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Rooted Remedies

Herbal Safety Guide

Clear, practical guidance for thoughtful herbal use. Our library blends traditional knowledge with modern research to help you make informed decisions safely.

Understanding Safety Ratings
Each herb is reviewed and categorized to support informed, responsible use.
safe

Well tolerated when used appropriately. Suitable for most individuals in recommended amounts.

caution

May require mindful use due to potential interactions, specific health conditions, or dosage considerations.

restricted

Best used under professional supervision. May have significant contraindications, stronger physiological effects, or elevated interaction potential.

Proper Usage Guidelines
  • •Start low and increase gradually.
  • •Use recommended doses — more is not better.
  • •Short-term use for acute issues; take breaks with long-term use.
  • •Store herbs in a cool, dry place.
  • •Choose reputable, tested sources.
  • •Track your response in a journal.
Special Populations

Pregnancy & Breastfeeding

  • •Some herbs are traditionally used for nausea or mild discomfort.
  • •Others are contraindicated due to uterine-stimulating or hormonal effects.
  • •Always consult your OB/GYN before therapeutic herbal use.

Children

  • •Under 2 years: Professional guidance recommended.
  • •Ages 2–12: Use reduced dosing and gentle herbs only.
  • •Avoid stimulating herbs, strong laxatives, and concentrated essential oils.

Elderly

  • •Start with lower doses due to slower metabolism
  • •Monitor for drug interactions carefully
  • •Be cautious with diuretics and sedatives
  • •Preferred: Gentle tonics, adaptogens, digestive herbs
Contraindications by Condition

Heart Conditions

  • •Avoid: Licorice (raises blood pressure), ephedra
  • •Use cautiously: Hawthorn (consult cardiologist first)

Kidney/Liver Disease

  • •Avoid: Herbs processed heavily by these organs
  • •Caution: Kava, comfrey, coltsfoot, pennyroyal
  • •Limit high-tannin herbs that stress kidneys

Autoimmune Diseases

  • •Avoid: Echinacea, alfalfa (contains L-canavanine)
  • •Consult specialist before immune-modulating herbs

Bleeding Disorders

  • •Avoid: Garlic, ginger, ginkgo, turmeric (high doses)
  • •Stop herbs 2 weeks before surgery
Drug Interactions

5-Alpha Reductase Inhibitors

  • •Saw Palmetto - Additive DHT suppression (Finasteride)

Absorption modifiers

  • •gum arabic tree - Reduced absorption (Oral medications (general))
  • •mazu - Reduced absorption (Oral medications)
  • •Flaxseed - Reduced absorption (Oral medications)
  • •English Oak - Reduced absorption (Oral medications)

Acid-reducing drugs

  • •Gentian - May reduce effectiveness by stimulating stomach acid (Proton pump inhibitors, H2 blockers, antacids)

Acid-reducing medications

  • •Bogbean - Reduced effectiveness due to increased gastric secretion (PPIs; H2 blockers)
  • •Chinese Field Mint - May worsen reflux via lower esophageal sphincter relaxation (PPIs; H2 blockers)

Acid-suppressing drugs

  • •Calumba - May reduce digestive stimulation (Proton pump inhibitors, H2 blockers)

Acid-suppressing medications

  • •Centaury - Reduced digestive stimulation (Proton pump inhibitors, H2 blockers)

All medications

  • •Birthwort - Severe nephrotoxicity; carcinogenic risk (All systemic drugs)

Analgesics

  • •Chinese Prickly Ash - Additive pain-relieving effect (NSAIDs)
  • •Chinese Clematis - Additive CNS effects (NSAIDs)

Anesthesia agents

  • •Kava - Potentiation of anesthetic effects (General anesthetics; Propofol; Midazolam)

Antacids / Acid-reducing drugs

  • •Manchurian Gentian - Opposes drug effect (increases acid) (Antacids / Acid-reducing drugs)

Antacids / GI drugs

  • •Blessed thistle - Opposes drug effect (increases acid) (Acid-reducing drugs)

Antacids / iron supplements

  • •Yellow dock - Alters absorption (GI drugs, iron)

Anti-inflammatory drugs

  • •Devil's Claw - Additive anti-inflammatory (NSAIDs; corticosteroids)
  • •Bear breeches - Possible additive GI irritation (NSAIDs)

Anti-inflammatory drugs (NSAIDs)

  • •Guaiacum - Increased anti-inflammatory effect (Anti-inflammatory drugs (NSAIDs))
  • •Heartseed - Additive anti-inflammatory effect (NSAIDs; corticosteroids)

Antiarrhythmics

  • •Scotch broom - Potential cardiac rhythm interaction (Class I and III antiarrhythmics)
  • •Cascara Sagrada - Electrolyte imbalance risk (Amiodarone)

Antibiotics

  • •Huang Bai - May alter absorption or metabolism (Antibiotics)
  • •Mastic Tree - Additive antimicrobial (broad-spectrum antibiotics)

Anticholinergic drugs

  • •Thornapple (Datura) - Severe anticholinergic toxicity (Antihistamines, antidepressants)
  • •Mandrake - Increased anticholinergic effects (Anticholinergic drugs)
  • •Sweet Flag - Additive effects (Antihistamines, antidepressants)

