Ginger + Rutin + Buchu + Hydrangea Root + Quercetin + Bromelain + Corn Silk + Bioperine (Black Pepper Fruit Extract)

Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol 2004;56:101-5.

Altman RD, Marcussen KC. Effects of ginger extract on kQUERCETINnee pain in patients with osteoarthritis. Arthritis Rheum 2001;44:2531-38.

Anon. Case problem: presenting conventional and complementary approaches for relieving nausea in a breast cancer patient undergoing chemotherapy. J Am Diet Assoc 2000;100:257-9.

Arfeen Z, Owen H, Plummer JL, et al. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care 1995;23:449-52.

Backon J. Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 1991;42:163-4.

Black CD, Herring MP, Hurley DJ, O’Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain 2010;11:894-903.

Black CD, O’Connor PJ. Acute effects of dietary ginger on muscle pain induced by eccentric exercise. Phytother Res 2010;24:1620-6.

Black CD, Oconnor PJ. Acute effects of dietary ginger on quadriceps muscle pain during moderate-intensity cycling exercise. Int J Sport Nutr Exerc Metab 2008;18:653-64.

Bliddal H, Rosetzsky A, Schlichting P, et al. A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthritis Cartilage 2000;8:9-12.

Bone ME, Wilkinson DJ, Young JR, et al. Ginger root-a new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia 1990;45:669-71.

Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56.

Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, et al. The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol 2006;194:95-9.

Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.

Drozdov VN, Kim VA, Tkachenko EV, Varvanina GG. Influence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip. J Alt Compl Med 2012;18:583-8.

Eberhart LH, Mayer R, Betz O, et al. Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Anesth Analg 2003;96:995-8.

Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth 2000;84:367-71.

Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19-24.

Frondoza CG, Sohrabi A, Polotsky A, et al. An in vitro screening assay for inhibitors of proinflammatory mediators in herbal extracts using human synoviocyte cultures. In Vitro Cell Dev Biol Anim 2004;40:95-101.

Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80.

Grontved A, Brask T, Kambskard J, Hentzer E. Ginger root against seasickness: a controlled trial on the open sea. Acta Otolaryngol 1998;105:45-9.

Grontved A, Hentzer E. Vertigo-reducing effect of ginger root. A controlled clinical study. ORL J Otorhinolaryngol Relat Spec 1986;48:282-6.

Haghighi M, Khalva A, Toliat T, Jallaei S. Comparing the effects of ginger (Zingiber officinale) extract and ibuprofen on patients with osteoarthritis. Arch Iran Med 2005;8:267-71.

Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2012 Jun 17.

Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145.

Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8.

Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32.

Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62.

Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60.

Langner E, Greifenberg S, Gruenwald J. Ginger: history and use. Adv Ther 1998;15:25-44.

Leach MJ, Kumar S. The clinical effectiveness of ginger (Zingiber officinale) in adults with osteoarthritis. Int J Evid Based Healthc 2008;6:311-20.

Lumb AB. Mechanism of antiemetic effect of ginger. Anaesthesia 1993;48:1118.

Manusirivithaya S, Sripramote M, Tangjitgamol S, et al. Antiemetic effect of ginger in gynecologic oncology patients receiving cisplatin. Int J Gynecol Cancer 2004;14:1063-9.

Marcus DM, Suarez-Almazor ME. Is there a role for ginger in the treatment of osteoarthritis? Arthritis Rheum 2001;44:2461-2.

Micklefield GH, Redeker Y, Meister V, et al. Effects of ginger on gastroduodenal motility. Int J Clin Pharmacol Ther 1999;37:341-6.

Nagabhushan M, Amonkar AJ, Bhide SV. Mutagenicity of gingerol and shogaol and antimutagenicity of zingerone in Salmonella/microsome assay. Cancer Lett 1987;36:221-33.

Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32.

Phillips S, Hutchinson S, Ruggier R. Zingiber officinale does not affect gastric emptying rate. A randomised, placebo-controlled, crossover trial. Anaesthesia 1993;48:393-5.

