Side effects and interactions
No adverse event report for this specific product was supplied to this site, and we are not going to invent one. What follows is the interaction literature for the named ingredients, with the ceiling attached to each.
No adverse event report for this product was supplied, and none is invented here. What follows is the interaction literature for the named ingredients, each with the ceiling that bounds it.
The entry to raise with a pharmacist first is grapefruit seed, because grapefruit–CYP3A4 is well documented. The Other Ingredients line contains xylitol, which is severely toxic to dogs.
What the label warns about
- Caution
- Do not exceed recommended dose. Not for use by individuals under the age of 18, or by pregnant or nursing women. Individuals with a known medical condition should consult a physician before using this or any dietary supplement.
- Keep out of reach
- KEEP OUT OF THE REACH OF CHILDREN. DO NOT USE IF SAFETY SEAL IS DAMAGED OR MISSING.
- Storage
- Keep away from heat, light, and humidity to preserve freshness.
That is the whole of the label's safety text. It names no interaction, no allergen and no adverse effect. The absence of a warning on a supplement label is not evidence that there is nothing to warn about; supplement labels are not required to carry interaction warnings the way drug labels are.
Interactions worth raising with a pharmacist
Each entry gives the concern, the literature behind it and the ceiling this label's descending order allows. Read both halves: the concerns are real and the amounts here are small.
- Grapefruit
- Grapefruit is one of the best-known food–drug interactions there is: it blocks intestinal CYP3A4 and can raise blood levels of several statins, calcium channel blockers, transplant medicines and others. The amount of grapefruit seed in this blend is bounded at 1.4 mg, which is small, and the interaction is well enough established that it belongs in a conversation with a pharmacist anyway.
- Green tea extract
- European regulators found that 800 mg of EGCG a day, for four months or longer, raised liver enzymes in a minority of people. The amount here is bounded far below that, and the label does not disclose it.
- Guarana and caffeine
- Guarana carries caffeine. The trials that used it delivered between about 4 and 100 mg of caffeine. The label does not state a caffeine content.
- Licorice
- Monoammonium glycyrrhizinate is a licorice derivative used as a flavouring. Regular intakes above roughly 100 mg a day of glycyrrhizin are associated with raised blood pressure and low potassium. The ceiling here is under a milligram, so this is context rather than a warning.
- Panax ginseng
- Commonly flagged alongside anticoagulants and diabetes medication. Raise it with a clinician if either applies to you.
- Under 18, pregnancy and nursing
- The label says do not use. That is the manufacturer's own instruction and nothing here modifies it.
- Xylitol and dogs
- The Other Ingredients line includes xylitol. Xylitol is seriously toxic to dogs. A sweetened liquid in a dropper bottle is exactly the sort of thing a dog will get into, so keep it out of reach of pets as well as children.
Why we list these at all
Every ingredient above is bounded by the 15.47 mg blend total, so the practical risk from a one-millilitre serving is low. We list them because a pharmacist checking your medicines needs the label, not our arithmetic, and because 'probably too small to matter' is our reading and not a clinical opinion.
The grapefruit line, specifically
Grapefruit is one of the few food–drug interactions that has its own FDA consumer page. It inhibits intestinal CYP3A4, which can raise blood levels of some statins, some calcium channel blockers, some immunosuppressants and several other drugs.
Grapefruit seed sits eleventh on this blend, giving it a ceiling of 1.41 mg, or up to 28.1 mg of raw-fruit equivalent if the 20:1 ratio is granted in full. That is a fraction of a glass of juice. It is still the entry we would name first in a pharmacy conversation, because the consequence when this interaction bites is a drug level, not a stomach ache.
There is a second grapefruit seed issue on this label that has nothing to do with drug interactions, and it has its own page.
Xylitol and pets
The Other Ingredients line includes xylitol. In dogs, xylitol causes a rapid insulin release and can produce severe hypoglycaemia and liver failure at doses far below anything that affects a person.
A sweetened 30 ml dropper bottle left on a counter is a realistic hazard in a house with a dog. The label carries no pet warning, so this site does: keep it closed, keep it out of reach, and if a dog swallows any, call a vet or a poison line immediately rather than waiting for symptoms.
The same is true of most sugar-free gum, mints and peanut butters. This is not a criticism of the formula so much as a warning the label could reasonably have carried.
When to stop
- Any rash, swelling, or difficulty breathing — stop and seek medical help. Two unspecified ingredients, natural flavors and citrus extract, make an allergy impossible to rule out from the label.
- Yellowing of the skin or eyes, dark urine, or persistent right-sided abdominal pain — stop and seek medical help. Green tea extract and gymnema both carry liver case reports at much higher intakes.
- A noticeable change in blood sugar readings if you monitor them.
- A noticeable change in blood pressure if you monitor it.
- Palpitations or sleeplessness, which would point at the undisclosed caffeine from guarana.
- Anything that worries you. Stopping a supplement costs nothing and a 180-day guarantee means it does not even cost the money.
Adverse events with dietary supplements can be reported to the FDA through MedWatch. That reporting system is how signals get found, and it is underused.
Nothing here is a diagnosis
This page is a reading of the published literature on named ingredients. It is not medical advice, it is not specific to you, and a pharmacist with your medication list in front of them is better placed than any website. Take the bottle to them.
See the Cognizil packs
Two, three or six bottles, priced plainly, with a 180-day window on the sales page kits. Read the best case first, then decide.
Shipping is calculated at checkout. This site publishes no figure it was not given.
References
Every source below was opened and read. Nothing here cites a study we did not read, and no identifier on this site was written from memory.
- U.S. Government Publishing Office21 CFR 101.36 — Nutrition labeling of dietary supplements — eCFR.gov · source
- U.S. Food and Drug AdministrationDietary Supplement Labeling Guide: Chapter IV, Nutrition Labeling — FDA.gov · source
- U.S. Food and Drug AdministrationDaily Value and Percent Daily Value: Changes on the New Nutrition and Supplement Facts Labels — FDA.gov · source
- U.S. Food and Drug AdministrationGrapefruit Juice and Some Drugs Don’t Mix — FDA.gov · source
- U.S. Food and Drug AdministrationFDA Calls on Certain Firms to Stop Producing and Issuing Misleading ‘FDA Registration Certificates’ — FDA.gov · source
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- Congretel, Bonnet, Gaudel et al. — 2023Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis — Nutrients · PMID 36678305 · source
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- National Institute of Diabetes and Digestive and Kidney DiseasesGymnema, in LiverTox: Clinical and Research Information on Drug-Induced Liver Injury — NCBI Bookshelf · NBK610217 · source
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- Takeoka, Dao, Wong, Lundin & Mahoney — 2001Identification of benzethonium chloride in commercial grapefruit seed extracts — Journal of Agricultural and Food Chemistry · PMID 11453769 · source
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