberry when used as a medicine has not been conducted.
General
...Orally, ginger is generally well tolerated.
However, higher doses of 5 grams per day increase the risk of side effects and reduce tolerability. Topically, ginger seems to be well tolerated.
Most Common Adverse Effects:
Orally: Abdominal discomfort, burping, diarrhea, heartburn, and a pepper-like irritant effect in the mouth and throat. However, some of these mild symptoms may be reduced by ingesting encapsulated ginger in place of powdered ginger.
Topically: Dermatitis in sensitive individuals.
Cardiovascular ...Orally, use of ginger resulted in mild arrhythmia in one patient in a clinical trial (16306).
Dermatologic
...Orally, ginger can cause hives (17933), as well as bruising and flushing (20316) or rash (20316).
Topically, ginger can cause dermatitis in sensitive individuals (12635,46902).
Gastrointestinal
...Orally, common side effects of ginger include nausea (17933,22602,89898,101761), belching (10380,103359), dry mouth (103359), dry retching (10380), vomiting (10380), burning sensation (10380), oral numbness (22602), abdominal discomfort (5343,89898,96253), heartburn (5343,7624,12472,16306,20316,51845,89894,89895,89898,89899)(101760,101761,101762,111543), diarrhea (5343,101760), constipation (89898,101760,101761), or a transient burning or "chilly hot" sensation of the tongue and throat (52076).
Orally, Number Ten, a specific product composed of rhubarb, ginger, astragalus, red sage, and turmeric, can increase the incidence of loose stools (20346).
Four cases of small bowel obstruction due to ginger bolus have been reported following the ingestion of raw ginger without sufficient mastication (chewing). In each case, the bolus was removed by enterotomy. Ginger is composed of cellulose and therefore is resistant to digestion. It can absorb water, which may cause it to swell and become lodged in narrow areas of the digestive tract (52115).
Genitourinary ...In one clinical trial, some patients reported increased menstrual bleeding while taking a specific ginger extract (Zintoma, Goldaru) 250 mg four times daily orally for 3 days (17931). An "intense" urge to urinate after 30 minutes was reported in two of eight patients given 0.5-1 gram of ginger (7624). However, this effect has not been corroborated elsewhere. Dysuria, flank pain, perineal pain, and urinary stream interruption have been reported in a 43-year-old male who drank ginger tea, containing 2-3 teaspoons of dry ginger, daily over 15 years. The adverse effects persisted for 4 years and were not associated with increases in urinary frequency or urgency. Upon discontinuing ginger, the patient's symptoms began to improve within one week and completely resolved after eight weeks, with no relapses six months later (107902).
Immunologic ...In one case report, a 59-year-old Japanese female with multiple allergic sensitivities developed pruritus and then anaphylactic shock after taking an oral ginger-containing herbal supplement for motion sickness (Keimei Gashinsan, Keimeido). The patient had used this supplement previously for over 20 years with no allergic reaction. The authors theorized the development of a cross-reactivity to ginger after the use of an oral supplement containing zedoary and turmeric, which are also in the Zingiberaceae family (102463).
Neurologic/CNS ...Orally, ginger may cause sedation, drowsiness, or dizziness (16306,17933,51845).
General
...Orally, Madagascar periwinkle is generally regarded as unsafe for use.
Any benefits of therapy may not outweigh the risk of toxicity. Madagascar periwinkle can cause hallucinations, seizures, gastrointestinal upset, hepatotoxicity, and alopecia (17). The vinca alkaloid constituents of Madagascar periwinkle have been reported to cause nausea, vomiting, alopecia, dizziness, nystagmus, vertigo, hearing impairment, leukopenia, thrombocytopenia, bleeding, hyperuricemia, neurotoxicity, and possibly death (6,15).
Exposure to the airborne pollen of Madagascar periwinkle can cause respiratory allergic reactions in sensitive individuals (100665).
Dermatologic ...Orally, Madagascar periwinkle can cause alopecia (17).
Gastrointestinal ...Orally, Madagascar periwinkle can cause gastrointestinal upset (17). The vinca alkaloid constituents of Madagascar periwinkle have been reported to cause nausea and vomiting (6,15).
