Gamboge fruit • Apple • Kiwi fruit • Konjac extract powder • Sweet Potato fiber.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
On October 10, 2013, the U.S. Food and Drug Administration (FDA) warned that this product was found to contain the weight loss drug sibutramine (Meridia), which has been removed from the market in 2010 due to problems with safety (19028). Advise people not to take this product.
Below is general information about the effectiveness of the known ingredients contained in the product Dr. Mao Slimming Capsules. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of gamboge.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Dr. Mao Slimming Capsules. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when used orally in food amounts. Eating apples and consuming apple juice is safe for most people. Apples are a common food source (3470,3472). However, eating apple seeds should be avoided because they can be toxic (6).
CHILDREN: LIKELY SAFE
when used orally in food amounts.
Eating apples and consuming apple juice is safe for most people. Apples are a common food source (3470,3472).
CHILDREN: POSSIBLY SAFE
when apple pectin is used orally and appropriately, short-term.
Preliminary clinical research suggests that combination products containing apple pectin and German chamomile (Diarrhoesan) are safe when used in infants for up to one week (19705,19706).
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of apple in amounts greater than those found in foods during pregnancy and lactation; avoid using.
POSSIBLY UNSAFE ...when used orally. Deaths have been reported with ingestion of 4 grams (18).
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally (18); avoid using.
LIKELY SAFE ...when used orally as food (11358,11359). Glucomannan powder or flour is often used to enrich noodles in traditional Japanese foods.
POSSIBLY SAFE ...when used orally with at least 250 mL (8 ounces) of water or other fluid. Glucomannan has been safely used in studies lasting up to 4 months (178,179,181,182,11046,11294,11357,11294,54240,57775)(57781,57783,57784,92004,92008,92009,92010,92011,106410). In the European Union, the maximum permitted level in foods is 10 grams/kg (106411).
POSSIBLY UNSAFE ...when used orally without any liquid, especially when in tablet form. There have been reports of choking and esophageal or gastrointestinal obstruction when glucomannan products are taken dry. A safety alert for this has been issued by Health Canada (11293,57785,106410).
CHILDREN: POSSIBLY SAFE
when used orally and appropriately with at least 250 mL (8 ounces) of water or other fluid.
Glucomannan has been safely used in children for up to 4 months (179,180,11295,57775,57779,92005,92006,97935).
CHILDREN: LIKELY UNSAFE
when used orally without any liquid, especially when in tablet form.
There have been reports of esophageal and gastrointestinal obstruction when glucomannan products are taken dry (11293,57785,106410).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally in food amounts (6). There is insufficient reliable information available about the safety of kiwi when used orally in amounts greater than those used in foods.
PREGNANCY AND LACTATION: LIKELY SAFE
when used in food amounts (6).
There is insufficient reliable information available about the safety of kiwi when used orally in medicinal amounts; avoid use.
LIKELY SAFE ...when unblemished, ripe potatoes are used as food (6).
POSSIBLY SAFE ...when unblemished, ripe potatoes are used orally for medicinal purposes (6). ...potato juice 200-300 mL has been consumed daily with apparent safety for up to 4 weeks (97757). ...a single dose of potato extract standardized to 15 mg or 30 mg protease inhibitor 2 (Slendesta, Kemin Foods) has been used with apparent safety (97755).
LIKELY UNSAFE ...when damaged, green potatoes and sprouts are consumed. These contain toxic solanum alkaloids that are not destroyed by cooking and can cause serious adverse effects (6). There is insufficient reliable information available about the safety of potato when used topically.
PREGNANCY AND LACTATION: LIKELY SAFE
when unblemished, ripe potatoes are used orally in food amounts.
There is insufficient reliable information available about the safety of medicinal use of potato in pregnancy and lactation.
Below is general information about the interactions of the known ingredients contained in the product Dr. Mao Slimming Capsules. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
 Details
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63% (17670). Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney (7046,94413). It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
|
Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Details
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples (31699).
|
Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Details
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients (31680).
|
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Details
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner (17999). Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney (7046). It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
|
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Details
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78% (7046,94413). Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine (94421). Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney (7046,94413). It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
|
There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
Details
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement (105342).
|
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Details
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP (7046,17605). Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78% (7046,94413), aliskiren by 63% (17670), and atenolol by up to 82% (17999). These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
|
Theoretically, prolonged use might have additive effects with drugs that deplete potassium, including corticosteroids (18,19).
|
Theoretically, overuse of gamboge could decrease potassium levels, increasing the risk of toxicity for cardiac glycoside drugs such as digoxin (Lanoxin) (19).
|
Overuse of gamboge might compound diuretic-induced potassium loss (19). There is some concern that people taking gamboge along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients.
|
Concomitant use of gamboge with stimulant laxatives may increase the risk of fluid and electrolyte loss (19).
|
Gamboge has stimulant laxative effects. In some people gamboge can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of gamboge.
|
Theoretically, glucomannan may decrease absorption of drugs taken orally.
