Meta Information
ID:aged-garlic-extract
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract possesses antiplatelet properties that can add to the effects of blood-thinning medications, significantly increasing the risk of bruising and serious bleeding events.
Actionable advice:
Concurrent use with blood-thinning medications should be avoided unless explicitly approved and monitored by a physician.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Some botanicals may cause bleeding events when taken alone (e.g., garlic and Ginkgo biloba) and may have anticoagulant, antiplatelet, and/or fibrinolytic properties.
Label source:
Action type:
avoid
Target id:
/procedure/surgery
Target name:
Surgical Procedures
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
168
Hours after target:
null
Description:
Due to its antiplatelet (blood-thinning) effects, aged garlic extract can increase the risk of excessive bleeding during and after surgical or dental procedures.
Actionable advice:
Use should be discontinued at least 7 days prior to any scheduled surgery, and it is important to let a surgeon know about its use.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Case reports have highlighted the possibility that garlic use may cause allergic reactions (allergic contact dermatitis, generalized urticaria, angiedema, pemphigus, anaphylaxis and photoallergy), alteration of platelet function and coagulation (with a possible risk of bleeding), and burns (when fresh garlic is applied on the skin, particularly under occlusive dressings).
Label source:
PubMed: Garlic (Allium sativum L.): adverse effects and drug interactions in humans. (PMID 17918162)
Action type:
avoid
Target id:
/class/antiretrovirals
Target name:
Antiretroviral Medications (for HIV)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Garlic components can induce the CYP3A4 metabolic enzyme, which may accelerate the breakdown of certain antiretroviral drugs (especially protease inhibitors like saquinavir), reducing their blood levels and effectiveness.
Actionable advice:
Aged garlic extract should be avoided when taking antiretroviral medications for HIV treatment.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We describe the different effects of DAS and DADS on hepatic CYP2B1/2, CYP3A and epoxide hydrolase (EpH) mRNAs in rats, in terms of activation profile, doses and kinetics.
Label source:
PubMed: Different activation patterns of rat xenobiotic metabolism genes by two constituents of garlic. (PMID 16679304)
Action type:
avoid
Target id:
/class/immunosuppressants
Target name:
Calcineurin Inhibitors
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract may induce the CYP3A4 enzyme, accelerating the metabolism of critical immunosuppressants like tacrolimus and cyclosporine, which could lead to sub-therapeutic levels and risk of organ rejection.
Actionable advice:
Aged garlic extract should not be taken during immunosuppressant therapy following an organ transplant.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Other herbal remedies with the potential to modulate cytochrome P450 activity and thus participate in interactions with conventional drugs include Milk thistle, Angelica dahurica, ginseng, garlic preparations, Danshen and liquorice.
Label source:
PubMed: Xenobiotica; the fate of foreign compounds in biological systems (2002)
Source url:
Exact phrase from label:
Garlic (Allium sativum) changes pharmacokinetic variables of paracetamol, decreases blood concentrations of warfarin and produces hypoglycaemia when taken with chlorpropamide.
Label source:
PubMed: Drugs (2001)
Action type:
avoid
Target id:
/condition/bleeding-disorders
Target name:
Bleeding Disorders
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The inherent antiplatelet activity of aged garlic extract can exacerbate bleeding tendencies in individuals with conditions like hemophilia or von Willebrand disease.
Actionable advice:
Aged garlic extract should be avoided completely with any diagnosed bleeding disorder.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Garlic modulates cardiovascular risk factors through 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibition, hydrogen sulfide-mediated vasodilation, and antiplatelet activity.
Label source:
PubMed: A Comparative Review of Phytochemical Composition, Bioactivity, and Health Implications of Single- and Multiple-Clove Garlic. (PMID 42040441)
Action type:
avoid
Target id:
/intervention/isoniazid
Target name:
Isoniazid
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract has been shown to interfere with the absorption and reduce the bioavailability of isoniazid, a primary medication for treating tuberculosis, potentially leading to treatment failure.
