Meta Information
ID:piperine
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/intervention/curcumin
Target name:
Curcumin
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Piperine inhibits UGT enzymes and P-glycoprotein, which rapidly metabolize and eliminate curcumin, increasing its bioavailability by up to 2000%.
Actionable advice:
Take piperine at the same time as curcumin to maximize absorption.
Target id:
/class/cyp3a4-substrates
Target name:
Drugs Metabolized by CYP3A4
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Piperine is a potent inhibitor of the CYP3A4 enzyme, which can dangerously increase the concentration of many medications (e.g., statins, calcium channel blockers, immunosuppressants), leading to toxicity.
Actionable advice:
Avoid piperine completely if you take medications metabolized by CYP3A4, unless cleared by a physician.
Target id:
/class/p-glycoprotein-substrates
Target name:
P-glycoprotein Substrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Piperine inhibits the P-glycoprotein (P-gp) efflux pump, which can significantly increase the absorption and decrease the clearance of certain drugs (e.g., digoxin, fexofenadine), raising toxicity risk.
Actionable advice:
Avoid piperine completely if you take P-gp substrate drugs, unless cleared by a physician.
Target id:
/class/anticonvulsants
Target name:
Anticonvulsant Medications (e.g., Phenytoin, Carbamazepine)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Piperine inhibits the metabolism of anticonvulsants like phenytoin and carbamazepine, leading to elevated serum levels and a high risk of dose-related toxicity.
Actionable advice:
Do not take piperine if you are on anticonvulsant medication.
Target id:
/intervention/theophylline
Target name:
Theophylline
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Piperine slows the clearance of theophylline, a drug with a narrow therapeutic window, increasing its concentration and the risk of serious side effects like seizures and arrhythmias.
Actionable advice:
Avoid piperine completely if you are taking theophylline.
Target id:
/class/immunosuppressants
Target name:
Immunosuppressants (e.g., Cyclosporine, Tacrolimus)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Piperine inhibits CYP3A4 and P-glycoprotein, drastically increasing levels of immunosuppressants like cyclosporine, which can lead to severe kidney toxicity.
Actionable advice:
Do not take piperine if you are on immunosuppressant medications like cyclosporine or tacrolimus.
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Digoxin is a P-glycoprotein substrate with a narrow therapeutic index; piperine's inhibition of P-gp can increase digoxin levels, raising the risk of life-threatening cardiac toxicity.
Actionable advice:
Avoid piperine completely if you are taking digoxin.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Piperine may have anti-fertility or uterine-contracting effects, and its impact on drug metabolism could be harmful during pregnancy. Safety has not been established.
Actionable advice:
Avoid piperine supplements completely during pregnancy.
Target id:
/procedure/surgery
Target name:
Upcoming Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
Due to its potential antiplatelet effects and interactions with anesthetic drugs, piperine may increase the risk of bleeding during and after surgery.
Actionable advice:
Discontinue piperine at least 2 weeks before any scheduled surgery.
Target id:
/intervention/resveratrol
Target name:
Resveratrol
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Piperine inhibits the glucuronidation (UGT enzyme) of resveratrol in the liver and intestines, significantly increasing its plasma concentration and bioavailability.
Actionable advice:
Take piperine at the same time as resveratrol to enhance its absorption.
Target id:
/intervention/coq10
Target name:
Coenzyme Q10
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Piperine enhances the absorption and bioavailability of Coenzyme Q10, likely by inhibiting its metabolism.
Actionable advice:
Take piperine at the same time as Coenzyme Q10 to improve its effectiveness.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets (e.g., Warfarin)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine may inhibit the metabolism of some anticoagulants (like warfarin via CYP2C9) and has its own mild antiplatelet effects, which can potentiate the risk of bleeding.
Actionable advice:
Use with extreme caution or avoid piperine if you take blood-thinning medications.
Target id:
/class/statins
Target name:
Statins (especially Atorvastatin, Simvastatin, Lovastatin)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine inhibits CYP3A4, the enzyme that metabolizes many statins, which can increase statin levels and elevate the risk of muscle pain (myopathy) and rhabdomyolysis.
Actionable advice:
Avoid piperine if taking statins metabolized by CYP3A4 (atorvastatin, simvastatin, lovastatin); use with caution for others.