Hematologic ...Orally, the vinca alkaloid constituents of Madagascar periwinkle have been reported to cause leukopenia, thrombocytopenia, bleeding, and hyperuricemia (6,15).
Hepatic ...Orally, Madagascar periwinkle can cause hepatotoxicity (17).
Immunologic ...Exposure to the airborne pollen of Madagascar periwinkle can cause allergic respiratory reactions. In one population of adults with respiratory allergies, 29.8% tested positive to Madagascar periwinkle pollen during skin prick testing (100665).
Neurologic/CNS ...Orally, Madagascar periwinkle can cause hallucinations and seizures (17). The vinca alkaloid constituents of Madagascar periwinkle have been reported to cause dizziness, vertigo, and neurotoxicity (6,15).
Ocular/Otic ...Orally, the vinca alkaloid constituents of Madagascar periwinkle have been reported to cause nystagmus and hearing impairment (6,15).
General
...There is currently a limited amount of information on the adverse effects of oral and intravaginal myrtle.
A thorough evaluation of safety outcomes has not been conducted. Topically, myrtle leaf seems to be generally well tolerated in adults.
Most Common Adverse Effects:
Topically: Dry skin.
Intravaginally: Vaginal irritation and dryness.
Serious Adverse Effects (Rare):
Orally: Hypotension, respiratory failure.
Topically: Bronchial spasm and respiratory failure, most commonly in infants or children.
Cardiovascular ...Orally, very large amounts of undiluted myrtle leaf oil might lead to low blood pressure and circulatory disorders due to the cineole constituent (18).
Dermatologic ...Topically, myrtle leaf extract has been reported to cause dry skin (106777).
Gastrointestinal ...Orally, myrtle berry extract has been reported to cause constipation in infants and young children (106781).
Genitourinary ...Intravaginally, myrtle leaf extract suppositories have been reported to cause vaginal irritation and dryness (98644).
Pulmonary/Respiratory
...Orally, consumption of very large amounts of undiluted myrtle leaf oil might lead to respiratory failure and collapse (18).
Topically, facial contact with myrtle oil preparations may cause glottal or bronchial spasm, asthma-like attacks, or respiratory failure in infants and children (18).
General ...Periwinkle is generally regarded as unsafe for use. Orally, periwinkle can cause cytotoxic, neurologic, liver, and kidney damage due to its vinca alkaloid constituents (17). Periwinkle has also been reported to cause gastrointestinal complaints, skin flushing, and hypotension (18).
Cardiovascular ...Orally, large amounts of periwinkle can cause a severe drop in blood pressure (18).
Dermatologic ...Orally, periwinkle can cause skin flushing (18).
Gastrointestinal ...Orally, periwinkle can cause gastrointestinal complaints (18).
Hepatic ...Orally, periwinkle can cause liver damage due to its vinca alkaloid constituents (17).
Neurologic/CNS ...Orally, periwinkle can cause neurologic damage due to its vinca alkaloid constituents (17).
Renal ...Orally, periwinkle can cause kidney damage due to its vinca alkaloid constituents (17).
General
...Orally, stevia and steviol glycosides appear to be well tolerated.
Most minor adverse effects seem to resolve after the first week of use.
Most Common Adverse Effects:
Abdominal bloating, dizziness, headache, myalgia, nausea, and numbness.
Serious Adverse Effects (Rare):
Allergic reactions.
Gastrointestinal ...Orally, stevia and steviol glycosides such as stevioside, can cause gastrointestinal adverse effects such as abdominal fullness and nausea. However, these generally resolve after the first week of use (11809,11810).
Immunologic ...Theoretically, stevia might cause allergic reactions in individuals sensitive to plants in the Asteraceae/Compositae family (11811). Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs.
Musculoskeletal ...Orally, stevia and steviol glycosides may cause myalgia, but this generally resolves after the first week of use (11809,11810).
Neurologic/CNS ...Orally, stevia and steviol glycosides may cause headache, dizziness, and numbness (11809,11810).