Anticoagulants

  • •Boneset - Possible bleeding risk (Blood thinners)
  • •Chai Hu - Increased bleeding risk (Warfarin)
  • •Wintergreen - Strong salicylate → bleeding risk (Warfarin)
  • •Sweet woodruff - Coumarin-related bleeding risk (Warfarin)
  • •Teasel - Possible bleeding risk (Blood thinners)
  • •Tree peony - Increased bleeding (Warfarin)
  • •Melilot (Sweet Clover) - Strong blood thinning (Warfarin)
  • •African Geranium - Mild bleeding risk (Warfarin)
  • •Onion - Increased bleeding (Warfarin)
  • •Ledebouriella Root (Fang Feng) - Mild blood-thinning effect (Anticoagulants)
  • •Kuth (Saussurea costus) - Possible blood-thinning effect (Anticoagulants)
  • •Allspice - Mild blood-thinning effect (Anticoagulants)
  • •Korean Ginseng - May reduce or alter effect (Anticoagulants)
  • •Chinese Garlic - Increased bleeding tendency (Anticoagulants)
  • •Lovage - Possible bleeding risk (Anticoagulants)
  • •Horseradish - Mild blood-thinning effect (Anticoagulants)
  • •Guaco - Mild blood-thinning effect (Anticoagulants)
  • •HALiM SEEDS - Increased bleeding risk (Warfarin, aspirin)
  • •Fever bark - Increased bleeding risk (Warfarin)
  • •Feverfew - Increased bleeding risk (Aspirin, NSAIDs)
  • •Sichuan Teasel Root - Increased bleeding risk (Blood thinners)
  • •Evening Primrose - Increased bleeding risk (Blood thinners)
  • •Cranberry - Additive bleeding risk (Warfarin, Aspirin)
  • •Curcuma Rhizome, Wen Yu Jin - Additive bleeding risk (Warfarin, Clopidogrel)
  • •Cyathula root - Additive bleeding risk (Warfarin)
  • •Zedoary - Additive bleeding risk (Warfarin, Heparin)
  • •Large Blood Vine - Additive bleeding risk (Warfarin)
  • •Chinese rosewood - Additive bleeding risk (Warfarin)
  • •Milletia vine - Additive bleeding risk (Warfarin)
  • •Sappanwood - Additive bleeding risk (Warfarin, Aspirin)
  • •Chinese Ground Orchid - Additive bleeding risk (Warfarin, Heparin)
  • •Chinese Lovage - Increased bleeding risk (Warfarin)
  • •Red Sage - Increased bleeding risk (Warfarin, Aspirin)
  • •Chervil - Possible mild bleeding interaction (Warfarin, aspirin)
  • •Cat’s Claw - Potential bleeding risk (Warfarin, aspirin)
  • •Cattail - Potential clotting interaction (Warfarin, heparin)
  • •Purslane - Mild blood thinning interaction (warfarin; antiplatelet drugs)
  • •Galangal - Mild additive blood-thinning effect (Warfarin, antiplatelet drugs)
  • •Wild Thyme - Potential mild blood-thinning activity (Aspirin, anticoagulant drugs)
  • •Rose Hip - Possible additive blood-thinning effect in large doses (Warfarin, aspirin)
  • •Bladderwrack - Increased bleeding risk (theoretical) (Warfarin; DOACs)
  • •Bilberry - Increased bleeding risk (Warfarin; aspirin)
  • •Oregano - Increased bleeding risk (high-dose extracts) (Warfarin; aspirin)
  • •Garlic - Increased bleeding risk (Warfarin; DOACs)
  • •Borage - Theoretical increased bleeding risk (Warfarin; Antiplatelets)
  • •Boldo - Theoretical increased bleeding risk (Warfarin; Direct oral anticoagulants)
  • •Chinese Field Mint - Theoretical increased bleeding risk (high dose) (Warfarin; Antiplatelets)
  • •Bakuchi - Theoretical increased bleeding risk (Warfarin; Direct oral anticoagulants)
  • •Bugle - Theoretical additive effect due to mild astringency (Warfarin; Direct oral anticoagulants)
  • •Bethroot - Astringent effect may alter clotting dynamics (Warfarin)
  • •Black Catechu - Theoretical bleeding modulation (Warfarin)
  • •Bishop’s weed - May enhance bleeding risk (Warfarin; Aspirin)
  • •Bear breeches - Theoretical additive bleeding risk (Warfarin; DOACs; Aspirin)
  • •Benzoin Gum - Theoretical bleeding interaction (resin) (Warfarin; Antiplatelets)
  • •Black Turmeric Root - Increased bleeding risk (Warfarin; DOACs)
  • •Asafoetida - Possible additive bleeding risk (Warfarin; Direct oral anticoagulants)
  • •St. John’s wort - CYP induction → reduced anticoagulant effect (Warfarin, DOACs)
  • •Myrrh - Antagonizes warfarin → reduced anticoagulation (Warfarin)

Anticoagulants / antihypertensives

  • •Celery seed - Bleeding / low BP (Warfarin, BP meds)

Anticoagulants / antiplatelet drugs

  • •Indian Gooseberry (Amla) - Possible increase in bleeding tendency (Warfarin, aspirin, clopidogrel)

Anticoagulants / antiplatelets

  • •Tienchi Ginseng (Sanqi) - Increased bleeding (Warfarin, aspirin)
  • •Sanqi - Increased bleeding (Warfarin, aspirin)
  • •Chaff Flower - Possible bleeding risk (Warfarin, aspirin)
  • •Chebulic Myrobalan - Possible bleeding risk (Warfarin, clopidogrel)
  • •Marestail - Possible bleeding risk (Warfarin, aspirin, clopidogrel)

Anticoagulants / Antiplatelets

  • •Japanese Knotweed - Increased blood-thinning effect (Anticoagulants / Antiplatelets)
  • •Bur Reed Tuber - Theoretical additive bleeding risk (blood-moving action) (Warfarin; Aspirin; Clopidogrel)
  • •Balm of Gilead (Commiphora gileadensis) - Resin compounds may increase bleeding tendency (Warfarin; aspirin; clopidogrel)
  • •Balm of Gilead (Populus balsamifera) - Salicylate content may increase bleeding risk (Warfarin; aspirin; clopidogrel; DOACs)
  • •Bay Leaf - High-dose use may increase bleeding tendency (theoretical) (Warfarin; aspirin)
  • •Saw Palmetto - Possible bleeding risk (theoretical) (Warfarin; Aspirin; Clopidogrel)
  • •Frankincense - Theoretical additive bleeding risk (Warfarin; DOACs; Aspirin)
  • •Coriander - Warfarin (Theoretical bleeding interaction (limited evidence))
  • •Cumin - Possible additive bleeding tendency (limited evidence) (Warfarin; Aspirin; Clopidogrel)
  • •Eleuthero - Possible interaction (rare case reports; platelet effects unclear) (Warfarin)
  • •Ginkgo - Increased bleeding risk; platelet-activating factor inhibition (Warfarin; Aspirin; Clopidogrel; Apixaban; Rivaroxaban)
  • •Ginger - Increased bleeding tendency (Warfarin; Aspirin; Clopidogrel; DOACs)
  • •White Peony - Increased bleeding tendency (Warfarin; Aspirin)
  • •Chamomile - Possible bleeding interaction (limited evidence) (Warfarin)
  • •Goji Berry - INR changes / bleeding (case reports) (Warfarin)
  • •Ginseng - Possible INR effect / bleeding risk (Warfarin)
  • •Fenugreek - Bleeding tendency (additive) (Warfarin; Antiplatelets)
  • •Turmeric - Increased bleeding tendency (Warfarin; Aspirin; Clopidogrel; Apixaban; Rivaroxaban)

Anticoagulants / NSAIDs

  • •White willow - Increased bleeding / GI irritation (Warfarin, aspirin)

Anticonvulsants

  • •Ginkgo - May lower seizure threshold (rare reports) (Valproate; Phenytoin; Carbamazepine)
  • •Sage (high dose/EO) - Thujone-related seizure risk at high doses (Anticonvulsants)
  • •Wormwood - Thujone neurotoxicity / seizure risk (Anticonvulsants)

