Consult a health practitioner if your symptoms persist or worsen, if you are pregnant or breastfeeding, have gallstones, a bile duct obstruction, stomach ulcers, excess stomach acid or liver disorder, or if taking any other medications or natural health products as piperine may alter their effectiveness. Stop use if diarrhoea, abdominal pain, heartburn, nausea, vomiting, hypersensitivity or allergy occurs.