Ingredients Tincture: Cat’s Claw ( Uncaria tomentosa ; TOA free extract from Peru) Other ingredients: Mineral water , Gluten free ethanol: 20-24% vol Cautions Should not be used with immune-suppressant medication, or by those who have had transplant surgery such as bone marrow or skin grafts. Should be avoided by pregnant women or those trying to fall pregnant Side-effects Herxheimer reaction may occur, particularly where Lyme disease is present. Advised to start with a low dose and build up. Leg cramps may occur in some individuals. If this occurs then Magnesium malate is recommended. Skin may become more sensitive to sunlight while using Samento, so adequate protection is advised. Combinations with other products Samento may be taken in conjunction with other medication, including antibiotics (although many physicians believe that antibiotics inhibit the action of herbal products). It is best to take Nutramedix products 30 minutes before meals and any additional supplements/pharmaceuticals after meals. Use during pregnancy and breastfeeding Do not use if pregnant or nursing Recommended dosage / usage instructions tincture: Must be taken on an empty stomach. Start with 1 drop twice daily, 30 minutes before meals, increasing slowly up to 30 drops twice daily.