Antidepressants

  • •Khat - Neurotransmitter interaction (Antidepressants)
  • •Rhodiola - Serotonergic modulation (SSRIs; SNRIs)
  • •St. John’s wort - Strong CYP/P-gp induction → reduced drug levels; risk of serotonin toxicity (SSRIs, SNRIs, TCAs, others)

Antidepressants (CNS-active)

  • •Kava - Additive CNS effects; sedation (SSRIs; SNRIs; TCAs)

Antidepressants / antipsychotics

  • •Peyote - Serotonin / psychiatric effects (SSRIs, MAOIs)

Antidepressants / Antipsychotics

  • •Indian Snakeroot (Rauwolfia) - Alters neurotransmitter activity (Antidepressants / Antipsychotics)

Antidepressants / stimulants

  • •Yohimbe - CNS overstimulation / BP increase (SSRIs, stimulants)
  • •Tibetan Rhodiola - Overstimulation / serotonin effects (SSRIs, stimulants)

Antidiabetic agents

  • •Butter Tree - Additive blood sugar lowering (Insulin; Metformin; Sulfonylureas)
  • •Burdock Root - Additive blood sugar lowering (Insulin; Metformin; GLP-1 agonists)

Antidiabetic Agents

  • •Psyllium - Additive blood sugar lowering (Insulin; Metformin)
  • •Coriander - Insulin; Metformin; Sulfonylureas (Additive blood sugar lowering (mild))
  • •Cumin - Additive blood sugar lowering (mild) (Sulfonylureas)
  • •Eleuthero - Additive blood sugar lowering (Insulin; Metformin; Sulfonylureas)
  • •Ginkgo - Mild additive glucose-lowering effect (Insulin; Metformin)
  • •Juniper - Additive blood sugar lowering (theoretical/mild) (Insulin; Metformin; Sulfonylureas)
  • •Ginseng - Additive blood sugar lowering (Insulin; Metformin; Sulfonylureas)
  • •American Ginseng - Additive blood sugar lowering (Insulin; Metformin; Sulfonylureas)
  • •Bitter Melon - Hypoglycemia risk (Insulin; Metformin; Sulfonylureas)
  • •Fenugreek - Hypoglycemia risk (Insulin; Metformin; Sulfonylureas)
  • •Black Cumin - Additive blood sugar lowering (Insulin; Metformin)
  • •Tamarind - Additive blood sugar lowering (Insulin; Metformin)
  • •Burdock Root - Additive blood sugar lowering (Insulin; Metformin)

Antidiabetic drugs

  • •Devil’s club - Blood sugar lowering (Insulin)
  • •White horehound - Blood sugar lowering (Insulin, metformin)
  • •Kudzu - Increased blood sugar lowering (Antidiabetic drugs)
  • •Korean Ginseng - Increased blood sugar lowering (Antidiabetic drugs)
  • •Jambul / Java Plum - Increased blood sugar lowering (Antidiabetic drugs)
  • •Sausage Tree (Kigelia) - Blood sugar lowering (Antidiabetic drugs)
  • •Kino - May lower blood sugar (Antidiabetic drugs)
  • •Indian Mulberry (Noni) - Increased blood sugar lowering (Antidiabetic drugs)
  • •Huang Bai - Increased blood sugar lowering (Antidiabetic drugs)
  • •Huang Lian (Coptis) - Increased blood sugar lowering (Antidiabetic drugs)
  • •Gurmar - Strong blood sugar lowering (Antidiabetic drugs)
  • •White mulberry - Additive hypoglycemia (Metformin, Insulin)
  • •Anemarrhena - Additive hypoglycemia (Metformin)
  • •Bamboo - Additive hypoglycemia (Metformin (mild))
  • •Neem - Blood sugar lowering (insulin; sulfonylureas)

Antidiabetic medications

  • •Gotu Kola - Possible additive glucose-lowering effect (Metformin, insulin)
  • •Chebulic Myrobalan - Possible additive glucose-lowering effect (Metformin, sulfonylureas)
  • •Chinese Goldthread - Possible additive glucose-lowering effect (Metformin, insulin)
  • •Cedar - Possible additive glucose-lowering effect (Metformin, insulin)
  • •Centaury - Possible glucose regulation influence (Metformin, sulfonylureas)
  • •Bishop’s weed - May lower blood glucose (Metformin; Insulin)
  • •Black Atractylodes - May enhance hypoglycemic effect (Metformin; Insulin)
  • •Beleric Myrobalan - May enhance glucose lowering (Metformin; Insulin; Sulfonylureas)
  • •Moringa - Additive glucose-lowering effect (Insulin; Metformin; Sulfonylureas)
  • •Prickly Pear - Additive glucose-lowering effect (Insulin; Metformin; Sulfonylureas)
  • •Stinging Nettle - Additive glucose-lowering effect (Metformin; Insulin)
  • •Asian Plum - Possible additive glucose-lowering (Metformin; Insulin)

Antidiabetics

  • •Kutki - Hypoglycemia (Insulin, metformin)
  • •Chinese Yam - Blood sugar lowering (Metformin, Insulin)
  • •Tiger Nut - Blood sugar lowering (Metformin)
  • •Blueberry - Enhanced glucose lowering (Metformin; insulin)
  • •Bilberry - Enhanced glucose lowering (Insulin; sulfonylureas)
  • •Oregano - Enhanced glucose lowering (Metformin)
  • •Brazilian Ginseng - May enhance glucose-lowering effect (Insulin; Metformin; Sulfonylureas)

Antidiabetics / alcohol-related drugs

  • •Thomson’s Kudzu - Hypoglycemia / altered alcohol metabolism (Insulin, metformin)

Antidiabetics / immunosuppressants

  • •Oregon Grape - Hypoglycemia / drug accumulation (Metformin, cyclosporine)

Antidiarrheals

  • •Carob - Additive effect (loperamide)
  • •Asthma Plant - Astringent effect may alter GI motility (Loperamide)

Antiemetics

  • •Ban Xia (Crowdipper) - Reduced drug effectiveness (Ondansetron)

Antihypertensive drugs

  • •Changium Root - Possible additive blood pressure reduction (ACE inhibitors, beta blockers)
  • •Cajeput - Potential blood pressure lowering (ACE inhibitors, beta blockers)
  • •Calumba - Possible blood pressure influence (ACE inhibitors, ARBs)

Antihypertensive medications

  • •Chinese Goldthread - Possible additive blood pressure reduction (ACE inhibitors, ARBs)

