← Medication interactions guide · A · B–C · D–L · M–O · P–S · T–Z
General information for discussion with your doctor, pharmacist or vet. It is not medical or veterinary advice. Never stop or change a medication without talking to your prescriber.
B
Baclofen
Trade names Lioresal, others
A central nervous system depressant that acts on the GABA-B receptors. There don’t appear to be any P450 family interactions at all, so it should be okay with Golden Paste.
Balsalazide
See also Mesalamine
Balsalazide releases mesalamine–see that entry for details.
Banamine: see Fluxinin
Beclometasone
Also known as: BECLOMETHASONE) (Trade names Qvar, Beconase, Clenil, Alanase
Beclometasone diproprionate is a glucosteroid inhaler or spray. Ok with Golden Paste.
Benazecare: see Benazepril
Benazepril
Trade names Benazecare, Lotensin, Benefortin and others
An ACE inhibitor, generally okay with Golden Paste. Benazecare is a veterinary formulation. Be careful not to get it confused with Benzecare or Benzacare, which is a benzoyl peroxide preparation sold in Spain and used topically for acne.
Bendroflumethiazide
Trade names Aprinox, Centyl
A thiazide diuretic used to treat high blood pressure. It’s also a vasodilator. Okay with Golden Paste.
References:
More detail and references
Drugbank: https://www.drugbank.ca/drugs/DB00436
Benefortin: see Benazepril
Benetec H: see Olmesartan
Benicar, Benicar HCT: see Olmesartan
Bentyl: see Dicyclomine
Benzydamine
Trade name Difflam, Tantum Verde
An NSAID that acts locally on inflamed tissues, does not affect COX enzymes, available as rinse or cream. Okay with Golden Paste.
Beronald: see Furosemide
Betahistine Dihydrochloride
Trade names Serc and others
Betahistine is prescribed typically in Meniere’s Disease for vertigo. It has a minor affect on serotonin, and would typically not be prescribed along with serotonin reuptake inhibitors. Probably okay with Golden Paste, though, as the modest MAO inhibition of turmeric and pepper would be unlikely to cause a significant elevation in serotonin levels.
Betaloc: see Metoprolol
Betmiga: see Mirabegron
Bevacizumab
Also known as: Avastin
Good with turmeric.It is a tumor-starving (anti-angiogenic) therapy. Avastin is designed to block a protein called vascular endothelial growth factor, or VEGF. Combination of turmeric extract with bevacizumab possessed potent anti-tumor effects without observable side effects,
Biliver: see Ursodeoxycholic acid
Bisphosphonates
(etidronate, tiludronate, pamidronate, alendronate, ibandronate, risedronate, zoledronate)
Bone tissue undergoes constant remodeling and is kept in balance (homeostasis) by osteoblasts creating bone and osteoclasts destroying bone. Bisphosphonates inhibit the digestion of bone by encouraging osteoclasts to undergo apoptosis, or cell death, thereby slowing bone loss.
The combination of curcumin and alendronate has beneficial effects on BMD and bone turnover markers among postmenopausal women with osteoporosis.
More detail and references
https://pubmed.ncbi.nlm.nih.gov/30304108/?from_single_result=bisphosphonate%2Ccurcumin
Bomazeal: see Carprofen
Bonamine: see Meclizine
Breo
Ellipta. See also Anoro, Incruse and Trelegy
The Ellipta inhalers contain two or three medication strips, compared with the Diskus and other inhalers that contain only one. Breo contains fluticasone and vilanterol. Fluticasone is not a problem with Golden Paste. There is a minor interaction with vilanterol but we’ve had no reports of problems.
Buccastem: see Prochlorperazine
Bumetanide
Trade names Bumex, Burinex
A loop diuretic similar to furosemide, usually prescribed as a second-line drug when large doses of furosemide have been ineffective. It is roughly 40 times as effective as furosemide. Okay with Golden Paste, with one observation—bumetanide is a prostaglandin G/H synthase 2 (COX-2) inducer and turmeric is a COX-2 inhibitor. I don’t think turmeric’s effect on COX-2 is likely to be potent enough to significantly overcome that of bumetanide. But it’s possible that the bumetanide could dampen turmeric’s COX-2 related anti-inflammatory benefits.
