Herb & supplement monograph

Hawthorn Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Hawthorn interacts with medications. The heart of this page is the interaction list — every drug Hawthorn is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Hawthorn is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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On this page

Hawthorn Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of clinically significant Hawthorn drug interactions is moderate for most people, with the greatest concern for those taking heart or blood pressure medicines. A small share of the listed interactions are rated major and the rest moderate, and nearly all involve possible additive effects on blood pressure or the heart.

Interactions deserving the most attention

The combinations that deserve the most care are nitrates and PDE-5 inhibitors, where hawthorn's possible blood-vessel-widening effect could add up and lower blood pressure too much. Beta-blockers and calcium channel blockers carry a similar additive blood pressure concern. With digoxin, hawthorn may strengthen the drug's effects, and one hawthorn species has caused digoxin-like effects and misleading blood test results. Hawthorn may also add to bleeding risk with blood thinners, though the human evidence is unclear.

What the rest of the list means

A long interaction list does not mean every combination is harmful. Most of these concerns are theoretical, drawn from lab or animal research or from hawthorn's possible effect on blood pressure rather than proven problems in people. For example, hawthorn does not appear to change how the body clears digoxin, and the predicted bleeding effect has not been clearly confirmed in humans.

Check your medications against Hawthorn

Based on HelloPharmacist’s Hawthorn interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Hawthorn

191 medications have a known interaction with Hawthorn, graded by severity. Select any drug for the full evidence-based detail.

14 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Hawthorn.

2,830 drugs
AvanafilStendra
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Avanafil interaction Avanafil drug page: uses, dosage & side effects
Finasteride, TadalafilEntadfi
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Finasteride, Tadalafil interaction
Glyceryl TrinitrateNitronal
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Glyceryl Trinitrate interaction
Isosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Isosorbide Dinitrate interaction Isosorbide Dinitrate drug page: uses, dosage & side effects
Isosorbide Dinitrate, HydralazineBiDil
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Isosorbide Dinitrate, Hydralazine interaction
Isosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Isosorbide Mononitrate interaction Isosorbide Mononitrate drug page: uses, dosage & side effects
Macitentan, TadalafilOpsynvi
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Macitentan, Tadalafil interaction
NicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Nicorandil interaction
NitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Nitroglycerin interaction Nitroglycerin drug page: uses, dosage & side effects
Pentaerythritol TetranitratePeritrate, Peritrate SA
Major Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.

Read the full Hawthorn + Pentaerythritol Tetranitrate interaction
SildenafilRevatio
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Sildenafil interaction Sildenafil drug page: uses, dosage & side effects
Sildenafil CitrateViagra
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Sildenafil Citrate interaction Sildenafil Citrate drug page: uses, dosage & side effects
TadalafilCialis, Tadliq
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Tadalafil interaction Tadalafil drug page: uses, dosage & side effects
VardenafilLevitra, Staxyn
Major Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.

Read the full Hawthorn + Vardenafil interaction Vardenafil drug page: uses, dosage & side effects
AbciximabReoPro
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Abciximab interaction
AbrocitinibCibinqo
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcebutololRhotral, Sectral
Moderate Beta-blockers

Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.

Read the full Hawthorn + Acebutolol interaction Acebutolol drug page: uses, dosage & side effects
AcenocoumarolSintrom
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Acenocoumarol interaction
Acetaminophen, AspirinGemnisyn
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, IbuprofenCombogesic
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Acetaminophen, Ibuprofen interaction
Acetylsalicylic AcidEntrophen
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Acetylsalicylic Acid interaction Acetylsalicylic Acid drug page: uses, dosage & side effects
Alteplase, TpaActilyse, Activase
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Alteplase, Tpa interaction
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction
Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Hawthorn + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interaction Aluminum Hydroxide, Aspirin, Magnesium Hydroxide drug page: uses, dosage & side effects
AmlodipineNorliqva
Moderate Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.

Read the full Hawthorn + Amlodipine interaction Amlodipine drug page: uses, dosage & side effects
Amlodipine BenzoateKaterzia
Moderate Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.