Actionable advice:
Aged garlic extract should not be taken concurrently with isoniazid.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Administration of crude aqueous extract of garlic significantly altered the pharmacokinetic parameters for isoniazid. C(max) was reduced from 15.4 +/- 5.6 to 5.4 +/- 3.3 microg/ml. AUC((0-24)) was reduced from 76.7 +/- 25.0 to 34.3 +/- 19.2 microg/ml.h.
Label source:
PubMed: Pharmacology (2006)
Source url:
Exact phrase from label:
Oral administration of garlic extract decreased the bioavailability of isoniazid significantly with no change in rate of elimination.
Label source:
PubMed: Pharmacology (2006)
Source url:
Exact phrase from label:
Freshly prepared garlic homogenate protects against isoniazid+rifampicin-induced liver injury in experimental animal models. Several mechanisms are likely to account for this protection.
Label source:
PubMed: Nutrition research reviews (2011)
Action type:
avoid
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract can lower blood pressure. When combined with antihypertensive drugs, this effect is additive and may lead to hypotension (dizziness, fainting).
Actionable advice:
Blood pressure should be monitored closely when combining with blood pressure medications, and it is important to talk to a doctor.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Thus, Kyolic aged garlic extract is considered to be highly tolerable with a high safety profile either as a stand-alone or adjunctive anti-hypertensive treatment, with multiple benefits for cardiovascular health.
Label source:
PubMed: Garlic lowers blood pressure in hypertensive subjects, improves arterial stiffness and gut microbiota: A review and meta-analysis. (PMID 32010325)
Action type:
monitor
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract may have a mild blood sugar-lowering effect, which can be additive with diabetes medications, increasing the risk of hypoglycemia (low blood sugar).
Actionable advice:
Blood glucose levels are best monitored carefully if combining with diabetes medications, and awareness of hypoglycemic symptoms is a good idea.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Metformin decreases liver uptake of lactate increasing lactate blood levels which may increase the risk of lactic acidosis, especially in patients at risk.
Label source:
Action type:
monitor
Target id:
/class/cyp3a4-substrates
Target name:
CYP3A4 Substrates
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract may mildly induce the CYP3A4 liver enzyme, which could potentially increase the breakdown and reduce the effectiveness of a wide range of medications.
Actionable advice:
It is a good idea to consult a pharmacist or doctor to review for interactions when taking any prescription medications.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Blood pressure should be closely
monitored when Amlodipine is co-administered with CYP3A4 inducers.
Label source:
Action type:
informational_none
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Aged garlic extract has modest lipid-lowering effects that can complement the action of statin medications, potentially contributing to improved overall cholesterol management.
Actionable advice:
It is generally best to let a doctor know about its use, as it may contribute to an overall lipid management strategy.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Drug Interactions
Atorvastatin is a substrate of the hepatic transporters, OATP1B1 and OATP1B3 transporter.
Label source:
Action type:
informational_none
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
informational
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking aged garlic extract with food can help minimize potential mild gastrointestinal side effects, such as stomach upset or garlic-related odor, improving overall tolerability.
Actionable advice:
Aged garlic extract is generally best taken with a meal to improve tolerability.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Among the three preparations, RGP caused severe damage, including erosion. BGP also caused reddening of the mucosa, whereas AGE did not cause any undesirable effects.
Label source:
PubMed: The Journal of nutrition (2001)
Source url:
Exact phrase from label:
Tolerability, compliance and acceptability were high in all garlic groups (93%) and highest in the groups taking one or two capsules daily.
Label source:
PubMed: European journal of clinical nutrition (2013)
Source url:
Exact phrase from label:
Gastrointestinal side effects prevented the use of higher doses of garlic which must be considered to be pharmacological as they exceed changes achievable by dietary modification.
Label source:
PubMed: Clinical and experimental pharmacology & physiology (1995)
Action type:
informational_none