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Piperine and Your Medicines: Why the Black Pepper in SynoCell Matters
Piperine, the active part of black pepper extract, helps some substances absorb. It can do the same to certain medicines. At 15 to 20 mg a day it raised blood levels of seizure, heart and other drugs in small studies. SynoCell has 5 mg per serving, and nobody has tested that amount with your medicines, so ask your pharmacist.
Written by the SynoCell editorial teamUpdated · 8 min read
Why is black pepper extract in SynoCell?
To help the other ingredients absorb. Each 2-capsule serving lists 5 mg of Black Pepper (fruit) Extract, sold under the trade name BioPerine (SynoCell, product page).
Piperine is the compound that gives black pepper its bite. Supplement makers add it because of one well-known study. In healthy volunteers, 20 mg of piperine taken with curcumin raised curcumin absorption by about 2000% (Shoba et al., 1998).
The catch: a substance that slows how the body clears one compound can slow how it clears prescription drugs too. That applies to any product with isolated piperine.
How does piperine change the level of a medicine in your blood?
It appears to slow the body's normal clean-up systems. Researchers point to three of them: two liver enzymes, CYP3A4 and CYP2C9, and a gut pump called P-glycoprotein that pushes some drugs back out (Horn and Hansten, 2017).
More gets in
With the gut pump slowed, more of a dose passes into the blood.
Less gets cleared
With the liver enzymes slowed, the drug lingers longer.
Levels rise
The result can act like a slightly bigger dose than your doctor prescribed.
A modest rise may not matter for many medicines, but it can matter for narrow-range drugs such as some seizure medicines.
Which medicines did piperine affect in studies?
Several common ones. In small human studies, piperine at about 15 to 20 mg a day raised blood levels or effects of the drugs below (Horn and Hansten, 2017). A German safety review puts the overall rise at roughly 1.1 to 2.7 times normal exposure at 20 mg a day (Ziegenhagen et al., 2021).
| Medicine | Used for | What piperine did |
|---|---|---|
| Carbamazepine | Seizures, nerve pain | Blood level (AUC) up about 48% (Horn and Hansten, 2017) |
| Fexofenadine | Allergies | Blood level (AUC) up about 68% (Horn and Hansten, 2017) |
| Diclofenac | Pain, arthritis | Raised blood levels (Horn and Hansten, 2017) |
| Phenytoin | Seizures | Modest rise (Horn and Hansten, 2017) |
| Midazolam | Sedation before procedures | Sedation lasted longer (Horn and Hansten, 2017) |
| Propranolol, theophylline | Heart and blood pressure; asthma | Higher exposure; early evidence (Horn and Hansten, 2017) (Ziegenhagen et al., 2021) |
Diclofenac stands out for joint pain readers: it is a common NSAID. If you use it, mention SynoCell to your pharmacist.
Is the 5 mg of piperine in SynoCell enough to matter?
Nobody knows for sure. The interaction studies used 15 to 20 mg a day (Horn and Hansten, 2017), three to four times the amount in one SynoCell serving. No study has tested 5 mg with specific medicines, so the risk is probably smaller, but not zero.
Regulators have taken different views on how much isolated piperine is sensible in a day. Supplements on the market often give 5 to 30 mg (Ziegenhagen et al., 2021).
Germany's guidance
The risk agency's cautious value, since human safety data are thin. SynoCell's 5 mg is above it (Ziegenhagen et al., 2021).
Australia's limit
A daily maximum. One SynoCell serving is half of it (Ziegenhagen et al., 2021).
Health Canada's limit
A daily maximum for supplements sold in Canada (Ziegenhagen et al., 2021).
So stay at the 2-capsule serving, and count piperine in other products such as turmeric supplements.
Do other SynoCell ingredients interact with medicines too?
Yes. Quercetin, at 310 mg per serving, may increase side effects of drugs handled by the CYP3A4 and CYP2C19 enzymes and may interact with losartan, a blood pressure drug (MSKCC, Quercetin). It is also listed with quinolone antibiotics, cyclosporine and P-glycoprotein substrates (RxList, Quercetin). Boswellia may add to bleeding risk with blood thinners (MSKCC, Boswellia).