Read the full Hawthorn + Amlodipine Benzoate interaction Amlodipine Benzoate drug page: uses, dosage & side effects
Amlodipine BesilateIstin
Moderate Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.

Read the full Hawthorn + Amlodipine Besilate interaction
Amlodipine BesylateNorvasc
Moderate Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.

Read the full Hawthorn + Amlodipine Besylate interaction Amlodipine Besylate drug page: uses, dosage & side effects
Amlodipine Besylate, BenazeprilLotrel
Moderate Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.

Read the full Hawthorn + Amlodipine Besylate, Benazepril interaction
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Hawthorn combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Hawthorn affects

Every type of medication (drug category) Hawthorn is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 6 drug categories Hawthorn interacts with
NitratesPhosphodiesterase-5 InhibitorsAnticoagulant/antiplatelet DrugsBeta-blockersCalcium Channel BlockersDigoxin (lanoxin)
Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.

Likelihood Probable Evidence D
Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans.

Likelihood Possible Evidence D
Beta-Blockers

Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Some evidence shows that hawthorn might lower blood pressure and heart rate.

Likelihood Possible Evidence D
Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Hawthorn appears to improve cardiac output; however, hawthorn does not appear to affect digoxin pharmacokinetics. Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels.

Likelihood Possible Evidence D
Monograph

Hawthorn: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the evidence is mixed and it should never replace prescribed heart medicines. Always talk to your pharmacist or doctor before using hawthorn, especially if you have a heart condition.

Hawthorn
Scientific name
Crataegus monogyna
Family
Rosaceae
Part used
Leaves, flowers, and berries (fruit)
Common forms
Capsules, tablets, standardized extracts, liquid tinctures, teas
People commonly use it for
  • Heart failure symptoms
  • High blood pressure
  • Chest pain (angina)
  • Irregular heartbeat
  • Digestive upset
  • Anxiety

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Generally well tolerated in studies, but heart conditions need medical supervision.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Hawthorn is a thorny shrub or small tree in the rose family. It grows across Europe, Asia, and North America and produces small white or pink flowers in spring and small red berries (called haws) in the fall.

People have used hawthorn in traditional medicine for hundreds of years, mostly for heart and circulation problems. Today, supplements are usually made from standardized extracts of the leaves, flowers, and berries. You can find it as capsules, tablets, tinctures, and teas.

How it works

Hawthorn contains plant compounds called flavonoids and oligomeric proanthocyanidins (OPCs). These are believed to act as antioxidants and may affect blood vessels and the heart.

Laboratory and animal research suggests hawthorn may help widen (relax) blood vessels, improve blood flow, and possibly strengthen how the heart pumps. Some studies suggest it may also help the heart muscle use oxygen more efficiently.

It is important to know that many of these effects come from test-tube or animal studies. How well they translate to people is not fully understood.

Effectiveness

Does Hawthorn work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 11 uses evaluated
11 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Hawthorn, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 11 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Angina
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral hawthorn is beneficial in patients with angina.

Insufficient Reliable Evidence To Rate Anxiety
Rating & evidence shown verbatim from Natural Medicines

Oral hawthorn has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Arrhythmia
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral hawthorn for arrhythmia, there is insufficient reliable information about the clinical effects of arrhythmia for this condition.

Insufficient Reliable Evidence To Rate Atherosclerosis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral hawthorn for atherosclerosis, there is insufficient reliable information about the clinical effects of arrhythmia for this condition.

Insufficient Reliable Evidence To Rate Cardiovascular disease (CVD)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral hawthorn for CVD, there is insufficient reliable information about the clinical effects of arrhythmia for this condition.

Insufficient Reliable Evidence To Rate Cognitive function
Rating & evidence shown verbatim from Natural Medicines

Oral hawthorn has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Congestive heart failure (CHF)
Rating & evidence shown verbatim from Natural Medicines

The evidence on the effects of oral hawthorn in patients with CHF is conflicting. Although some older research suggests it may be beneficial, more recent, larger studies suggest it may actually increase the risk for complications.

Insufficient Reliable Evidence To Rate Hyperlipidemia
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral hawthorn for hyperlipidemia, there is insufficient reliable information about the clinical effects of arrhythmia for this condition.