Bumex: see Bumetanide
Buprenorphine
Trade names Cizdol, Subutex, Temgesic, Buprenex, others
Buprenorphine is an opioid derivative sometimes used to treat opioid withdrawal, but also used for pain in dogs and cats. I’ve used it in a cat that was getting Golden Paste with no adverse effects. I think the dosage is low enough in veterinary use that it’s not a problem.
For humans, though, it may well be a problem, especially if it’s being taken in the larger doses typically prescribed for opioid withdrawal. It’s quickly metabolized via CYP3A4 to norbuprenorphine, which binds strongly with P-glycoprotein. Piperine is a strong P-gp inhibitor, and this can result in high enough levels of norbuprenorphine to cause CNS depression. Doctor needs to be consulted before human use, and it would really be good to suggest vet consultation for veterinary use.
More detail and references
Sources:
DrugBank: https://www.drugbank.ca/drugs/DB00921
DrugBank Biointeractions: https://www.drugbank.ca/drugs/DB00921/biointeractions
PubChem: https://www.ncbi.nlm.nih.gov/pccompound/?term=%22buprenorphine%22
Bupropion
Trade names Wellbutrin, Zyban, one of the components of Chantal
Bupropion is a norepinephrine-dopamine reuptake inhibitor, which means it does not increase serotonin levels. It is a CYP3A4 substrate, but with only a minor contribution. However, the manufacturer states that it should not be taken along with any MAO inhibitor, which turmeric and pepper are (curcumin is a potent MAO inhibitor, so this would be especially true for anyone using curcumin extracts). Doctor consult recommended.
Sources:
More detail and references
DrugBank: https://www.drugbank.ca/drugs/DB01156
Burinex: see Bumetanide
Butorphanol
Formerly sold as Stadol, now available only as the generic
In veterinary use as a sedative, often given along with demotidine. In human use as a nasal spray for migraines. May also be given for post-operative shivering and labor pain. Metabolized by glucoronidation, so in extended use, there could be interactions with turmeric, but for the usual applications that shouldn’t be a problem.
Buwecon: see Hyoscyamine
C
Canagliflozin
Trade name Invokana
Oral diabetic medication, a third-line treatment after metformin. Like the other similar medications ending in -gliflozin, it lowers blood glucose by inhibiting sodium-glucose transporters. This inhibits the kidneys’ reuptake of glucose and therefore lowers the glucose level in the blood and promotes the excretion of glucose in the urine.
Canagliflozin is metabolized in part via CYP3A4, and its consumption along with Golden Paste could result in higher than prescribed bloodstream levels. Considering its wide range of adverse side effects (UTI’s, increased vulnerability to fungal infections, increased risk of bone loss, others), it would be best to consult with the prescribing physician before adding Golden Paste.
More detail and references
CANDESARTANl
Candesartan is an angiotensin receptor blocker used mainly for the treatment of high blood pressure and congestive heart failure. ACE inhibitor and ok with turmeric.
Canidryl: see Carprofen
Capecitabine
Trade names Xeloda among others
A chemotherapy drug that has been trialled with curcumin. Curcumin was found to sensitize human colorectal cancer to capecitabine. However, Roche and the FDA have issued a ‘black box’ warning that it can adversely affect clotting times for anyone taking warfarin. Given that turmeric is a modest anticoagulant, patients should probably be advised to talk to their doctors about it.
References:
Curcumin sensitizes human colorectal cancer to capecitabine by modulation of cyclin D1, XOC-2, MMP-9, VEGF and CXCR4 expression in an orthotopic mouse model: https://www.ncbi.nlm.nih.gov/pubmed/19623659
More detail and references
Black box warning for Roche’s Xeloda: https://www.accessdata.fda.gov/drugsatfda_docs/label/2001/20896S1011lbl.pdf
Carbamazepin
Trade names Tegetrol, others
For neuropathic pain and some kinds of seizures. Metabolized via CYP3A4, and has multiple undesirable side effects (Stevens-Johnson syndrome, adverse effects on red blood cells, white blood cells and platelets, others). Physician consult required, probably should not be used at all with Golden Paste.