Details
Due to its viscosity and bulking effects, there is concern that glucomannan can decrease the absorption of oral drugs. A small clinical study in healthy volunteers shows that taking glyburide 2.5 mg plus glucomannan 3.9 grams with breakfast reduces plasma levels of glyburide when compared with breakfast and glyburide alone (11360). In addition, animal research demonstrates this effect on amoxicillin, but shows increased absorption of metronidazole. This mouse model also demonstrates that metronidazole elimination is prolonged, but amoxicillin elimination is enhanced by 38%; glucomannan may also affect the distribution of some drugs (112703). To avoid changes in absorption, take glucomannan 30-60 minutes after taking oral drugs.
|
Clinical research suggests that kiwi inhibits platelet aggregation (57498,57581). Theoretically, kiwi might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
|
Clinical research suggests that consuming kiwi reduces systolic and diastolic blood pressure in hypertensive individuals (57648). Theoretically, concomitant use of kiwi and antihypertensive drugs may increase the risk of hypotension when used in combination with drugs that lower blood pressure. These include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
|
In humans, consuming potatoes prior to preoperative fasting prolongs the duration of the succinylcholine-induced neuromuscular block and slows recovery from anesthesia. This interaction is possibly related to inhibition of the butyrylcholinesterase enzyme by potato glycoalkaloids (97756).
|
Theoretically, concomitant use of potato may enhance the effects of thrombolytic drugs. A carboxypeptidase inhibitor isolated from potato tubers may have inhibitory effects on thrombin-activatable thrombolysis inhibitor, and thereby enhance the activity of thrombolytic agents (474,475).
|
Below is general information about the adverse effects of the known ingredients contained in the product Dr. Mao Slimming Capsules. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, apple fruit is well tolerated.
Apple seeds, which contain cyanide, may cause serious adverse effects when consumed in large amounts.
Most Common Adverse Effects:
Orally: Bloating, flatulence.
Serious Adverse Effects (Rare):
Orally: Allergic reactions, including anaphylaxis. Ingestion of large amounts of apple seeds may cause cyanide poisoning, leading to death.
Gastrointestinal ...Orally, apple products, including whole apples, apple puree, and apple juice, may cause bloating and flatulence in some people (104184).
Immunologic ...Patients allergic to other fruits in the Rosaceae family, including apricot, almond, plum, peach, pear, and strawberry, can also be allergic to apples (7129). Rarely, the allergy has resulted in anaphylaxis (94425).
Other ...Orally, ingestion of large amounts of apple seeds, which contain hydrogen cyanide (HCN), may cause cyanide poisoning, leading to death. One death is attributed to ingestion of a cupful of apple seeds. To release cyanide, seeds must be hydrolyzed in the stomach, and several hours may elapse before poisoning symptoms occur (6).
General ...Orally, abdominal pain and vomiting have been reported with gamboge at doses as low as 200 mg. Deaths have been reported after ingestion of 4 grams of gamboge (18).
Gastrointestinal ...Orally, abdominal pain and vomiting have been reported with gamboge at doses as low as 200 mg (18).
Other ...Orally, deaths have been reported after ingestion of 4 grams of gamboge (18).
General
...Orally, glucomannan is generally well tolerated when taken with plenty of water or other liquid.
Most Common Adverse Effects:
Orally: Abdominal pain, bloating, constipation, diarrhea, flatulence, nausea, and vomiting.
Serious Adverse Effects (Rare):
Orally: Choking and esophageal or gastrointestinal obstruction, especially when taken as a dry powder or in tablet form.
Gastrointestinal ...Orally, glucomannan can cause gastrointestinal disturbances, including abdominal pain, bloating, constipation, diarrhea, flatulence, nausea, and vomiting, especially when taken in doses of more than 3 grams daily (57781,57784,92004,92010,92011,97935,106411). Esophageal and gastrointestinal obstructions have been reported when dry glucomannan-containing products are taken with insufficient fluid (11293,57785,106410).
Hepatic ...Acute cholestatic hepatitis occurred in a 31-year-old male after taking glucomannan orally for 45 days (57777). He was also taking other supplements, including garlic and chitosan, so it is unclear whether the hepatitis was due to glucomannan, other supplements, or the combination.
Pulmonary/Respiratory ...Cases of occupational respiratory disorders, including respiratory sensitization and bronchial asthma, have been reported in workers exposed to glucomannan (57789,57810).
General
...Orally, kiwi fruit is generally well tolerated.
Eating kiwi fruit or drinking the juice can lead to hypersensitivity reactions of the lips, mouth, tongue, and throat, including dysphagia, urticaria, dermatitis, angioedema, and vomiting immediately following ingestion in some patients (6,963,57465,57496,57491,57497,57635,57636,109591). Other reported symptoms of kiwi allergy include nausea, diarrhea, and acute pancreatitis (57464,57588,57593,57644). Anaphylactic reactions and kiwi allergy-induced asthma exacerbations have also been reported after eating kiwi fruit (51576,57464,57492,57497,57617,57624,57625,57635,109591,109592).
Topically, kiwi can cause contact urticaria (6). Topical application of kiwi may also cause hypersensitivity reactions, which are more common in patients who are allergic to latex (6197,7853).
