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Supplement · Grade B

Cranberry Extract (PAC-standardised) and medications.

Every documented pair, every citation. Below: 1 documented pair grouped by mechanism.

Cranberry Extract (PAC-standardised) is classified as a targeted supplement in the Distil database, evidence Grade B. The page below lists every medication we have explicitly assessed it against.

Cranberry extract standardised for proanthocyanidins is taken to prevent recurrent urinary tract infections. The PACs stop P-fimbriated E. coli from sticking to the bladder wall, so the mechanism is anti-adhesive rather than antimicrobial. Evidence is Grade B for recurrent UTIs in women and for intervention-related UTIs after catheterisation, with around a quarter to a half reduction in recurrence depending on the group. Dose is the catch: you need at least 36mg of PACs a day, sustained for three to six months, and most over-the-counter capsules and gummies fall well below that and simply do not work. Choose a PAC-standardised tablet or capsule, not juice, which carries a heavy sugar load. Benefit was not shown in institutionalised elderly adults or in neuromuscular bladder dysfunction. On interactions, monitor INR if combined with warfarin, and avoid high-volume juice. Exclude it in pregnancy, where trials showed no benefit, and in anyone with a calcium oxalate kidney stone history, since cranberry raises urinary oxalate.

Below are the 1 documented pair we have explicitly assessed for Cranberry Extract (PAC-standardised): 1 amber. The pairs cluster around 1 mechanism: CYP2C9 inhibition. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

CYP2C9 inhibition

Cranberry can occasionally push warfarin's blood-thinning effect higher, mainly when taken as large volumes of cranberry juice. Standardised cranberry extract at studied doses appears safer than high-volume juice, but tell your GP either way and ask whether INR monitoring should be a little tighter for the first few weeks.

PMID 21364039 · PMID 17322161 · BNF: Warfarin

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology
Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.