Carbidopa/levodopa
Trade name Levocarb, co-careldopa
Levodopa is commonly prescribed for Parkinson’s, but its prompt metabolism to dopamine has undesirable side effects in the body (mostly nausea). Adding carbidopa slows the conversion to dopamine and allows more of the levodopa to cross the blood-brain barrier before it’s metabolized. Carbidopa can’t cross the blood brain barrier, so it does not affect the metabolism of levodopa to dopamine in the brain. Okay with Golden Paste.
Carboplatin
Carboplatin is an alkylating antineoplastic agent. Similar to cisplatin, its chemical reactivity is nonspecific. However, carboplatin causes alkylation of DNA strands causing crosslinking, which impairs DNA replication, RNA transcription, and protein synthesis, leading to inhibition of tumor growth.
Carboplatin is a broad spectrum antineoplastic agent useful for a variety of veterinary neoplastic diseases including: carcinoma (squamous cell carcinoma, ovarian carcinoma, mediastinal carcinoma, pleural adenocarcinoma, pulmonary carcinoma, nasal carcinoma, anal sac apocrine gland adenocarcinoma,1 colonic adenocarcinoma, urinary tract carcinoma,2 hepatocellular carcinoma and thyroid adenocarcinoma), melanoma,3 and sarcoma (osteosarcoma,4 lymphoma). Sensitises to radiation. The metabolism and elimination of carboplatin are complex. After degradation into platinum and platinum-complexed compounds, they become highly protein bound and are slowly eliminated by the kidneys. In dogs, almost one half of the dose is excreted unchanged in the urine within 24 hours and approximately 70% of the platinum administered is secreted in the urine after 72 hours.
More detail and references
Turmeric is supportive.
References:
Curcumin sensitizes human lung cancer cells to apoptosis and metastasis synergistically combined with carboplatin
https://journals.sagepub.com/doi/abs/10.1177/1535370215571881
Curcumin activates DNA repair pathway in bone marrow to improve carboplatin-induced myelosuppression
Cardalis
Cardalis is a trade name for a combination of benazepril and spironolactone (generic is aldectone). It should be okay with Golden Paste except in renal-impaired dogs. The manufacturer explicitly states that it may result in hyperkalemia (it increases sodium excretion and therefore weights the sodium/potassium balance toward potassium). Dogs with kidney disease may not be able to handle the excess potassium. Interestingly, at least one trial suggested that it is not a problem with humans, even those with kidney impairment.
Carprofen
Trade names Acticarp, Austiofen, Bomazeal, Canidryl, Carporal, Carprieve, Carprocow, Carprodolor, Carprodyl, Carprofelican, Carprofen, Carprofène, Carprofeno, Carprofenum, Carprogesic, Carprosol, Carprotab, Carprox, Comforion, Dolagis, Dolocarp, Dolox, Eurofen, Kelaprofen, Librevia, Norocarp, Norodyl, Novocox, Ostifen, Prolet, Quellin, Reproval, Rimadyl, Rimifin, Rofeniflex, Rovera, Rycarfa, Scanodyl, Tergive, Vetprofen, Xelcor
Carprofen is an NSAID that inhibits production of both COX-1 and COX-2. The selectivity of the inhibition is species dependent. Information on that will be added here. It appears not to be a problem along with Golden Paste or a curcumin extract.
Carvedilol
Trade names Coreg, others
A non-selective alpha/beta blocker for hypertension, congestive heart failure and left ventricular dysfunction. Metabolized primarily via CYP2D6 and CYP2C9, should be okay with Golden Paste.
Cephalexin
Also cefalexin; trade names Rilexine, Keflex, Ceporex
A beta-lactam antibiotic in the cephalosporin family, effective against both some gram-positive and gram-negative bacteria, particularly gram-positive cocci. Rilexine is the veterinary trade name, but it’s the same thing sold as Keflex for humans. It’s sold as Ceporex in the UK. No significant problem with Golden Paste.
