Safety

Allergies

Caution should be exercised in patients with known allergy or hypersensitivity to apple cider vinegar or any of its ingredients, including apples and pectin.

Side Effects and Warnings

There is little scientific study of the safety of apple cider vinegar. The acidity of undiluted apple cider vinegar may destroy tooth enamel when sipped orally. Use cautiously in patients with low potassium levels or taking potassium- lowering medications. Use cautiously in patients with diabetes since apple cider vinegar may contain chromium, which may affect insulin levels. Use cautiously in patients with osteoporosis, based on one case report. Avoid sipping or drinking undiluted apple cider vinegar.

Pregnancy and Breastfeeding

Not recommended due to lack of sufficient data. Likely safe when taken orally as food flavoring. Possibly unsafe when used in larger amounts.

Interactions

Interactions with Drugs

Note: Theoretical interactions are based on potential pH altering effects of apple cider vinegar. The degree to which apple cider vinegar affects blood pH is currently not established.

Theoretically, long- term oral use of apple cider vinegar can decrease potassium levels, increasing the risk of toxicity of cardiac glycoside drugs such as digoxin (Lanoxin®). Long- term use may also add to the potassium- lowering effects of insulin, laxatives, and diuretics such as furosemide (Lasix®).

Interactions with Herbs and Dietary Supplements

Note: Theoretical interactions are based on potential pH altering effects of apple cider vinegar. The degree to which apple cider vinegar affects blood pH is currently not established.

Theoretically, long- term oral use of apple cider vinegar can decrease potassium levels. This may increase the risk of toxicity of cardiac glycoside herbs, add to the potassium- lowering effects of diuretics, and/ or add to the potassium- lowering effects of laxative herbs.