Phillips S, Ruggier R, Hutchinson SE. Zingiber officinale (ginger)-an antiemetic for day case surgery. Anaesthesia 1993;48:715-7.

Pongrojpaw D, Somprasit C, Chanthasenanont A. A randomized comparison of ginger and dimenhydrinate in the treatment of nausea and vomiting in pregnancy. J Med Assoc Thai 2007;90:1703-9.

Portnoi G, Chng LA, Karimi-Tabesh L, et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 2003;189:1374-7.

Schechter JO. Treatment of disequilibrium and nausea in the SRI discontinuation syndrome. J Clin Psychiatry 1998;59:431-2.

Smith C, Crowther C, Wilson K et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45.

Srivastava KC, Mustafa T. Ginger (Zingiber officinale) and rheumatic disorders. Med Hypotheses 1989;29:25-8.

Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5.

Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20.

Suekawa M, Ishige A, Yuasa K, et al. Pharmacological studies on ginger. I. Pharmacological actions of pungent constitutents, (6)-gingerol and (6)-shogaol. J Pharmacobiodyn 1984;7:836-48.

Terry R, Posadzki P, Watson LK, Ernst E. The use of ginger (Zingiber officinale) for the treatment of pain: a systematic review of clinical trials. Pain Med 2011;12:1808-18.

Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8.

Visalyaputra S, Petchpaisit N, Somcharoen K, Choavaratana R. The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia 1998;53:506-10.

Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82.

Weidner MS, Sigwart K. Investigation of the teratogenic potential of a zingiber officinale extract in the rat. Reprod Toxicol 2001;15:75-80.

Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11:783-9.

Wilkinson JM. Effect of ginger tea on the fetal development of Sprague-Dawley rats. Reprod Toxicol 2000;14:507-12.

Wilkinson JM. What do we know about herbal morning sickness treatments? A literature survey. Midwifery 2000;16:224-8.

Wood CD, Manno JE, Wood MJ, et al. Comparison of efficacy of ginger with various antimotion sickness drugs. Clin Res Pr Drug Regul Aff 1988;6:129-36.

Cruz T, Galvez J, Ocete MA, et al. Oral administration of rutoside can ameliorate inflammatory bowel disease in rats. Life Sci 1998;62:687-95.

Drewa G, Schachtschabel DO, Palgan K, et al. The influence of rutin on the weight, metastasis and melanin content of B16 melanotic melanoma in C57BL/6 mice. Neoplasma 1998;45:266-71.

Erlund I, Kosonen T, Alfthan G, et al. Pharmacokinetics of quercetin from quercetin aglycone and rutin in healthy volunteers. Eur J Clin Pharmacol 2000;56:545-53.

Escarpa A, Gonzalez MC. High-performance liquid chromatography with diode-array detection for the determination of phenolic compounds in peel and pulp from different apple varieties. J Chromatogr A 1998;823:331-7.

Galvez J, Cruz T, Crespo E, et al. Rutoside as mucosal protective in acetic acid-induced rat colitis. Planta Med 1997;63:409-14.

Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest 2000;19:15-23.

Kostyuk VA, Potapovich AI, Speransky SD, Maslova GT. Protective effect of natural flavonoids on rat peritoneal macrophages injury caused by asbestos fibers. Free Radical Biol Med 1996;21:487-93.

Kostyuk VA, Potapovich AI. Antiradical and chelating effects in flavonoid protection against silica-induced cell injury. Arch Biochem Biophys 1998;355:43-8.

Mehta DK (Ex Ed). British National Formulary, Number 37. British Medical Association and Royal Pharmaceutical Society of Great Britain: London, England, March 1999.

Perez Guerrero C, Martin MJ, Marhuenda E. Prevention by rutin of gastric lesions induced by ethanol in rats: role of endogenous prostaglandins. Gen Pharmacol 1994;25:575-80.

Schmitt A, Salvayre R, Delchambre J, Negre-Salvayre A. Prevention by alpha-tocopherol and rutin of glutathione and ATP depletion induced by oxidized LDL in cultured endothelial cells. Br J Pharmacol 1995;116:1985-90.