Target id:
/class/calcium-channel-blockers
Target name:
Calcium Channel Blockers
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
By inhibiting CYP3A4, piperine can increase the concentration of many calcium channel blockers, enhancing their blood pressure-lowering effects and increasing the risk of hypotension and dizziness.
Actionable advice:
Use with caution and monitor blood pressure closely if combining piperine with calcium channel blockers.
Target id:
/class/benzodiazepines
Target name:
Benzodiazepines
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine can inhibit the metabolism of benzodiazepines that are CYP3A4 substrates (e.g., midazolam, alprazolam), potentially leading to excessive sedation and respiratory depression.
Actionable advice:
Avoid piperine if taking benzodiazepines, especially those metabolized by CYP3A4.
Target id:
/class/cyp2c9-substrates
Target name:
Drugs Metabolized by CYP2C9
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine inhibits the CYP2C9 enzyme, which can increase levels of drugs like warfarin, phenytoin, and some NSAIDs, raising the risk of bleeding or other toxicities.
Actionable advice:
Avoid piperine if taking critical dose drugs metabolized by CYP2C9, such as warfarin.
Target id:
/class/ugt1a1-substrates
Target name:
UGT1A1 Substrates
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine inhibits the UGT1A1 enzyme, which is crucial for metabolizing certain drugs (e.g., irinotecan, some statins). This can increase drug levels and toxicity.
Actionable advice:
Consult a pharmacist or physician before using piperine if you take medications metabolized by UGT enzymes.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
It is unknown if piperine or its metabolites are excreted in breast milk, and its effects on a nursing infant are unknown. Safety has not been established.
Actionable advice:
Avoid piperine supplements while breastfeeding.
Target id:
/condition/bleeding-disorders
Target name:
Bleeding Disorders
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine may have antiplatelet activity, which could worsen bleeding in individuals with pre-existing bleeding disorders like hemophilia or von Willebrand disease.
Actionable advice:
Avoid piperine if you have a known bleeding disorder.
Target id:
/condition/hepatic-impairment
Target name:
Liver Disease / Hepatic Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Piperine's primary mechanism involves altering liver enzyme function. In individuals with compromised liver function, these effects can be unpredictable and potentially harmful.
Actionable advice:
Avoid piperine if you have significant liver disease, unless approved by your doctor.
Target id:
/intervention/vitamin-a
Target name:
Beta-Carotene / Vitamin A
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Piperine has been shown to significantly increase the serum levels of beta-carotene, likely by enhancing its absorption from the gut.
Actionable advice:
Take piperine with beta-carotene-rich foods or supplements to increase its absorption.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking piperine with food, especially a meal containing fats, can improve its absorption and may reduce the risk of gastrointestinal irritation.
Actionable advice:
Take piperine with a meal for best results and to minimize stomach upset.
Target id:
/intervention/selenium
Target name:
Selenium
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Piperine can increase the bioavailability of selenium, potentially by improving its transport and retention in tissues.
Actionable advice:
Take piperine at the same time as selenium to enhance its absorption.
Target id:
/intervention/vitamin-b6
Target name:
Vitamin B6
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Studies suggest that piperine can increase the serum concentration and bioavailability of Vitamin B6.
Actionable advice:
Take piperine at the same time as Vitamin B6 to enhance its absorption.
Target id:
/class/iron-supplements
Target name:
Iron Supplements
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Piperine may enhance the absorption of iron from the gastrointestinal tract, potentially improving iron status.
Actionable advice:
Take piperine with iron supplements to potentially improve absorption, but monitor iron levels to avoid overload.
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Piperine may have its own glucose-lowering effects and can inhibit the metabolism of some oral diabetes drugs, potentially increasing the risk of hypoglycemia (low blood sugar).
Actionable advice:
Monitor blood glucose levels closely if you have diabetes and choose to use piperine.
Target id:
/class/serotonergic-agents
Target name:
Serotonergic Medications (SSRIs, SNRIs)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
There is a theoretical risk that piperine may have weak monoamine oxidase (MAO) inhibiting properties, which could interact with serotonergic drugs to increase the risk of serotonin syndrome.
Actionable advice:
Use with caution if taking SSRIs or other serotonergic drugs and be aware of the symptoms of serotonin syndrome.