Dermatologic
...Orally, eating kiwi fruit or drinking the juice can lead to hypersensitivity reactions of the lips, mouth, tongue, and throat, including urticaria, dermatitis, and angioedema in some patients (6,963,57465,57496,57491,57497,57635,57636,109591,109592).
Topically, kiwi can cause contact urticaria (6). Topical application of kiwi may also cause hypersensitivity reactions, which are more common in patients who are allergic to latex (6197,7853).
Gastrointestinal ...Orally, eating kiwi fruit or drinking the juice can lead to hypersensitivity reactions of the lips, mouth, throat, and tongue, including dysphagia and vomiting immediately following ingestion in some patients (6). Other reported symptoms of kiwi allergy include nausea, diarrhea, and acute pancreatitis (57464,57588,57593,57644).
Immunologic
...Eating kiwi fruit or drinking the juice can lead to hypersensitivity reactions of the lips, mouth, tongue, and throat, including dysphagia, urticaria, dermatitis, angioedema, and vomiting immediately following ingestion in some patients (6,963,57465,57496,57491,57497,57635,57636,109591,109592).
Other reported symptoms of kiwi allergy include nausea, diarrhea, and acute pancreatitis (57464,57588,57593,57644). Anaphylactic reactions and kiwi allergy-induced asthma exacerbations have also been reported after eating kiwi fruit (51576,57464,57492,57497,57617,57624,57625,57635,109591,109592). Some observational research suggests that anaphylaxis after consuming kiwi fruit is more common when compared with other fruits, especially in children. Of 250 patients reporting to the emergency department for fruit-induced anaphylaxis, around 16% reported kiwi fruit as the culprit, followed by banana (11%) and mango (9%) (109591). Rarely, exercise may trigger an anaphylactic reaction to kiwi fruit in individuals with no history of kiwi fruit allergy (109592).
Topically, kiwi can cause contact urticaria (6). Topical application of kiwi may also cause hypersensitivity reactions, which are more common in patients who are allergic to latex (6197,7853).
Pulmonary/Respiratory ...Orally, anaphylactic reactions and kiwi allergy-induced asthma exacerbations have been reported after eating kiwi fruit (51576,57464,57492,57497,57617,57624,57625,57635,109591,109592).
General
...Orally, consuming whole, unblemished, ripe potatoes has not been associated with adverse effects.
Drinking potato juice has resulted in heartburn, abdominal distension, diarrhea, and increased mucus production (97757). Potatoes absorb oil readily, increasing their energy content. Fried potatoes, potato chips, and French fries are commonly associated with weight gain (97752).
The solanum glycosides found in damaged, green potatoes and sprouts can cause sweating, headache, flushing, nausea, vomiting, diarrhea, abdominal pain, thirst, bronchospasm, and restlessness. Deaths have been reported (17,97758). These glycoalkaloids cannot be destroyed by cooking (97758).
When inhaled, potato dust is associated with a high incidence of respiratory symptoms due to bacterial and fungal contaminants (6).
Gastrointestinal
...Orally, potato juice has resulted in heartburn, abdominal distension, diarrhea, and increased mucus production (97757).
Glycoalkaloids found in damaged, green potatoes and sprouts can cause nausea, vomiting, diarrhea, abdominal pain, and thirst (17,97758). The glycoalkaloids in potato cannot be destroyed by cooking (97758).
Immunologic ...Orally, one case of food-dependent exercise-induced allergic reaction has been reported after potato consumption. A 31-year-old female experienced several acute, exercise-induced allergic reactions shortly after eating. Symptoms included widespread urticaria, palpitation, fever, faintness, vomiting, abdominal pain, and swelling of the eyelids, palms, and soles. Blood tests were positive for IgE antibodies to potato and negative for other foods she had eaten, suggesting that potato was the precipitating allergen (103260).
Neurologic/CNS ...Orally, glycoalkaloids found in damaged, green potatoes and sprouts affect the nervous system. This can cause sweating, headache, flushing, bronchospasm, and restlessness (17,97758). Severe poisoning can result in paralysis, respiratory insufficiency, cardiac failure, coma, and death (97758). The glycoalkaloids in potato cannot be destroyed by cooking (97758).
Pulmonary/Respiratory ...When inhaled, potato dust is associated with a high incidence of respiratory symptoms due to bacterial and fungal contaminants (6).
Other
...Potatoes absorb oil readily, increasing the energy content.
Fried potatoes, potato chips, and French fries are commonly associated with weight gain (97752).
The solanum glycosides (glycoalkaloids) found in damaged, green potatoes and sprouts can cause toxicity at doses of approximately 2 mg/kg, and lethal poisoning at doses of approximately 3 mg/kg (97758). Levels of glycoalkaloids can increase post-harvest due to improper storage at higher temperatures, lower humidity, or areas with light. Also, mechanical damage or exposure to gamma-radiation or fungi increases these levels. Glycoalkaloids are concentrated in the peel; although when levels are high they also increase in the flesh of the tuber. Peeling will remove about 30% of the glycoalkaloids (97758).