Webster RP, Gawde MD, Bhattacharya RK. Protective effect of rutin, a flavonol glycoside, on the carcinogen-induced DNA damage and repair enzymes in rats. Cancer Lett 1996;109:185-91.

Electronic Code of Federal Regulations. Title 21. Part 182 — Substances Generally Recognized As Safe. Available at: 786bafc6f6343634fbf79fcdca7061e1&rgn=div5&view= text&node=21:

Fetrow CW, Avila JR. Professional’s Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.

Hamid S, Rojter S, Vierling J. Protracted cholestatic hepatitis after the use of Prostata. Ann Intern Med 1997;127:169-70.
Anon. Quercetin. Alt Med Rev 1998;3:140-3.

Bobe G, Weinstein SJ, Albanes D, et al. Flavonoid intake and risk of pancreatic cancer in male smokers (Finland). Cancer Epidemiol Biomarkers Prev 2008;17:553-62.

Choi JS, Choi BC, Choi KE. Effect of quercetin on the pharmacokinetics of oral cyclosporine. Am J Health Syst Pharm 2004;61:2406-9.

Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8.

Conquer JA, Maiani G, Azzini E, et al. Supplementation with quercetin markedly increases plasma quercetin concentration without effect on selected risk factors for heart disease in healthy subjects. J Nutr 1998;128:593-7.

de Pascual-Teresa S, Johnston KL, DuPont MS, et al. Quercetin metabolites downregulate cyclooxygenase-2 transcription in human lymphocytes ex vivo but not in vivo. J Nutr 2004;134:552-7

Di Bari L, Ripoli S, Pradhan S, Salvadori P. Interactions between quercetin and warfarin for albumin binding: A new eye on food/drug interference. Chirality 2010;22:593-6.

DiCenzo R, Frerichs V, Larppanichpoonphol P, et al. Effect of quercetin on the plasma and intracellular concentrations of saquinavir in healthy adults. Pharmacotherapy 2006;26:1255-61.

Edwards RL, Lyon T, Litwin SE, et al. Quercetin reduces blood pressure in hypertensive subjects. J Nutr 2007;137:2405-11.

El Attar TM, Virji AS. Modulating effect of resveratrol and quercetin on oral cancer cell growth and proliferation. Anticancer Drugs 1999;10:187-93.

Erlund I, Freese R, Marniemi J, et al. Bioavailability of quercetin from berries and the diet. Nutr Cancer 2006;54:13-7.

Erlund I, Kosonen T, Alfthan G, et al. Pharmacokinetics of quercetin from quercetin aglycone and rutin in healthy volunteers. Eur J Clin Pharmacol 2000;56:545-53.

Ferry DR, Smith A, Malkhandi J, et al. Phase I clinical trial of the flavonoid quercetin: Pharmacokinetics and evidence for in vivo tyrosine kinase inhibition. Clin Cancer Res 1996;2:659-67.

Gates MA, Tworoger SS, Hecht JL, et al. A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer. Int J Cancer 2007;121:2225-32.

Goldberg DM, Yan J, Soleas GJ. Absorption of three wine-related polyphenols in three different matrices by healthy subjects. Clin Biochem 2003;36:79-87.

Harwood M, Danielewska-Nikiel B, Borzelleca JF, et al. A critical review of the data related to the safety of quercetin and lack of evidence of in vivo toxicity, including lack of genotoxic / carcinogenic properties. Food Chem Toxicol 2007;45:2179-205.

Hertog MG, Feskens EJ, Hollman PC, et al. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet 1993;342:1007-1011.

Huang Z, Fasco MJ, Kaminsky LS. Inhibition of estrone sulfatase in human liver microsomes by quercetin and other flavonoids. J Steroid Biochem Mol Biol 1997;63:9-15.

Hubbard GP, Wolffram S, Lovegrove JA, Gibbins JM. Ingestion of quercetin inhibits platelet aggregation and essential components of the collagen-stimulated platelet activation pathway in humans. J Thromb Haemost 2004;2:2138-45.