Insufficient Reliable Evidence To Rate Hypertension
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral hawthorn is beneficial for lowering blood pressure.

Insufficient Reliable Evidence To Rate Obesity
Rating & evidence shown verbatim from Natural Medicines

Oral hawthorn has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Orthostatic hypotension
Rating & evidence shown verbatim from Natural Medicines

Oral hawthorn has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

In clinical studies, hawthorn has generally been well tolerated for short-term use. Even so, anyone with a heart condition, high blood pressure, or an irregular heartbeat should only use it under the care of a doctor or pharmacist. Hawthorn should never be used to replace prescribed heart medications.

If you have new or worsening symptoms such as chest pain, severe shortness of breath, swelling in your legs, fainting, or a very fast or irregular heartbeat, seek medical care right away rather than trying to treat yourself with hawthorn.

Pregnancy and breastfeeding: There is not enough reliable safety information for these groups. To be safe, hawthorn should be avoided during pregnancy and while breastfeeding.

Side effects

When side effects happen, they are usually mild. Reported effects include dizziness, nausea, digestive upset, headache, and a feeling of tiredness. Dizziness may be more likely because hawthorn can affect blood vessels and blood pressure.

Serious side effects are uncommon in studies, but because hawthorn can affect the heart and circulation, anyone who feels faint, has palpitations, or notices a major change in their heartbeat should stop using it and contact a healthcare professional.

Hawthorn: Reported Adverse Effects

Documented safety reports on Hawthorn from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, hawthorn seems to be well tolerated when used appropriately. Topically, no adverse effects have been reported, although a thorough evaluation of safety outcomes has not been conducted.

Serious Adverse Effects (Rare):

Orally: Multiorgan hypersensitivity reactions resulting in acute renal failure have been reported rarely.

Reports by condition
Acute bronchitis Pulmonary/Respiratory

Orally, bronchitis has been reported following the use of hawthorn extract WS 1442, and bradypnea has been reported following the use of hawthorn root extract.

  1. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5.
  2. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298.
Angina Cardiovascular

Orally, tachycardia (with facial pains) of uncertain relationship to hawthorn was reported in a multicenter clinical trial. Palpitations were reported in three patients in a large surveillance trial of 3,664 patients with cardiac failure and in 11 patients with congestive heart failure (CHF) in a literature review of 5,577 patients. Circulation failure has been reported in two patients with CHF in a literature review of 5,577 patients. Incidences of hospitalization, hospitalization due to CHF, worsening of CHF, angina, and atrial fibrillation have also been reported with the use of hawthorn extract WS 1442 (Crataegutt forte), although it is unclear if these events are related to hawthorn supplementation or existing CHF. In clinical trials, chest pain, short-term increases in blood pressure, and other non-specific heart problems have also been reported following the use of various hawthorn preparations (e.g. WS 1442, Korodin).

Orally, severe bradycardia, bradypnea, and Mobitz type 1 second degree heart block have been reported in a 16-year-old female who consumed Hawthorn root extract. Blood tests indicated plasma digoxin levels in the therapeutic range, despite no history of digoxin use. Medical treatment for digoxin cardiotoxicity did not improve symptoms. Symptoms gradually normalized over 3 days after discontinuation of the product. Similarly, a 40-year-old female presented with bradycardia and elevated plasma digoxin levels after taking hawthorn root extract 196 mg daily for 2 days with no history of digoxin use. Symptoms resolved within 24 hours.

  1. Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
  2. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26.
  3. Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
  4. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35.
  5. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99.
  6. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5.
  7. Werner NS, Duschek S, and Schandry R. D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo controlled double blind study. Phytomedicine. 2009;16:1077-82.
  8. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63.
  9. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298.
  10. Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6.
Back pain Musculoskeletal

In clinical trials, arthritis, back pain, weakness, and other non-specific musculoskeletal effects have been reported following the use of various hawthorn preparations (e.g. WS 1442, CKBM-A01). Additionally, in a case report, myalgia has been reported following use of hawthorn root extract.