| If you take | Ingredient to ask about | Why |
|---|---|---|
| Blood thinners (warfarin and others) | Quercetin, Boswellia | A raised INR was reported with quercetin; Boswellia may add to bleeding risk. (MSKCC, Quercetin) (MSKCC, Boswellia) |
| Cyclosporine, some antibiotics (quinolones) | Quercetin | Listed moderate interactions. (RxList, Quercetin) |
| Seizure drugs (phenytoin, carbamazepine) | Black pepper extract | Piperine raised blood levels in small studies. (Horn and Hansten, 2017) (Ziegenhagen et al., 2021) |
| Heart and blood pressure drugs (propranolol, losartan) | Black pepper, quercetin | Piperine raised propranolol levels; quercetin may interact with losartan. (Ziegenhagen et al., 2021) (MSKCC, Quercetin) |
| Drugs cleared by liver CYP3A4 or CYP2C19 | Quercetin, black pepper | Both can slow how some drugs are broken down. (MSKCC, Quercetin) (Horn and Hansten, 2017) |
| NSAID pain relievers | None known | No listed interaction, but tell your doctor about every supplement you take. (NIH ODS, Dietary Supplements: What You Need to Know) |
The SynoCell side effects page covers the full safety picture, and the black pepper extract profile covers the ingredient itself.
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Order nowWho should be most careful with piperine?
Anyone on a narrow-range drug, anyone taking several daily prescriptions, and anyone who is pregnant. The German safety review advises pregnant women to avoid isolated piperine (Ziegenhagen et al., 2021).
- People taking seizure medicines such as phenytoin or carbamazepine
- People on warfarin or other blood thinners, because of the quercetin and Boswellia in the same capsule
- Anyone scheduled for a procedure with sedation
- Older adults on several daily medicines
If a pharmacist says the combination is a poor idea, the supplement is the one to drop.
What should I ask my pharmacist before taking SynoCell?
Bring the bottle and your full medicine list, including creams and other supplements. Then ask:
Are any of my medicines sensitive to piperine?
Name the 5 mg of black pepper extract per serving.
Do any interact with quercetin or Boswellia?
Especially blood thinners, cyclosporine and blood pressure drugs.
Should I take it at a different meal from my pills?
No spacing rule is published, so ask for advice on your own drugs.
Do I need an extra blood test?
For example, an INR check on warfarin or a drug level on a seizure medicine.
What side effects should I watch for?
Ask which signs mean you should stop and call.
Once you have the go-ahead, see how to take SynoCell.
So is the black pepper extract in SynoCell a problem?
For most healthy adults on no daily medicines, probably not. For people on seizure, heart, transplant or blood-thinning drugs, it is a real question worth five minutes with a pharmacist. The amount is small, but it has never been tested with your medicines.
FAQ
Questions about piperine and medicines
Does black pepper extract interact with medications?
It can. Piperine, the active part of black pepper extract, slowed how the body clears several drugs in small studies, raising levels of carbamazepine, fexofenadine, diclofenac, phenytoin and others at 15 to 20 mg a day (Horn and Hansten, 2017). Whether smaller amounts do the same has not been tested, so check with a pharmacist.
What is the daily limit for piperine?
There is no single answer. Germany's risk agency derived a cautious guidance value of about 2.3 mg a day, Australia sets a limit of 10 mg and Health Canada 14 mg (Ziegenhagen et al., 2021). SynoCell has 5 mg per serving. Stick to one serving and count piperine in any other supplements you take.
Is BioPerine safe during pregnancy?
Pregnant women are advised to avoid isolated piperine, which is what BioPerine is (Ziegenhagen et al., 2021). Reliable safety data in pregnancy are lacking. If you are pregnant or breastfeeding, skip SynoCell and ask your doctor about joint pain options.
Can piperine make seizure medicine levels too high?
In small studies, piperine raised carbamazepine levels by about 48% and modestly increased phenytoin (Horn and Hansten, 2017). Those drugs have narrow safe ranges, so even modest rises can matter. If you take a seizure medicine, do not start any piperine product without asking your prescriber, who may want a blood level check.
Does piperine affect warfarin?
Piperine is not the main worry with warfarin in SynoCell. Quercetin, another ingredient, was linked to a raised INR in a man on warfarin (MSKCC, Quercetin), and Boswellia may add to bleeding risk (MSKCC, Boswellia). Together they make a prescriber check essential before you start, plus an INR test if advised.
Why do so many supplements contain BioPerine?
Because of absorption. A classic study found 20 mg of piperine raised curcumin absorption by about 2000% in volunteers (Shoba et al., 1998), so makers add it to help other ingredients get into the blood. The same effect on body clean-up systems is why it can change some medicine levels too (Horn and Hansten, 2017).
Who wrote this
Written and reviewed by
Plain-language pages built from the label, the brand store and linked medical sources.
Last updated . Read our editorial standards and how we check reviews. This website is run by an authorized U.S. retailer, not by the manufacturer. We earn money when you buy through our order links.
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Read moreBlack pepper extract
5 mg of piperine: why it is added, which medicines it can affect, and how it compares with safety limits.
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