Janssen K, Mensink RP, Cox FJ, et al. Effects of the flavonoids quercetin and apigenin on hemostasis in healthy volunteers: results from an in vitro and a dietary supplement study. Am J Clin Nutr 1998;67:255-62.

Kim KA, Park PW, Kim HK, et al. Effect of quercetin on the pharmacokinetics of rosiglitazone, a CYP2C8 substrate, in healthy subjects. J Clin Pharmacol 2005;45:941-6.

Koga T, Meydani M. Effect of plasma metabolites of (+)-catechin and quercetin on monocyte adhesion to human aortic endothelial cells. Am J Clin Nutr 2001;73:941-8.

Kuo SM, Leavitt PS, Lin CP. Dietary flavonoids interact with trace metals and affect metallothionein level in human intestinal cells. Biol Trace Elem Res 1998;62:135-53.

Lean ME, Noroozi M, Kelly I. Dietary flavonols protect diabetic human lymphocytes against oxidative damage to DNA. Diabetes 1999;48:176-81.

McAnlis GT, McEneny J, Pearce J, Young IS. Absorption and antioxidant effects of quercetin from onions, in man. Eur J Clin Nutr 1999;53:92-6.

Miodini P, Fioravanti L, Di Fronzo G, Cappelletti V. The two phyto-oestrogens genistein and quercetin exert different effects on oestrogen receptor function. Br J Cancer 1999;80:1150-5.

Murota K, Terao J. Antioxidative flavonoid quercetin: implication of its intestinal absorption and metabolism. Arch Biochem Biophys 2003;417:12-7.

Nemeth K, Piskula MK. Food content, processing, absorption and metabolism of onion flavonoids. Crit Rev Food Sci Nutr 2007;47:397-409.

Nieman DC, Henson DA, Davis JM, et al. Quercetin ingestion does not alter cytokine changes in athletes competing in the Western States Endurance Run. J Interferon Cytokine Res 2007;27:1003-11.

Nieman DC, Henson DA, Davis JM, et al. Quercetin’s influence on exercise-induced changes in plasma cytokines and muscle and leukocyte cytokine mRNA. J Appl Physiol 2007;103:1728-35.

Nieman DC, Henson DA, Gross SJ, et al. Quercetin reduces illness but not immune perturbations after intensive exercise. Med Sci Sports Exerc 2007;39:1561-9.

Nöthlings U, Murphy SP, Wilkens LR, et al. Flavonols and pancreatic cancer risk: the multiethnic cohort study. Am J Epidemiol 2007;166:924-31.

Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John’s wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000;294:88-95.

Otsuka H, Inaba M, Fujikura T, Kunitomo M. Histochemical and functional characteristics of metachromatic cells in the nasal epithelium in allergic rhinitis: studies of nasal scrapings and their dispersed cells. J Allergy Clin Immunol 1995;96:528-36.

Perez-Vizcaino F, Duarte J, Andriantsitohaina R. Endothelial function and cardiovascular disease: effects of quercetin and wine polyphenols. Free Radic Res 2006;40:1054-65.

Rachkauskas GS. The efficacy of enterosorption and a combination of antioxidants in schizophrenics. Lik Sprava 1998;4:122-4.

Sesink AL, O’Leary KA, Hollman PC. Quercetin glucuronides but not glucosides are present in human plasma after consumption of quercetin-3-glucoside or quercetin-4′-glucoside. J Nutr 2001;131:1938-41.

Shoskes D, Lapierre C, Cruz-Corerra M, et al. Beneficial effects of the bioflavonoids curcumin and quercetin on early function in cadaveric renal transplantation: a randomized placebo controlled trial. Transplantation 2005;80:1556-9.

Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: A preliminary prospective, double-blind, placebo-controlled trial. Urol 1999;54:960-3.

Starvic B. Quercetin in our diet: from potent mutagen to probable anticarcinogen. Clin Biochem 1994;27:245-8.