Antihypertensives

  • •Cat’s Whiskers - Additive blood pressure lowering (Antihypertensives)
  • •Chinese Garlic - Additive BP lowering (Antihypertensives)
  • •Magnolia Bark - Additive blood pressure lowering (Antihypertensives)
  • •Lesser Periwinkle - Additive BP lowering (Antihypertensives)
  • •BARREN WORT LEAVES - Additive hypotension (Blood pressure medications)
  • •Eucommia bark - Additive hypotension (Blood pressure drugs)
  • •Evodia - Additive hypotension (Blood pressure medications)
  • •Gambir Vine - Additive hypotension (ACE inhibitors, Beta-blockers)
  • •Chinese Licorice - Blood pressure modulation (ACE inhibitors, Beta-blockers)
  • •Blood Root - Blood pressure modulation (ACE inhibitors; beta blockers)
  • •Blue Cohosh - Additive hypotensive effect (ACE inhibitors; calcium channel blockers)
  • •Garlic - Additive blood pressure lowering (ACE inhibitors; ARBs)
  • •Chinese Black Cohosh - Possible additive hypotensive effect (ACE inhibitors; Beta blockers)
  • •Scotch broom - Additive blood pressure effects (ACE inhibitors; Calcium channel blockers)
  • •Brazilian Ginseng - Additive hypotensive effect (ARBs; Beta blockers)
  • •Butcher's Broom - Possible additive vascular effects (ACE inhibitors; ARBs; Calcium channel blockers)
  • •Black Haw - Mild hypotensive additive effect (ACE inhibitors)
  • •Black Horehound - May enhance BP lowering (Beta-blockers)
  • •Moringa - Additive blood pressure lowering (ACE inhibitors; ARBs; Beta blockers)
  • •Stinging Nettle - Additive hypotensive effect (ACE inhibitors; ARBs)
  • •Arjun - Additive blood pressure lowering (ACE inhibitors; Calcium channel blockers)
  • •Asafoetida - Additive blood pressure lowering (ACE inhibitors; ARBs)
  • •Maca root - Potential additive hypotensive effect (ACE inhibitors, ARBs)
  • •Licorice Root - May reduce effectiveness (raises BP) (ACE inhibitors; ARBs; Beta blockers)
  • •Coriander - Mild additive blood pressure lowering (ACE inhibitors; ARBs; Beta blockers)
  • •Cumin - ACE inhibitors; ARBs; Beta blockers (Mild additive blood pressure lowering)
  • •Eleuthero - ACE inhibitors; ARBs; Beta blockers (Additive blood pressure effects (may raise or lower BP depending on dose))
  • •Ginkgo - Additive blood pressure lowering (mild) (ACE inhibitors; ARBs; Beta blockers)
  • •Juniper - Additive blood pressure lowering (mild) (ACE inhibitors; ARBs; Beta blockers)
  • •Ginger - Additive blood pressure lowering (ACE inhibitors; ARBs; Beta blockers)
  • •Black Cumin - Additive blood pressure lowering (ACE inhibitors; ARBs)
  • •Dandelion - Additive blood pressure lowering (ACE inhibitors; ARBs)

Antihypertensives / antidiabetics

  • •Olive leaf - Low BP / hypoglycemia (BP meds, insulin)

Antihypertensives / sedatives

  • •Blue vervain - Low BP / sedation (BP meds, sedatives)
  • •Motherwort - Low BP / sedation (BP meds, sedatives)

Antimalarials

  • •Chirata - Additive pharmacologic effect (Artemisinin-based drugs)
  • •Blue Evergreen Hydrangea - Pharmacodynamic potentiation (Artemisinin derivatives; chloroquine)

Antimicrobials

  • •Japanese honeysuckle - Additive antimicrobial effect (Antibiotics)
  • •Andrographis - Additive antimicrobial effect (Antivirals)

Antiparasitic drugs

  • •Wormseed - Additive toxicity (Anthelmintics)
  • •Levant Wormseed - Additive toxicity (Antiparasitic drugs)
  • •False Black Pepper - Synergistic effects (Anthelmintics)

Antiplatelet / Anticoagulants

  • •Arjun - Possible additive bleeding risk (Aspirin; Clopidogrel; Warfarin)

Antiplatelet drugs

  • •Catnip - Possible additive bleeding risk (Aspirin, clopidogrel)

Antiplatelets

  • •Red Sage - Additive blood-thinning (Clopidogrel)
  • •Garlic - Additive antiplatelet effect (Aspirin; clopidogrel)
  • •Black Turmeric Root - Additive antiplatelet effect (Clopidogrel; Aspirin)

Antipsychotics

  • •Kava - Haloperidol; Quetiapine; Olanzapine (Excess sedation; motor impairment)

Antipyretics

  • •Chinese Indigo - Additive cooling effect (Acetaminophen)

Antitussives

  • •Ussuri Fritillary (Bei Mu) - Additive or opposing effects (Cough suppressants)

Antitussives / Expectorants

  • •Chinese Bellflower - May enhance mucus clearance or cough suppression effects (Cough suppressants; expectorants)

Antivirals

  • •Chinese Woad - Synergistic immune modulation (Antiviral medications)

Anxiolytics

  • •Kava - Buspirone; Benzodiazepines (Additive sedation and psychomotor impairment)

ARBs

  • •Maca root - Additive blood-pressure lowering (animal data) (Losartan)

Bioavailability enhancers

  • •Pepper - Increased drug absorption (Multiple drug classes (CYP450 substrates))

Blood pressure medications

  • •Indian Snakeroot (Rauwolfia) - Additive blood pressure lowering (Blood pressure medications)
  • •Hibiscus - Additive blood pressure lowering effect (ACE inhibitors, beta blockers, diuretics)

Blood sugar medications

  • •Cassava (Manioc) - Glycemic effects (insulin; metformin)

Blood thinners / NSAIDs

  • •Meadowsweet - Increased bleeding / GI irritation (Warfarin, aspirin)

Bronchodilators

  • •Asthma Plant - May have additive bronchodilatory effects (Beta-agonist inhalers; theophylline)
  • •Asthma Plant - Additive bronchodilatory effect (Salbutamol; Formoterol)

Calcineurin inhibitors

  • •Barberry - Raises tacrolimus/cyclosporin levels → toxicity risk (Tacrolimus, cyclosine)

Calcium metabolism drugs

  • •Drynaria Rhizome - Altered calcium metabolism (Supplements, osteoporosis drugs)

Cardiac / cytotoxic drugs

  • •Meadow saffron - Toxicity / arrhythmia (Antiarrhythmics, immunosuppressants)

Cardiac drugs

  • •Yellow foxglove - Cardiotoxic interaction (Digoxin, antiarrhythmics)
  • •European yew - Cardiotoxic interaction (Antiarrhythmics)
  • •Wahoo bark - Electrolyte-related cardiac effects (Heart medications)
  • •Squill - Cardiotoxic interaction (Antiarrhythmics, digoxin)
  • •Monkshood Root - Cardiotoxic interaction (Antiarrhythmics)
  • •Butterfly weed - Mild cardiac interaction (Heart medications)
  • •Monkshood - Cardiotoxic interaction (Antiarrhythmics)
  • •Bala - Cardiac stimulation risk (Antiarrhythmics)
  • •St. John’s wort - CYP/P-gp induction → reduced plasma levels (Digoxin, antiarrhythmics)

