Dextromethorphan

• Robitussin DM, others

Berberine might decrease how quickly the body breaks down dextromethorphan. This might increase the effects and side effects of dextromethorphan.

Losartan

• Cozaar

• Hyzaar

• Used for: high blood pressure, heart failure

The liver activates losartan to make it work. Berberine might decrease how quickly the body activates it, which might decrease the effects of losartan.

Medications changed by the liver

• Glipizide

• Phenytoin

• Losartan

Some medications are changed and broken down by the liver. Berberine might change how quickly the liver breaks down these medications. If you are taking medications metabolised by the liver, monitor for any changes in how your medication affects you.

• Tramadol

• Metoprolol

• Fluoxetine

• Paroxetine

• Tamoxifen

• Amitriptyline

• Atorvastatin

• Simvastatin

• Amlodipine

• Diltiazem

• Cyclosporine

• Tacrolimus

• Midazolam

• Alprazolam

• Rivaroxaban

• Some HIV antiretrovirals

Medications for diabetes

• Glyburide

• Glipizide

• Insulin

• Sitagliptin

• Empagliflozin

• Semaglutide

• Dapagliflozin

Berberine might lower blood sugar levels. Taking berberine along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Medications for high blood pressure

• Amlodipine

• Ramipril

• Perindopril

• Metoprolol

• Losartan

• Hydrochlorothiazide

Berberine might lower blood pressure. Taking berberine along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications that slow blood clotting

• Heparin

• Rivaroxaban

• Apixaban

• Dabigatran

• Clopidogrel

Berberine might slow blood clotting. Taking berberine along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Berberine might increase the amount of metformin in the body. This may increase its effects and side effects. This interaction seems to occur when berberine is taken around 2 hours before metformin. Taking berberine and metformin at the same time doesn't appear to increase the amount of metformin in the body.

Midazolam

• Versed

The body breaks down midazolam to get rid of it. Berberine can decrease how quickly the body breaks it down. This might increase the effects and side effects of midazolam.

Pentobarbital

• Nembutal

Pentobarbital is a medication that can cause sleepiness. Berberine might also cause sleepiness and drowsiness. Taking berberine with pentobarbital might cause too much sleepiness.

Sedative medications

• Diazepam

• Alprazolam

• Temazepam

• Zolpidem

• Zopiclone

• Promethazine

Berberine might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking berberine with sedative medications might cause breathing problems and/or too much sleepiness.

Tacrolimus

• Astagraf

• Used for: organ transplant anti-rejection

Tacrolimus is removed from the body by the liver. Berberine might slow down the body's ability to remove tacrolimus. This might increase the effects and side effects of tacrolimus.

Drying medications

• Anticholinergic drugs

European barberry can block a chemical in the body called acetylcholine, which has many important functions. Some medications, called anticholinergic drugs, also block acetylcholine. There is some concern that taking them together might increase the risk for confusion, blurred vision, increased sweating, and increased heart rate.

Some medications are changed and broken down by the liver. European barberry might change how quickly the liver breaks down these medications. If you are taking medications metabolised by the liver, monitor for any changes in how your medication affects you.

European barberry might lower blood sugar levels. Taking European barberry along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

European barberry might lower blood pressure. Taking European barberry along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

European barberry might slow blood clotting. Taking European barberry along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

European barberry might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking European barberry with sedative medications might cause breathing problems and/or too much sleepiness.

Various medications used for glaucoma, Alzheimer disease, and other conditions

• Cholinergic drugs

Some medications that are used for glaucoma, Alzheimer disease, and other conditions increase acetylcholine levels. But European barberry can block acetylcholine. Taking European barberry with these medications might decrease the effects of these drugs.