Checklist · Interactions
SynoCell and Your Medicines: 7 Checks Before You Combine Them
Quercetin and black pepper extract can change how some medicines work, and Boswellia may add to bleeding risk. Ask your doctor or pharmacist first if you take blood thinners, cyclosporine, seizure medicines, heart or blood pressure drugs, or any daily prescription. Nobody has tested what SynoCell's 5 mg of piperine does to your medicines.
Written by the SynoCell editorial teamMedically reviewed by Dr. Nehad Soloman, MD, FACR, PhysicianReviewed · Updated · 8 min read
Key facts
- Quercetin at 310 mg and black pepper extract at 5 mg per serving raise most of the interaction questions.
- One man on warfarin who took quercetin showed a raised INR, and Boswellia may add to bleeding risk.
- In small studies, piperine at 15-20 mg a day raised blood levels of seizure drugs and other medicines. SynoCell has 5 mg.
- What 5 mg does to a given medicine is untested, and no spacing rule is published.
- Quercetin is listed with moderate interactions for cyclosporine and quinolone antibiotics.
- Every supplement belongs on the list your doctor sees. Carry the bottle or a photo of the label.
- Never stop or change a prescribed medicine on your own because of a supplement.
Check 1: Do you take a blood thinner?
Start here, because two ingredients are involved. A man on warfarin who used quercetin showed a raised INR, the blood test that follows clotting time (MSKCC, Quercetin). Boswellia may also add to bleeding risk, although how much is not established (MSKCC, Boswellia).
The rule is plain. On warfarin or another blood thinner, start only with your prescriber's agreement. If the answer is yes, expect an extra blood test afterward, and watch for unusual bruising, nosebleeds, bleeding gums or dark stools.
Do not alter your blood thinner routine by yourself because of a supplement.
Check 2: Do you take a seizure medicine?
Seizure drugs have a narrow safe range, so small shifts in blood level count. In small human studies, about 15 to 20 mg a day of piperine raised carbamazepine exposure by 48% and modestly raised phenytoin (Horn and Hansten, 2017).
One SynoCell serving has 5 mg of black pepper extract, well below those doses. Its effect on your seizure medicine is untested. A pharmacist may advise avoiding the product, or checking a drug level once you start.
Watch for new drowsiness or unsteadiness, and call your doctor the same day if either appears.
Check 3: Do you take a heart or blood pressure drug?
Piperine raised propranolol levels in early studies, and quercetin may interact with losartan (Ziegenhagen et al., 2021)(MSKCC, Quercetin). Quercetin is also listed as a moderate interaction with blood pressure medicines (RxList, Quercetin).
Both compounds can slow liver enzymes, named CYP3A4 and CYP2C19, and a gut pump that clear many drugs. Slower clearing may leave more of the drug in your blood. A pharmacist can look up your exact medicine and dose.
Take the bottle to the counter. The panel prints each amount, including 5 mg of black pepper extract and 310 mg of quercetin, so the check takes a few minutes.
Check 4: Do you take cyclosporine or a quinolone antibiotic?
Quercetin has listed moderate interactions with cyclosporine and with quinolone antibiotics (RxList, Quercetin). Speak to the doctor who manages your cyclosporine before you start SynoCell.
If a doctor prescribes antibiotics, mention that you take SynoCell and show the label. Do not guess which antibiotic belongs to which family. Let the pharmacist check.
If your pharmacist has looked at the label and agrees, the order page shows the price and the 90-day guarantee before you pay.2 capsules a day, 60 per bottle. Free standard shipping in the mainland U.S. We earn money when you buy through our order links.
See today's price and guaranteeCheck 5: Do you use NSAIDs or acetaminophen for pain?
No interaction is listed for NSAID pain relievers, but all supplements should be reported to your doctor (NIH ODS, Dietary Supplements: What You Need to Know). Piperine at 15-20 mg a day raised levels of diclofenac, another NSAID (Horn and Hansten, 2017), and ibuprofen was not studied.
Use the lowest NSAID dose for the shortest time. FDA warns that heart attack and stroke risk can begin in the first weeks (FDA, 2015 NSAID safety communication). With acetaminophen, stay under 4,000 mg a day from all sources, and avoid it if you have three or more alcoholic drinks a day (MedlinePlus, Acetaminophen).
Read every label so nothing is doubled, since many cold remedies also contain acetaminophen.
Check 6: Do you already take another supplement?