Cardiac glycosides

  • •Common Foxglove - Potentiation / toxicity risk (Digoxin)

Cardiac Glycosides

  • •Senna - Increased toxicity risk (hypokalemia) (Digoxin)
  • •Licorice Root - Hypokalemia increases toxicity (Digoxin)
  • •Cascara Sagrada - Increased toxicity risk (low potassium) (Digoxin)

Cardiac glycosides / Heart meds

  • •Lily of the Valley - Additive cardiac effects (Cardiac glycosides / Heart meds)

Cardiac medications

  • •Black Swallow-wort - Potential cardiac glycoside interaction (Digoxin)
  • •Bittersweet Nightshade - Alkaloid-related toxicity risk (Digoxin)

Cardiovascular drugs

  • •Figwort - Blood pressure lowering (Antihypertensives)
  • •False hellebore - Severe toxicity risk (Cardiac glycosides)

Cardiovascular medications

  • •Hawthorn - May alter heart medication activity (Digoxin, beta blockers, blood pressure medications)

Central nervous system drugs

  • •Ipecac - Vomiting reduces drug absorption (Central nervous system drugs)

Chemotherapy agents

  • •Tu Bei Mu - Theoretical additive cytotoxic or anti-proliferative effects (Antineoplastics; targeted cancer therapies)

Cholinergic drugs

  • •Calabar bean - Excess cholinergic activity (Acetylcholinesterase inhibitors)

CNS depressants

  • •White bryony - Increased sedation / toxicity (Sedatives)
  • •Wild lettuce - Increased sedation (Sedatives, opioids)
  • •Mexican poppy - Increased sedation (Sedatives)
  • •Manchurian Wild Ginger (Xi Xin) - Increased sedation (CNS depressants)
  • •Sweet Flag - Potentiation (Sedatives, benzodiazepines)
  • •American Skullcap - Additive sedative effect (Benzodiazepines; Barbiturates; Sleep medications)

CNS Depressants

  • •Corniader - Mild calming effect (very mild interaction potential) (Benzodiazepines; Sleep aids)
  • •Kava - Additive CNS depression; excessive sedation; respiratory depression risk (Benzodiazepines; Z-drugs (zolpidem); Barbiturates; Opioids; Alcohol)
  • •Ashwagandha - Additive drowsiness (Benzodiazepines; Zolpidem; Opioids; Alcohol)
  • •Valerian - Excess sedation / grogginess (Benzodiazepines; Zolpidem; Opioids; Alcohol)
  • •Hops - Additive sedation (Benzodiazepines; Alcohol)
  • •Californian Poppy - Additive sedation (Benzodiazepines; Opioids; Sleep meds)
  • •Albizia - Mild additive sedation (Benzodiazepines; Sleep meds)
  • •Lavender (internal oil) - Additive sedation (concentrated oil) (Benzodiazepines; Sleep meds)

CNS drugs

  • •Harmal - MAOI interaction (Antidepressants (SSRIs, MAOIs))

CNS drugs / hepatotoxic drugs

  • •Tansy - Neurotoxicity / liver toxicity (Sedatives, liver-metabolized drugs)

CNS stimulants

  • •Muira Puama - Increased stimulation (Caffeine, stimulants)
  • •Coca - Additive stimulation (Amphetamines)
  • •Camphor - Neurotoxic risk at high doses (Stimulants, certain antidepressants)

CNS-active drugs

  • •Marijuana - Increased sedation / neuro effects (Sedatives, antidepressants, opioids)

CNS-active medications

  • •Arisaema - Theoretical interaction in high doses (Anticonvulsants; Sedatives)

Corticosteroids

  • •Chinese Licorice - Potentiation / prolonged effect (Prednisone)
  • •Senna - Additive potassium depletion (Prednisone)
  • •Licorice Root - Additive mineralocorticoid effect (Prednisone)

Corticosteroids (respiratory)

  • •Asthma Plant - Additive anti-inflammatory respiratory effects (Inhaled corticosteroids)

Cyclosporine

  • •Huang Lian (Coptis) - Increases drug levels (Cyclosporine)

CYP2C9 substrate drugs

  • •Schisandra - Possible metabolism alteration (Warfarin; NSAIDs)

CYP3A4 substrate drugs

  • •Schisandra - Enzyme modulation may alter drug levels (Statins; Immunosuppressants; Benzodiazepines)

CYP450 substrate drugs

  • •Barberry - CYP modulation → altered drug levels (Various CYP2D6, CYP2C9, CYP3A4 substrates)

CYP450 substrate drugs (general)

  • •Cinnamon - Possible CYP inhibition (preclinical) → altered drug metabolism (CYP2C9 substrates, CYP3A4 substrates)

CYP450 Substrate Medications

  • •Gingko - Alters metabolism (mild CYP2C19, CYP3A4 modulation) (Omeprazole; Certain statins; Benzodiazepines)
  • •Goldenseal - Alters drug levels (metabolism inhibition) (Antidepressants; statins; benzodiazepines; heart meds; oral contraceptives)

Cytotoxic / GI drugs

  • •Wolf Poison (Langdu) - Severe toxicity (Chemotherapy, GI meds)

Cytotoxic agents

  • •Giant voodoo lily - Toxic synergy (Chemotherapy drugs)

Cytotoxic drugs

  • •Bloodroot - Tissue toxicity (Chemotherapy)
  • •Chinese Stargrass (Paris polyphylla) - Potential additive toxicity (Chemotherapy agents)

Digestive stimulants / Bitters

  • •Balmony - Additive gastric stimulation (Digestive bitters; proton pump inhibitors (theoretical))

Digoxin

  • •Eleuthero - Possible assay interference (historical reports; not true pharmacologic interaction) (Digoxin)