Vaclavikova R, Horsky S, Simek P, Gut I. Paclitaxel metabolism in rat and human liver microsomes is inhibited by phenolic antioxidants. Naunyn Schmiedebergs Arch Pharmacol 2003;368:200-9.

Walle T, Otake Y, Walle UK, Wilson FA. Quercetin glucosides are completely hydrolyzed in ileostomy patients before absorption. J Nutr 2000;130:2658-61.

Wiseman H. The bioavailability of non-nutrient plant factors: dietary flavonoids and phyto-oestrogens. Proc Nutr Soc 1999;58:139-46.

Bradbrook ID, Morrison PJ, Rogers HJ. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol 1978;6:552-4.

Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.

Hale LP, Greer PK, Sempowski GD. Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation. Clin Immunol 2002;104:183-90.

Hotz G, Frank T, Zoller J, Wiebelt H. [Antiphlogistic effect of bromelaine following third molar removal]. Dtsch Zahnarztl Z 1989;44:830-2.

Kane S, Goldberg MJ. Use of bromelain for mild ulcerative colitis. Ann Intern Med 2000;132:680.

Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest 2000;19:15-23.

Masson M. [Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice]. Fortschr Med 1995;113:303-6.

Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257-8.

Stone MB, Merrick MA, Ingersoll CD, et al. Preliminary comparison of bromelain and Ibuprofen for delayed onset muscle soreness management. Clin J Sport Med 2002;12:373-8.

Tanabe S, Tesaki S, Watanabe M, Yanagihara Y. [Cross-reactivity between bromelain and soluble fraction from wheat flour]. Arerugi 1997;46:1170-3.

Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.

Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exptl Clin Res 1978;4:39-44.

Valueva TA, Revina TA, Mosolov VV. Potato tuber protein proteinase inhibitors belonging to the Kunitz soybean inhibitor family. Biochemistry (Mosc) 1997;62:1367-74.

Walker AF, Bundy R, Hicks SM, Middleton RW. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine 2002;9:681-6.

Zavadova E, Desser L, Mohr T. Stimulation of reactive oxygen species production and cytotoxicity in human neutrophils in vitro and after oral administration of a polyenzyme preparation. Cancer Biother 1995;10:147-52.

Zimacheva AV, Mosolov VV. [Cysteine proteinase inhibitors from soy seeds]. Biokhimiia 1995;60:118-23.

Electronic Code of Federal Regulations. Title 21. Part 182 — Substances Generally Recognized As Safe. Available at: 786bafc6f6343634fbf79fcdca7061e1&rgn=div5&view= text&node=21:

Hasanudin K, Hashim P, Mustafa S. Corn silk (Stigma maydis) in healthcare: a phytochemical and pharmacological review. Molecules 2012;17:9697-715.

Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9.

Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7.

Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50.

Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6.

el-Mofty MM, Khudoley VV, Shwaireb MH. Carcinogenic effect of force-feeding an extract of black pepper (Piper nigrum) in Egyptian toads (Bufo regularis). Oncology 1991;48:347-50.

Electronic Code of Federal Regulations. Title 21. Part 182 — Substances Generally Recognized As Safe. Available at: 786bafc6f6343634fbf79fcdca7061e1&rgn=div5&view= text&node=21:

Khajuria A, Zutshi U, Bedi KL. Permeability characteristics of piperine on oral absorption-an active alkaloid from peppers and a bioavailability enhancer. Indian J Exp Biol 1998;36:46-50.

Nalini N, Sabitha K, Viswanathan P, Menon VP. Influence of spices on the bacterial (enzyme) activity in experimental colon cancer. J Ethnopharmacol 1998;62:15-24.

Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.

Sheahan K, Page DV, Kemper T, Suarez R. Childhood sudden death secondary to accidental aspiration of black pepper. Am J Forensic Med Pathol 1988;9:51-3.

Singh A, Rao AR. Evaluation of the modulatory influence of black pepper (Piper nigrum, L.) on the hepatic detoxication system. Cancer Lett 1993;72:5-9.

Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7.