Stacking is the quiet risk. A separate quercetin product plus SynoCell adds up. Standalone quercetin products often supply as much as 1,000 mg a day, and good safety data stop beyond 12 weeks at that level (Andres et al., 2018). One SynoCell serving gives 310 mg.
A second pepper extract works the same way. Piperine appears in many supplements, and Germany's guidance value for isolated piperine is about 2.3 mg a day (Ziegenhagen et al., 2021). One SynoCell serving already holds 5 mg.
List the amount from every label on a single page, then show the page to your pharmacist.
Check 7: Do you have surgery or a procedure coming up?
Your surgeon should know before the operation, since Boswellia may add to bleeding risk (MSKCC, Boswellia). Most surgeons ask patients to stop supplements beforehand, and the stop date is theirs to set, not ours.
Take the bottle to the pre-op visit and restart only when your surgical team says so. The same applies to dental surgery and any other procedure where bleeding matters.
Joint surgery is no exception. One man on warfarin had a raised INR after quercetin, so tell the team about every capsule you take.
Which medicines should you check, and which ingredient is the reason?
Here is the whole picture on one page.
| If you take | Ingredient behind the question | Reason |
|---|---|---|
| Warfarin or another blood thinner | Quercetin, Boswellia | A raised INR was reported with quercetin; Boswellia may add to bleeding risk |
| Cyclosporine, quinolone antibiotics | Quercetin | Moderate interactions are listed |
| Phenytoin or carbamazepine | Black pepper extract | In small studies, piperine pushed their blood levels up |
| Propranolol, losartan | Black pepper extract, quercetin | Piperine raised propranolol levels; quercetin may interact with losartan |
| Drugs cleared by CYP3A4 or CYP2C19 | Quercetin, black pepper extract | Each can slow how some drugs are broken down |
| NSAID pain relievers | None known | No interaction is listed, but tell your doctor |
Is 5 mg of black pepper extract enough to matter?
Nobody knows. The drug studies used three to four times more piperine than one SynoCell serving. A German safety review put the effect at about 1.1 to 2.7 times normal exposure at 20 mg a day (Ziegenhagen et al., 2021). At 5 mg, the effect on your medicine is untested, and that uncertainty cuts both ways.
Reference points: Germany's risk agency suggests about 2.3 mg a day as a cautious value, Australia allows up to 10 mg and Health Canada up to 14 mg. SynoCell's 5 mg sits between them, which is one reason not to double the serving. Our post on piperine and your medicines goes deeper.
What to ask: show the full list, name every medicine including the over-the-counter ones, and ask whether doses should be spaced apart or whether a blood level or INR check makes sense after you start.
FAQ
Frequently asked questions
Can I take SynoCell with my prescription medicine?
Ask your pharmacist first. The brand publishes no spacing rule, and 5 mg of black pepper extract has never been tested against your particular medicine. Piperine and quercetin can change how certain drugs are handled by the body, blood thinners and seizure medicines among them.
Can warfarin users take SynoCell?
Only with your prescriber's approval. One man on warfarin had a raised INR after taking quercetin, and Boswellia may raise bleeding risk. Never alter a blood thinner routine by yourself.
Does black pepper extract interact with medicines?
It can. Small studies found that piperine at 15-20 mg a day pushed up blood levels of carbamazepine, phenytoin and propranolol (Horn and Hansten, 2017). Nobody has tested 5 mg in your situation, so your pharmacist is the person to ask.
Can I take SynoCell with ibuprofen?
No interaction is listed, and ibuprofen was not studied. Tell your doctor about every supplement you use, and keep NSAID use to the lowest dose for the shortest time.
Should I stop SynoCell before surgery?
Check with your surgeon first. Boswellia may add to bleeding risk, and most surgeons ask patients to stop supplements before an operation. Restart only when your surgical team agrees.
Is SynoCell a medication that treats arthritis?
No. It is a dietary supplement, not a drug, not a pain reliever and not a treatment for arthritis, and it has no FDA approval.
Our view
The list of medicines to check is short and specific: blood thinners, seizure drugs, heart and blood pressure drugs, cyclosporine and some antibiotics. The reasons are quercetin, black pepper extract and Boswellia.
What nobody knows is how much 5 mg of piperine changes any one of them. That is why a few minutes with a pharmacist is worth it. Bring the bottle, bring your list and ask.
If you take no daily medicines, much of this list may not apply to you. Even so, tell your doctor what you take. FDA has not approved SynoCell.
Last updated
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