Diuretics

  • •Corn silk - Increased urine output (Diuretic drugs)
  • •Asian water plantain - Electrolyte imbalance (Loop/thiazide diuretics)
  • •Prince’s pine - Increased fluid loss (Diuretic drugs)
  • •Lovage - Increased urine output (Diuretics)
  • •Juniper - Increased urine output (Diuretics)
  • •Cat’s Whiskers - Increased urine output (Diuretics)
  • •Jalap - Excessive fluid and electrolyte loss (Diuretics)
  • •Goldenrod - Increased urine output (Diuretics)
  • •Gravel Root - Increased fluid loss (Diuretics)
  • •Heather - Increased urine output (Diuretics)
  • •stone-breaker - Additive diuresis (Loop diuretics)
  • •Glabrous Greenbrier Rhizome - Additive diuresis (Diuretics)
  • •Gokulakanta - Additive diuresis (Diuretics)
  • •Elecampane - Additive diuresis (Diuretics)
  • •Chocolate Vine - Additive diuretic effect (Loop diuretics)
  • •Rice paper plant - Additive diuretic effect (Furosemide)
  • •Couch grass - Additive diuretic effect (Thiazides)
  • •Club Moss - Increased urinary elimination (Diuretics)
  • •Chinese Smilax - Increased fluid loss (Loop diuretics)
  • •Cleavers - Additive diuretic effect (Thiazide diuretics)
  • •Chickweed - Possible additive diuretic effect (Thiazide diuretics, loop diuretics)
  • •Marestail - Possible additive diuretic effect (Thiazide diuretics, loop diuretics)
  • •Bur Marigold - Additive diuretic effect (Loop diuretics; Thiazides)
  • •Black Atractylodes - Additive fluid loss (Furosemide)
  • •Culver’s Root - Additive dehydration risk (Loop diuretics)
  • •Stinging Nettle - Additive diuretic effect (Furosemide; Hydrochlorothiazide)
  • •Licorice Root - Increased potassium loss (Loop diuretics; Thiazides)
  • •Cascara Sagrada - Electrolyte depletion risk (Loop diuretics; Thiazides)
  • •Senna - Electrolyte depletion (potassium loss) (Loop diuretics; Thiazides)
  • •Juniper - Additive diuretic effect (electrolyte imbalance risk) (Loop diuretics (furosemide); Thiazides (HCTZ))
  • •Burdock Root - Additive diuresis / dehydration (Loop diuretics; Thiazides)
  • •Dandelion - Additive diuresis / electrolyte shift (Loop diuretics; Thiazides)

Diuretics / kidney drugs

  • •Fen Fang Ji - Fluid/electrolyte imbalance (Diuretics)

Diuretics / urinary drugs

  • •Bearberry - Increased urinary effect (Diuretics)

Dopamine agonists/antagonists

  • •Chasteberry - Dopaminergic modulation (Bromocriptine; antipsychotics)

Dopaminergic meds

  • •Kava - Levodopa; Dopamine agonists (Possible motor effects; dystonia (rare case reports))

Drug absorption modifiers

  • •Guar Gum - May slow absorption of medications due to soluble fiber (Oral medications, diabetes drugs, cholesterol drugs)

drug_category

  • •herb - risk_type (example_drug_classes)

Electrolyte-affecting medications

  • •Desert Squash - Severe diarrhea may alter drug absorption or electrolytes (Diuretics, laxatives, electrolyte-sensitive medications)

Electrolyte-altering drugs

  • •Aloe Vera - Potassium depletion risk (Diuretics, Digoxin)

Gastrointestinal medications

  • •Ceylon Leadwort - Increased gastric irritation risk (NSAIDs, corticosteroids)

General drugs

  • •Euphorbia Root - Toxic potentiation (Multiple classes)

GI irritation drugs

  • •Cubeb - Additive irritation (NSAIDs)
  • •Chinese honey locust - Additive irritation (Strong medications)

Heart medications

  • •Kola Nut - Affects heart rate and blood pressure (Heart medications)
  • •Jalap - Electrolyte imbalance affects heart rhythm (Heart medications)
  • •Guarana - Affects heart rate and blood pressure (Heart medications)
  • •Ipecac - Electrolyte imbalance may cause arrhythmia (Heart medications)

Hepatic drugs

  • •Chinese Thorowax - Altered liver metabolism (CYP450-metabolized drugs)

Hepatically metabolized drugs

  • •Rooibos - Rare case reports of liver enzyme changes (General CYP-metabolized medications)

Hepatotoxic drugs

  • •Celandine - Liver toxicity (Liver-metabolized drugs)
  • •Butterbur (non-PA-free) - Liver toxicity (Liver drugs)
  • •Blue Flag - Liver toxicity (Liver-metabolized drugs)
  • •Tonkin Aphora (Shan Dou Gen) - Liver toxicity risk (Liver-metabolized drugs)
  • •Tree-of-heaven - Liver toxicity (Liver-metabolized drugs)
  • •Mezereon - Liver toxicity (Various liver-metabolized drugs)
  • •Pennyroyal - Severe liver toxicity (Liver-metabolized drugs)
  • •Life Root (Senecio) - Increased liver toxicity (Hepatotoxic drugs)
  • •Flowery Knotweed - Increased liver burden (Liver-metabolized drugs)
  • •Black Cohosh - Liver stress risk (Acetaminophen)
  • •Andrographis - Liver metabolism interaction (Various hepatically metabolized drugs)
  • •Coltsfoot Leaf - Increased liver strain (Acetaminophen (high dose))
  • •Blue Evergreen Hydrangea - Additive liver stress (Acetaminophen (high dose); isoniazid)
  • •Blood Root - Additive toxicity risk (Methotrexate; statins)
  • •Borage - Increased liver stress (PA alkaloids in leaf) (Acetaminophen; Methotrexate)
  • •Kava - Increased liver toxicity risk (Acetaminophen (high dose); Isoniazid; Methotrexate; Valproate; Statins (monitor))

Hepatotoxic medications

  • •Chaparral - Increased liver stress risk (Acetaminophen, methotrexate)
  • •Boldo - Additive liver stress risk (Statins; Isoniazid)

HIV medications

  • •St. John’s wort - CYP3A4 induction → reduced antiretroviral levels (Protease inhibitors, NNRTIs)

Hormonal agents

  • •BARREN WORT LEAVES - Hormonal modulation (Estrogen therapy)
  • •Chinese Black Cohosh - Theoretical estrogen-modulating interaction (Hormone replacement therapy; Oral contraceptives)

Hormonal contraceptives

  • •St. John’s wort - CYP3A4 induction → reduced contraceptive efficacy (Combined oral contraceptives, progestin-only pills)

Hormonal drugs

  • •Indian Kudzu - Hormonal modulation (Hormone therapies)
  • •Goathead - Hormonal modulation (Testosterone therapy)

Hormonal therapies

  • •Guggul - May alter hormone metabolism (Hormonal therapies)
  • •Black Cohosh - Hormonal modulation (Estrogen therapy)
  • •Curculigo Rhizome - Hormonal modulation (Hormone therapy)
  • •Chasteberry - Hormone modulation interference (Oral contraceptives; HRT)
  • •Bethroot - Potential uterine activity interaction (Estrogen therapies; Progesterone)

Hormonal Therapies

  • •Licorice Root - Mild estrogenic interaction (HRT; Oral contraceptives)
  • •Saw Palmetto - Antiandrogenic interaction (theoretical) (Testosterone therapy; Oral contraceptives)

Hormone lab testing

  • •Maca root - Interference with testosterone assays (Testosterone immunoassays)

