Meta Information
ID:mastic-gum
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:
/condition/anacardiaceae-allergy
Target name:
Allergy to Pistachio/Cashew Family
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Mastic gum is derived from the Pistacia lentiscus tree, which belongs to the Anacardiaceae family, the same family as pistachios, cashews, and mangoes, posing a high risk of cross-reactive allergic reactions.
Actionable advice:
This should be strictly avoided with a known allergy to pistachios, cashews, or related plants.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Botanical inference: mastic is from Pistacia lentiscus (Anacardiaceae), the family that includes pistachio, cashew and mango, so cross-reactive allergy is plausible in sensitized individuals. FLAG: the cited PMID 11806621 is an H. pylori bactericidal study and does NOT address allergy/cross-reactivity - citation mismatch; the botanical rationale stands but lacks a clinical allergy reference.
Label source:
Class inference
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The safety of mastic gum during pregnancy has not been established through clinical research.
Actionable advice:
Use should be avoided during pregnancy due to a lack of safety data.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
There isn't enough reliable information to know if mastic is safe to use when pregnant or breast-feeding.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown if components of mastic gum are excreted in breast milk or what effects they may have on a nursing infant; safety has not been established.
Actionable advice:
Use should be avoided while breastfeeding due to a lack of safety data.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
There isn't enough reliable information to know if mastic is safe to use when pregnant or breast-feeding.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Mastic gum may possess mild antiplatelet properties, which could theoretically increase the risk of bleeding when combined with medications like warfarin, clopidogrel, or aspirin.
Actionable advice:
This is best used with caution, and it is important to talk to a doctor before combining it with blood-thinning medications.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Major bleeding episodes were not more frequent among patients receiving aspirin plus warfarin than among those receiving warfarin alone, but the incidence of minor bleeding episodes was higher in the combined therapy group.
Label source:
Action type:
informational_none
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:
Mastic gum may lower blood glucose levels, potentially enhancing the effect of diabetes medications and increasing the risk of hypoglycemia (low blood sugar).
Actionable advice:
Blood glucose levels are best monitored closely if combining with diabetes medications, and it is important to consult a doctor.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Metformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes mellitus, lowering both basal and postprandial plasma glucose.
Label source:
Action type:
monitor
Target id:
/class/cyp2c19-substrates
Target name:
CYP2C19 Substrates
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Mastic gum may inhibit the CYP2C19 enzyme, potentially increasing the concentration and side effects of drugs metabolized by this pathway, such as clopidogrel, omeprazole, and some antidepressants.
Actionable advice:
It is important to talk to a pharmacist or doctor before combining this with drugs metabolized by CYP2C19.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
CYP2C19 Substrates (e.g., clopidogrel, citalopram, cilostazol, phenytoin, diazepam) Clopidogrel Concomitant use of omeprazole 80 mg results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition [see Clinical Pharmacology (12.3)].
Label source:
Action type:
informational_none
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
2
Description:
Taking mastic gum with food can reduce its direct contact with the stomach lining, potentially diminishing its effectiveness for gastrointestinal issues like H. pylori or dyspepsia.
Actionable advice:
It is best taken at least 1 hour before eating or 2 hours after a meal for optimal GI effects.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Unsupported: the cited PMID 41832367 is a 2026 H. pylori eradication RCT that does not address taking mastic with food, gastric-lining contact, or reduced GI efficacy. The meal-timing claim is speculative; no supporting evidence found.
Action type:
separate
Target id:
/class/acid-dependent-absorption-drugs
Target name:
Drugs Requiring Acid for Absorption
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Mastic gum may reduce stomach acidity, which can decrease the absorption of certain medications that require an acidic environment, such as the antifungal ketoconazole or some iron formulations.
Actionable advice:
Mastic gum and medications requiring stomach acid should be separated by at least 2 hours.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: IF mastic reduces gastric acidity, absorption of acid-dependent drugs (e.g., ketoconazole, some iron salts) could fall. FLAG: the premise that mastic meaningfully lowers stomach acid is itself unproven, and the cited PMID 11806621 (H. pylori bactericidal study) does not support it - low-evidence theoretical caution.
Label source:
Class inference
Action type:
separate
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Mastic gum may have a mild blood pressure-lowering effect, which could be additive to the effects of antihypertensive medications.
Actionable advice:
It is a good idea to check blood pressure when starting mastic gum while on blood pressure medication.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
Kontogiannis et al. [61] also investigated the effect of CMG on blood pressure in a short-term study. Twenty-seven participants (including thirteen hypertensive) were recruited for a cross-over study and were randomly allocated to 2.8 g of CMG or a placebo to be taken one week apart. Two to three hours after administration, blood pressure and the aortic augmentation index were measured, as well as the expression of several genes related to pro-oxidant responses and pathways of inflammation. Improvements in peripheral and aortic SBP and peripheral pulse pressure were observed in hypertensive subjects after CMG administration, and the gene analysis indicated a downregulation of the NOX-2 pro-oxidant pathway [61].
Label source:
Action type:
monitor
Target id:
/class/herbal-anticoagulants
Target name:
Herbal Anticoagulants/Antiplatelets
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining mastic gum with other supplements that have blood-thinning properties (e.g., ginkgo, garlic, high-dose fish oil) may theoretically increase the cumulative risk of bleeding.
Actionable advice:
Some mindfulness when combining with other supplements known to affect blood clotting is generally best.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Generic class caution: combining multiple supplements with antiplatelet/anticoagulant properties (ginkgo, garlic, high-dose fish oil) may additively raise bleeding risk. FLAG: the cited PMID 12747455 is an oral-antiplaque (dental) study with no bleeding data - citation mismatch; this is a non-specific herb-stacking caution, not evidenced for mastic.
Label source:
Class inference
Action type:
informational_none
Target id:
/class/cyp3a4-substrates
Target name:
CYP3A4 Substrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Mastic gum may weakly inhibit the CYP3A4 enzyme, which could slightly increase levels of many common medications, such as some statins and calcium channel blockers, though the clinical significance is likely low.
Actionable advice:
This potential interaction is worth keeping in mind, especially when taking multiple medications metabolized by CYP3A4.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Monitor for symptoms of hypotension and edema
when amlodipine is co-administered with CYP3A4 inhibitors.
Label source:
Action type:
informational_none
Target id:
/class/acid-suppressors
Target name:
Gastric Acid Suppressors
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Mastic gum can help reduce stomach acid and has antibacterial effects against H. pylori, which may complement the action of medications like proton pump inhibitors (PPIs) or H2 blockers.
Actionable advice:
May be used together for GI benefits, but discuss the combined regimen with your doctor.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: mastic gum and acid-suppressing drugs both target gastric/H. pylori-related symptoms, so effects on dyspepsia may overlap; no pharmacokinetic interaction is established. Low-evidence, informational.
Label source:
Class inference
Action type:
informational_none
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
null
Description:
Taking mastic gum before bed may help manage symptoms of nighttime acid reflux or indigestion due to its soothing effects on the stomach and esophageal lining.
Actionable advice:
Consider taking a dose 30 minutes before bedtime if you experience nighttime GI symptoms.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Unsupported: the cited PMID 41832367 (2026 H. pylori eradication RCT) does not address bedtime dosing or nighttime reflux. The circadian/sleep claim is speculative; no supporting evidence found.
Action type:
informational_none