Chlorambucil
Trade name Leukeran
Chlorambucil is an alkylating agent (one of the many derived from the same source as the ‘mustard gas’ used during World War I) that can decrease white blood cell levels. For that reason, it’s often prescribed for CLL (chronic lymphocytic leukemia) and similar conditions (MGUS, for example). It’s metabolized primarily via glutathione S-transferase (GST), whose production is stimulated by turmeric. Thus the bloodstream levels of chlorambucil could be lower than intended (since it would be metabolized and cleared faster). Needs consult with prescribing vet or physician
Chlorpheniramine, Chlorphenamine
Trade name Piriton, others
An antihistamine widely used in veterinary practice. It is also a serotonin-norepinephrine reuptake inhibitor, so it may not be appropriate with Golden Paste. In addition, it’s metabolized via CYP2D6, and turmeric is a modest inhibitor of that. Probably not significant if not for the SNRI aspect of it. Vet consult recommended before use.
Chlorthalidone
Also chlortalidone
A thiazide-type diuretic (though not a benzothiadiazide itself), one of the older drugs, was initially approved in 1960 and has stood the test of time. OK with Golden Paste.
More detail and references
DrugBank entry: https://www.drugbank.ca/drugs/DB00310
Cipralex: see Escitalopram
Cisapride
Trade names Prepulsid, Propulsid, others
This has been removed from the market for human use in most countries, but is still in veterinary use in many places. It increases gut motility. It’s a serotonin agonist, so not good with anything else that increases serotonin levels, such as turmeric and pepper. Besides that, it is metabolized via CYP3A4. It works very similar to the way turmeric works on the gut, in fact, which is why its effects are similar to those of turmeric. Vet consult needed.
Cisplatin
Also known as: Cisplatinum, platamin, neoplatin, cismaplat
Cisplatin-based chemotherapeutic regimens are the most frequently used adjuvant treatments for many types of cancer. However, the development of chemoresistance to cisplatin results in treatment failure. Despite the significant developments in understanding the mechanisms of cisplatin resistance, effective strategies to enhance the chemosensitivity of cisplatin are lacking. Phytochemicals are naturally occurring plant-based compounds that can augment the anti-cancer activity of cisplatin, with minimal side effects. Notably, some novel phytochemicals, such as curcumin, not only increase the efficacy of cisplatin but also decrease toxicity induced by cisplatin.
Platinum coordination compound that inhibits DNA synthesis; cross-links and denatures strands of DNA; disrupts DNA function by covalently binding to DNA bases; can also produce DNA intrastrand cross-linking and breakage
More detail and references
Not a true alkylating agent
Pharmacokinetics: Half-life elimination (terminal): 24hr to 47 days; Protein bound: >90%
Excretion: Urine (90%); feces (10%)
Clonazepam
Trade name Klonopin
Clonazepam is a benzodiazepine-class tranquilizer, and as such is metabolized via CYP3A4. Needs a doctor’s okay to use with Golden Paste.
Clonazepam
Sold as Rivotril, Emcloz, Linotril, Clonotril, Riklona, Klonopin, Clonoten, Ravotril, Rivatril, Iktorivil, Clonex, Paxam, Petril, Naze, Kriadex
Clonazepam is a benzodiazepine tranquilizer, with potent central nervous system effects. It’s prescribed very widely for a long list of things–anxiety, restless leg syndrome, seizures (in children, but not typically for adults), spasticity related to ALS, mania or psychosis-induced aggression, bipolar 2, others.
Like all the benzo’s, it’s metabolized by CYP3A4, and should not be combined with Golden Paste without physician consent.
Clonidine
Trade names Catapres, Kapvay, Nexiclon, Clophelin
An alpha-2 adrenergic agonist used to treat high blood pressure, and also for ADHD, the tics from Tourette’s Syndrome, anxiety and other neuropsychiatric disorders. Most people do not use it on a regular basis so its interaction with Golden Paste is probably minimal. It is cleared via CYP2D6, which is inhibited by turmeric. But in most cases, it shouldn’t be a problem. Watch for indications that it might be in use for opioid withdrawal–that would be a good probability that it needs a physician consult first.
