Drug & supplement interaction

Berberine + Losartan Potassium

Losartan Potassium brand name: Cozaar.

Moderate Interaction
The bottom line Moderate

Losartan Potassium falls into 4 drug categories that Berberine can interact with; the most serious is rated moderate. Theoretically, berberine might have additive effects with antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Berberine and Losartan Potassium

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Berberine interacts with whole categories of medication. Losartan Potassium falls into 4 of those categories, so it can interact with Berberine in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 4

Why this applies to Losartan Potassium

Losartan Potassium falls under ANTIHYPERTENSIVE DRUGS — the group Berberine interacts with.

Theoretically, berberine might have additive effects with antihypertensive drugs.
Animal research suggests that berberine can have hypotensive effects. Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: berberine itself may gently lower blood pressure. Since losartan (Cozaar) is already working to bring your pressure down, stacking the two could add up and push your numbers lower than expected. That's not about losartan building up in your body, it's more that two blood-pressure-lowering effects can combine.

If your pressure dips too far, you might feel dizzy, lightheaded, tired, or wobbly when you stand up quickly. The good news is the evidence here is mostly from animal and lab studies, so it's a theoretical concern, not a guaranteed problem. Still, if you'd like to try berberine, check with your pharmacist or doctor first and keep an eye on your home blood pressure readings.

References
  1. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  2. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  3. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 4

Losartan Potassium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, berberine might increase serum levels of drugs metabolized by CYP2C9.
Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, taking berberine with drugs metabolized by CYP2C9 might increase drug levels and increase the risk of adverse effects.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's a small wrinkle worth knowing about. Losartan is actually a prodrug, meaning your body has to convert it into its more active form, and the enzyme CYP2C9 does much of that work. Berberine appears to slow that same enzyme down, at least in early research. So in theory, berberine could leave you with less of the fully active drug, which might make losartan a little less effective at controlling your blood pressure.

The honest truth is this is mostly theoretical and based on limited evidence, so I wouldn't lose sleep over it. Still, if you start berberine, it's smart to keep an eye on your blood pressure readings and let your pharmacist or doctor know what you're taking so they can watch things with you.

References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Losartan Potassium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, berberine might increase serum levels of drugs metabolized by CYP3A4.
In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, use of berberine with drugs metabolized by CYP3A4 might increase drug levels and increase the risk of adverse effects.
Severity Moderate Likelihood Possible Evidence A

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's a wrinkle worth knowing with losartan: it's actually a prodrug. Your body uses an enzyme (mostly CYP2C9, with some CYP3A4) to turn losartan into its more powerful active form, which does much of the blood-pressure-lowering work. Berberine is thought to mildly slow down CYP3A4.

Because of that, the picture is a little mixed. In theory, slowing this enzyme could reduce how much active drug gets made, which might soften losartan's effect. But berberine also has its own blood-sugar and possibly blood-pressure-lowering activity, so things could shift the other way too. This concern is mostly theoretical for losartan. If you take both, just have your pharmacist or doctor keep an eye on your blood pressure rather than guessing.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

LOSARTAN (Cozaar)

4 of 4
Berberine might reduce the therapeutic effects of losartan by decreasing its conversion to its active form.
Preliminary clinical research suggests that berberine can inhibit cytochrome P450 2C9 (CYP2C9) activity and reduce metabolism of losartan.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's something interesting about losartan: it's actually a prodrug, meaning your liver has to convert it into its more active form using an enzyme called CYP2C9. Berberine appears to slow that enzyme down. So instead of building losartan up, it can mean less of the active medicine gets made, which could make your blood pressure control a little weaker than expected.

In real life that might show up as readings creeping back up. This comes from early, lower-quality research, so it's a possible concern, not a sure thing. I wouldn't panic, but I also wouldn't add berberine on your own. Talk with your pharmacist or doctor first, and if you do combine them, keep an eye on your home blood pressure numbers.

References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Berberine Also Interacts With Other Medications

Berberine has 1 major, 1,158 moderate known drug interactions in our database — the Losartan Potassium one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Berberine

Covers the 2,830 medications we’ve checked against Berberine. Pick one to open its full report.

From our Q&A

Questions About Berberine or Losartan Potassium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Berberine or Losartan Potassium, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Losartan Potassium

This page covers Berberine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Losartan Potassium page lists 253 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Grapefruit (major) and St. John's Wort (major).

By severity: 6 major · 205 moderate · 42 minor.

From our pharmacist’s overview on the Losartan Potassium page

“Losartan potassium (Cozaar) treats high blood pressure, and this is a list to respect, because six of its 253 supplement interactions carry a major rating. Most entries do one of two things.”

Reviewed by 2 · Jul 18, 2026

Open the Losartan Potassium interaction page

One more smart check

Taking Berberine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 908 real supplement products containing Berberine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Berberine. Your product may carry other ingredients that interact with Losartan Potassium too, on top of Berberine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Berberine and Losartan Potassium Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Berberine
Top 10%

#115 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Losartan Potassium
Top 10

#6 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Berberine

What is Berberine?

Berberine
  • Blood sugar control
  • High cholesterol
  • Heart and metabolic health
  • Digestive upset
  • Antimicrobial support
  • Weight management

Berberine is a yellow plant compound that has shown promise for lowering blood sugar and cholesterol in some studies, but the quality of research varies and it is not a replacement for prescribed medicine. It can cause stomach upset and should be avoided during pregnancy and breastfeeding. Always check with your pharmacist or doctor before starting it, especially if you take other medications.

Read the full Berberine monograph & all interactions
Medication

About Losartan

What Is Losartan Used For?

Brand name: Cozaar

Losartan tablets — available as branded Cozaar and several generic products — are used to treat high blood pressure (hypertension) in adults and children 6 years and older. Lowering blood pressure reduces the risk of strokes and heart attacks. Losartan tablets are also used to reduce the risk of stroke in people with high blood pressure who also have left ventricular hypertrophy (an enlarged left side of the heart). Note: evidence suggests this stroke-risk benefit may not apply to Black patients.

Losartan tablets are additionally approved to protect the kidneys in people with type 2 diabetes, high blood pressure, and signs of kidney damage (diabetic nephropathy). Arbli, the oral suspension form, shares these same approved uses.

See full Losartan drug information
Keep checking

Other Drugs & Berberine

Browse every other medication we’ve checked against Berberine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
1,158Moderate
0Minor
1,670No known interaction
Major

1 interaction

Moderate

1,158 interactions

Showing 60 of 1,158 moderate interactions — see all 1,158 on the Berberine page.

No interaction 1,670 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Berberine and Losartan Potassium Together: Common Questions

Can you take Berberine with Losartan Potassium?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 4 interactions listed for Berberine and Losartan Potassium?
Losartan Potassium belongs to more than one drug category, and Berberine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Berberine and Losartan Potassium interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Losartan Potassium and Berberine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.