American Hellebore - Toprol XL (Metoprolol) Interaction
Herbal: American Hellebore
Also Known As: Veratrum viride, American Veratrum, American White Hellebore, Bugbane, Devil's Bite, Earth Gall, False Hellebore, Green Hellebore, Green Veratrum, Indian Poke, Itchweed, Tickleweed, Varaire Vert, Veratro Verde
Drug: Metoprolol
Brand names:
Lopressor, Toprol XL
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 06, 2024
Interaction Details
Metoprolol is classified as belonging to the following category: Antihypertensive Drugs
American hellebore can have potent cardiovascular effects due to the toxic steroid ester alkaloids it contains. The alkaloids in this plant notably reduce blood pressure even in small doses. Additionally, the alkaloids can exhibit cardiac depressant, bradycardic, and sedative effects. These alkaloids inhibit the inactivation of sodium-ion channels in excitable cells, particularly those regulating cardiac activity. Furthermore, American hellebore's alkaloids induce vasodilation and block beta-adrenergic activity, potentially influencing the effectiveness or side effects of antihypertensive medications (source https://pubmed.ncbi.nlm.nih.gov/5457326/). Patients should exercise caution and consult healthcare professionals before using American hellebore for any reason.
Interaction Rating
Likelihood of Occurrence
LikelyWell-controlled human studies have demonstrated the likely existence of this interaction
American Hellebore Overview
Veratrum viride, commonly known as green false hellebore and American hellebore, is a perennial herbaceous plant native to North America. The applicable part of this plant for medicinal purposes is the rhizome and root. It contains toxic alkaloids, including veratrine, which can cause severe poisoning if ingested. The toxins are thought to be able to be absorbed through unbroken skin as well. Isolated alkaloids in Veratrum viride include O-acetyljervine, cevadine, cryptenamine, cyclopamine (11-deoxojervine), cycloposine, germitrine, germidine, jervine, muldamine, protoveratrine (A&B), veratramine, veratridine, and veriloid. Despite its toxicity, Veratrum viride has been used in traditional medicine for its potential medicinal properties, although these uses are not supported by scientific evidence. Commercial dietary supplement products containing American hellebore are typically homeopathic.
Metoprolol Overview
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Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to treat chronic (long-term) angina (chest pain). Metoprolol is also used to improve survival after a heart attack. Metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
American Hellebore - More Interactions
American Hellebore interacts with 320 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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