Hypoglycemics

  • •Indian barberry - Additive hypoglycemia (Insulin, metformin)
  • •False daisy - Additive hypoglycemia (Antidiabetic drugs)
  • •Kothala Himbutu - Additive hypoglycemia (Antidiabetic drugs)
  • •Goat’s Rue - Additive hypoglycemia (Insulin)
  • •Dwarf Lilyturf Tube - Additive hypoglycemia (Antidiabetics)

Immune modulators

  • •Globe Thistle Root - Immune modulation (Immunosuppressants)

Immunomodulators

  • •Black Swallow-wort - Immune modulation theoretical interaction (Corticosteroids)

Immunosuppressants

  • •Wild indigo - Immune stimulation (Immune drugs)
  • •Andrographis - Opposing or additive immune effects (Corticosteroids)
  • •Sinomenium vine - Additive suppression (Immunosuppressants)
  • •Chinese Pasqueflower - Opposing immune activity (Cyclosporine, tacrolimus)
  • •Cat’s Claw - Opposing immune activity (Cyclosporine, tacrolimus)
  • •Cat’s Claw - Immune stimulation (corticosteroids; biologics)
  • •Asmatica - Potential immunomodulatory interference (Corticosteroids; Cyclosporine)
  • •Frankincense - Theoretical immune modulation (Tacrolimus)
  • •Eleuthero - Immune-modulating conflict (Cyclosporine; Tacrolimus; Biologics)
  • •American Ginseng - Immune-stimulating conflict (Cyclosporine; Tacrolimus; Biologics)
  • •Echinacea - Immune-stimulating conflict (Cyclosporine; Tacrolimus; Biologics)
  • •Astragalus - Immune-stimulating conflict (Steroids; Biologics; Tacrolimus)

Iron supplements

  • •Beleric Myrobalan - Tannins may reduce absorption (Oral iron salts)
  • •Black Catechu - Tannins reduce absorption (Oral iron)
  • •Bistort - Tannins reduce iron absorption (Oral iron)
  • •Blackberry - Leaf tannins reduce absorption (Oral iron)
  • •Bayberry - Astringent tannins may reduce absorption (Oral iron; mineral supplements)
  • •Avens - Tannins may reduce absorption (Ferrous sulfate; Iron formulations)
  • •Cumin - May enhance iron absorption (not harmful but alters absorption dynamics) (Oral iron supplements)

Kidney-toxic drugs

  • •Bearberry - Increased kidney strain (Nephrotoxic drugs)

Laxatives

  • •Aloe Vera - Additive laxative effect (Stimulant laxatives)
  • •Chinese Rhubarb - Excessive bowel stimulation (Senna, Bisacodyl)
  • •Castor Plant - Additive effect (stimulant laxatives; stool softeners)
  • •Culver’s Root - Additive cathartic effect (Stimulant laxatives)

Limited documented interactions

  • •Christ's Thorn - Insufficient data; theoretical digestive effects (General medications)

Lithium

  • •Juniper - Reduced lithium clearance (Lithium)
  • •Gravel Root - Alters lithium levels (Lithium)
  • •Goldenrod - Reduced lithium clearance (Lithium)
  • •Psyllium - Reduced absorption (Lithium)
  • •Juniper - Increased lithium levels due to fluid shifts (Lithium carbonate)

Liver drugs

  • •Fumitory - Altered metabolism (Hepatic medications)
  • •Desmodium - Hepatoprotective modulation (Liver medications)

Multiple drug classes

  • •American Mandrake - High toxicity (Various)

Nephrotoxic drugs

  • •Birthwort - Additive kidney damage risk (NSAIDs; Aminoglycosides)
  • •Juniper - Additive blood pressure lowering (mild) (ACE inhibitors; ARBs; Beta blockers)

Nicotine agents

  • •Lobelia - Nicotinic receptor interaction (nicotine replacement therapy)

None well documented

  • •Butterwort - No clinically established interactions (—)

NSAIDs

  • •Frankincense - Additive anti-inflammatory effect (Ibuprofen; Naproxen)
  • •Ginkgo - Additive bleeding risk (Ibuprofen; Naproxen; Diclofenac)

Oncology drugs

  • •St. John’s wort - CYP3A4 induction → reduced chemotherapy levels (Irinotecan, imatinib)

Opioids / Alcohol

  • •Jamaica Dogwood - Strong central nervous system depression (Opioids / Alcohol)

Opioids / Sedatives

  • •Opium Poppy - CNS depression (opioids; benzodiazepines)

Oral medications

  • •Gum Arabic - Reduced absorption (various oral drugs due to fiber binding)
  • •Plantain Leaf - Reduced absorption from mucilage (oral pharmaceuticals)
  • •Marshmallow Root - May reduce absorption when taken simultaneously (Most oral medications)
  • •Bistort - Tannins may reduce absorption (Various oral drugs)

Oral Medications

  • •Psyllium - Reduced drug absorption (fiber binding) (Thyroid meds; SSRIs; Cardiac meds)

Oral medications (general)

  • •Slippery Elm - Reduced absorption due to mucilage barrier (Any oral medications taken simultaneously)

Oral oncology drugs

  • •Barberry - Modeled interaction → increased exposure (Bosutinib)

Other Stimulant Laxatives

  • •Senna - Additive stimulant effect (Bisacodyl; Cascara)
  • •Cascara Sagrada - Additive laxative effect (Senna; Bisacodyl)

Oxytocic drugs

  • •Blue Cohosh - Additive uterine stimulation (Oxytocin; misoprostol)

Photosensitizing drugs

  • •Bakuchi - Increased photosensitivity risk (Tetracyclines; Thiazides; Retinoids)
  • •Burning Bush (Dictamnus albus) - Increased photosensitivity risk (Tetracyclines; Retinoids; Sulfonamides)

Photosensitizing meds

  • •Angelica - Increased sun sensitivity (Retinoids; Tetracyclines)
  • •Bergamot (EO) - Phototoxicity (topical) (Retinoids; Tetracyclines)

Potassium-sparing drugs

  • •Indian Mulberry (Noni) - Increases potassium levels (Potassium-sparing drugs)

Psychoactive drugs

  • •Harmal - Additive CNS effects (Antipsychotics)

Respiratory / mucolytics

  • •Soap Bark - Additive effect (Expectorants)

Respiratory drugs

  • •Gumweed - Additive effect (Bronchodilators)
  • •Soapwort - Additive irritation / effect (Expectorants)
  • •MALABAR NUTS LEAVES - Synergistic bronchodilation (Bronchodilators)
  • •Cocillana Bark - Enhanced expectoration (Expectorants)
  • •Chinese Snake Gourd - Additive expectorant effect (Bronchodilators)