Clopidogrel Bisulphate
Also known as: Plavix
Oral, once-daily platelet aggregation inhibitor that may be useful in hypercoagulable states in dogs and in preventing thromboembolic disease in cats.
Clopidogrel is a prodrug, and must be hepatically metabolized to form an active, highly unstable thiol compound (not yet identified and commonly referred to as clopidogrel active metabolite (CAM). This compound binds selectively to platelet surface adenosine diphosphate (ADP) receptor P2Y12 and irreversibly alters the ADP receptor for the lifespan of the platelet. This receptor alteration causes reduced platelet activation and subsequent inhibition of primary and secondary platelet aggregation. Different to aspirin and curcumin but is compatible with feeding curcumin id doses of both are not too high causing extreme lack of clotting.
Coaprovel
This is a combination of irbesartan (blood pressure med) and hydrochlorothiazide (diuretic). Should be okay with Golden Paste. Look up the individual meds for more.
Codeine
Sold as hydrocodone, oxycodone, Panadol, Co-codamol, Co-daprin, Nurofen Plus, Panadeine, Hysingla, Zohydro ER, Norco, Vicodin, Lortab, others
Codeine is more often found in combination with other substances than by itself (though it may be prescribed by itself). It is available OTC in some locations (South Africa, Japan, Iran, Sri Lanka, and a few provinces in Canada). The particular formulation that’s available varies widely, with some being very low dosages (for example, hydrocodone–codeine and acetaminophen–is available in dosages of 7.5 or 10 milligrams of codeine and 325mg acetaminophen). It is cleared via CYP2D6 and CYP3A4, so it will be affected by both the pepper in Golden Paste and by curcumin extract (which inhibits CYP3A4 and CYP2D6). CBD oil is also a potent inhibitor of codeine’s metabolic pathways (both CYP2D6 and CYP3A4). Because of the variability of CYP2D6 expression in humans, codeine’s clearance is already unpredictable.
More detail and references
Codeine can possibly be managed in many cases by having it at least 3-4 hours away from Golden Paste, but caution is advised. If you’re unsure about combining it with inhibitors of either of these enzymes, check with your doctor or vet first. This would be particularly important if CBD is in use along with Golden Paste (or, even more important, both Golden Paste and curcumin).
Colchicine
Trade name Colcrys
Colchicine is best known for its use in gout and in Behcet’s Disease. It’s metabolized primarily via CYP3A4, and considering its multiple and serious side effects (fatalities have occurred), Golden Paste should not be consumed along with it without specific physician consent.
Colesevelam
Sold as Cholestagel, Welchol, Valeant
Colesevelam is a bile acid sequestrant prescribed to reduce LDL cholesterol and to help with blood glucose control in type II diabetes. It is excreted without being metabolized and is not absorbed into the bloodstream. So it has no significant interactions with Golden Paste (if any at all).
Cyclobenzaprine
Trade name Flexeril
A muscle relaxer prescribed for muscle spasms. It can affect serotonin levels and there have been instances of serotonin syndrome when it was taken along with MAO inhibitors. Since both turmeric and black pepper are moderate non-selective MAO inhibitors, that would be an immediate red flag. But in addition, cyclobenzaprine is cleared primarily via CYP3A4. Physcian consult required, but it would probably be prohibited.
Half-life: ranges from 8-37 hours
More detail and references
Drugbank: https://www.drugbank.ca/drugs/DB00924
Cyclosporine, Ciclosporine
A potent immunosuppressant widely used in various kinds of preparations, for both animals and humans. It works against T-lymphocytes. One trial examined a combination of cyclosporine and curcumin and found that curcumin enhanced the immunosuppressant effect of cyclosporine. Even so, the wide range and severity of side effects when dosages are exceeded make it sensible to discuss its use with the prescribing physician or vet.
References
More detail and references
Drugbank.ca: https://www.drugbank.ca/drugs/DB00091
Science Direct: http://www.sciencedirect.com/science/article/pii/S0041134503003774
Can’t find your medication? Ask Dr Doug and it may be added to the guide. A · B–C · D–L · M–O · P–S · T–Z