Respiratory medications

  • •English Ivy - May increase drug effects (Respiratory medications)
  • •Myrtle - Additive expectorant effect (bronchodilators)
  • •Asmatica - Additive bronchodilatory effect (Beta-agonist inhalers)

Sedatives

  • •Vervain - Increased sedation (CNS depressants)
  • •Gardenia - Additive sedation (CNS depressants)
  • •Gastrodia - Additive sedation (Anticonvulsants)
  • •Damiana - Additive sedation (Sedatives)
  • •Corydalis Rhizome, Yan Hu Suo - Additive CNS depression (Benzodiazepines, Opioids)
  • •Gambir Vine - Additive CNS depression (Sedatives, Antihypertensives)
  • •Bacopa - Additive CNS depression (Benzodiazepines)
  • •Black Cohosh - Additive CNS depression (Sedatives)
  • •Cajeput - Additive sedative effect (Benzodiazepines, sleep medications)
  • •Calamint - Mild additive calming effect (Benzodiazepines, sedative antihistamines)
  • •Catnip - Additive calming effect (Benzodiazepines, sleep medications)
  • •Cedar - Additive sedative effect (Benzodiazepines, sedative antihistamines)
  • •Nutmeg - CNS interaction (benzodiazepines; sleep medications)
  • •Ylang Ylang - May enhance relaxation or sedation (Sedatives, anxiolytics)
  • •Bottlebrush - Mild additive calming effect (Benzodiazepines; CNS depressants)
  • •Betony - Additive CNS depression (Benzodiazepines; Barbiturates; Sedative antihistamines)
  • •Black Horehound - Additive CNS depression (Sedatives; Alcohol)
  • •Bittersweet Nightshade - Additive CNS depression (Benzodiazepines)
  • •Black Haw - Additive CNS depression (Benzodiazepines)

Sedatives / anti-anxiety drugs

  • •Holy Basil (Tulsi) - May increase sedative effects (Benzodiazepines, sleep medications)

Sedatives / CNS depressants

  • •Magnolia Bark - Increased sedation (Sedatives / CNS depressants)
  • •Jamaica Dogwood - Increased sedation (Sedatives / CNS depressants)
  • •Gotu Kola - Additive sedative effect (Benzodiazepines, sleep medications)
  • •Chinese Asparagus Root - Possible additive calming effect (Benzodiazepines, sedative antihistamines)

Sedatives / neurological drugs

  • •Yellow Jasmine - Additive CNS depression or toxicity risk (Sedatives, anticonvulsants, anesthetics)

Sedatives / sleep medications

  • •Passionflower - Additive sedative effect (Benzodiazepines, sleep aids)

Sedatives / topical medications

  • •Sandalwood - Mild additive calming effect (Sedatives, anxiolytics)

SSRIs / SNRIs

  • •Ginkgo - Increased bleeding tendency (platelet interaction) (Sertraline; Fluoxetine; Venlafaxine)

Statins

  • •Guggul - May change drug metabolism (Statins)
  • •St. John’s wort - CYP3A4 induction → reduced statin levels (Simvastatin, atorvastatin)
  • •Cinnamon - Reported hepatitis risk; possible CYP interaction (Simvastatin, atorvastatin)

Steroids

  • •Asthma Plant - Possible additive anti-inflammatory effect (Prednisone; Inhaled corticosteroids)

Stimulant laxatives

  • •Butternut - Additive laxative effect (Senna; Cascara; Bisacodyl)

Stimulant medications

  • •Yerba Maté - Additive stimulant effects (ADHD stimulants, caffeine-containing medications)

Stimulants

  • •Khat - Excessive stimulation (Stimulants)
  • •Kola Nut - Increased stimulation (Stimulants)
  • •Guarana - Increased stimulation (Stimulants)
  • •Bala - Additive stimulation (Caffeine, sympathomimetics)
  • •Rhodiola - Additive stimulation (Amphetamines; methylphenidate)
  • •Eleuthero - Overstimulation; insomnia; increased heart rate (ADHD meds (methylphenidate, amphetamines); High caffeine intake)
  • •Ginseng - Overstimulation / insomnia (ADHD meds; high caffeine)
  • •American Ginseng - Overstimulation / insomnia (ADHD meds; high caffeine)

Stimulants / Caffeine

  • •Korean Ginseng - Increased stimulation (Stimulants / Caffeine)

Stimulants / CNS drugs

  • •Nux Vomica - Nervous system stimulation (stimulants; antidepressants)

Sulfonylureas

  • •Barberry - Alters metabolism → hypoglycemia risk (Glibenclamide, gliclazide)

Thiazolidinediones

  • •Cinnamon - Increased exposure (animal data) (Pioglitazone)

Thyroid medications

  • •Horseradish - May interfere with iodine metabolism (Thyroid medications)
  • •Guggul - Alters thyroid hormone levels (Thyroid medications)
  • •Bladderwrack - Thyroid hormone modulation (Levothyroxine)
  • •Bugleweed - May suppress thyroid activity (Levothyroxine; Methimazole)

Thyroid meds

  • •Ashwagandha - May increase thyroid activity (Levothyroxine)

Topical analgesics

  • •Camphor - Additive topical irritation risk (Menthol creams, capsaicin creams)

Topical anticoagulants

  • •Arnica - Theoretical interaction (Warfarin (topical minimal))

Topical drugs

  • •Eastern Hemlock - Local interaction (Topical agents)

Topical irritants

  • •Thuja - Additive skin irritation (Retinoids; Benzoyl peroxide)

Topical medications

  • •Henna - Skin irritation interaction (topical antifungals; corticosteroids)
  • •Peruvian Balsam - Allergic contact reaction (topical antibiotics; corticosteroids)

Topical respiratory medications

  • •Balsam Fir - Additive topical decongestant effect (Topical menthol/camphor products)

Transplant immunosuppressants

  • •St. John’s wort - CYP3A4/P-gp induction → reduced levels, rejection risk (Tacrolimus, cyclosporine)

Vasodilators

  • •zallouh - Additive vasodilation (Nitrates)
When to Seek Medical Care

Seek professional evaluation if:

  • •Symptoms persist beyond 10–14 days
  • •Symptoms are severe or worsening (high fever, difficulty breathing, intense pain)
  • •You experience signs of allergic reaction (rash, swelling, shortness of breath)
  • •You are pregnant, breastfeeding, or managing a chronic condition
  • •The herb is intended for a child under 2 years old

🚨 Emergency symptoms such as chest pain, uncontrolled bleeding, or loss of consciousness require immediate medical care.

In Case of Severe Reaction

If you experience a serious or unexpected reaction:

  • •Seek immediate medical attention
  • •Bring the herb packaging if available
  • •Note the amount taken and time of use

Emergency services: 999 (UAE)

Poison Control Centers can provide additional guidance.

Last updated: February 2026 • For educational purposes only