  1. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5.
  2. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
  3. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99.
  4. Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6.
Cluster headache Neurologic/CNS

Orally, headache and dizziness/vertigo were reported in 2 patients in a large surveillance trial of 3,664 patients with cardiac failure, in 15 patients with CHF as reported in a literature review of 5,577 patients, in a varying number of clinical trial participants, and in case reports. Incidences of fainting, fever, and infrequent, mild and transient sleepiness have also been reported.

  1. Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
  2. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35.
  3. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5.
  4. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99.
  5. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26.
  6. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298.
  7. Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6.
  8. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63.
  9. Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312.
Congestive heart failure (CHF) Dermatologic

Orally, erythematous rash has been reported in patients with CHF in a literature review of 5,577 patients. Non-specific rashes and itching as well as toxiderma from the fruits of hawthorn have also been reported.

  1. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35.
  2. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99.
  3. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
  4. Rogov VD. [Toxiderma due to the fruits of the hawthorn]. Vestn Dermatol Venerol 1984;7(7):46-47.
Congestive heart failure (CHF) Gastrointestinal

Orally, rare abdominal discomfort of uncertain relationship to hawthorn has been reported in a large clinical trial, surveillance study, case reports, and a literature review. Digestive intolerance, diarrhea, flatulence, gastroenteritis, increased bowel movements, obstipation, mild and rare nausea, vomiting, nutritional and metabolic problems, and other non-specific gastrointestinal effects, have also been reported. Furthermore, gastrointestinal hemorrhage has been reported in two patients with CHF in a literature review of 5,577 patients.

  1. Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75.
  2. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
  3. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298.
  4. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5.
  5. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74..
  6. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35.
  7. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26.
  8. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63.
  9. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99.
Influenza Other

Flu-like syndrome and other non-specific infections have been reported following the use of the hawthorn extract WS 1442. Hawthorn has also been reported to cause nosebleeds.

  1. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5.
  2. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63.
  3. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99.
  4. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74..
Kidney failure Renal

A case of multiorgan hypersensitivity reaction and acute renal failure following the consumption of C. orientalis has been reported.

  1. Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no single standard dose of hawthorn that fits everyone. Products vary widely in their strength and in how they are standardized (often to flavonoids or OPCs), so doses used in studies are not the same from product to product.

The best approach is to follow the directions on the product label and to check with your pharmacist or doctor before starting. This is especially important if you take heart or blood pressure medicines or have any chronic health condition. Do not assume that more is better.

Pregnancy & Breastfeeding

Hawthorn & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Hawthorn & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 25 references that drive our Hawthorn monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
  2. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed
  3. Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
  4. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63. PubMed
  5. Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
  6. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
  7. Werner NS, Duschek S, and Schandry R. D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo controlled double blind study. Phytomedicine. 2009;16:1077-82. PubMed
  8. Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75. PubMed
  9. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
  10. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
  11. Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen.Pract 2006;56:437-43.
  12. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
  13. Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J.Clin.Pharmacol. 2003;43:637-42. DOI
  14. Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
  15. Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042. PubMed
Keep reading

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.

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

Brand directory

Brands that make products with Hawthorn

513 brands in our database make a supplement containing Hawthorn.

Product directory

Supplement products with Hawthorn

2,656 products in our database contain Hawthorn. Open any to see its full ingredient list and every drug interaction we check.

+Mind Mental Acuity Plus by Shaklee Other (e.g. Tea Bag) 90 Caplet(s) View ingredients & interactions 120/80 Care by Redd Remedies Capsule 60 Vegetarian Capsule(s) View ingredients & interactions 40+ Every Man II Multivitamin by New Chapter Tablet Or Pill 96 Tablet(s) View ingredients & interactions 40+ Every Man II Multivitamin by New Chapter Tablet Or Pill 48 Tablet(s) View ingredients & interactions 40+ Every Man's One Daily Multi by New Chapter Tablet Or Pill 96 Vegetarian Tablet(s) View ingredients & interactions 40+ Every Man's One Daily Multi by New Chapter Tablet Or Pill 24 Tablet(s) View ingredients & interactions 40+ Every Woman II Multivitamin by New Chapter Tablet Or Pill 48 Tablet(s) View ingredients & interactions 40+ Every Woman's One Daily Multi by New Chapter Tablet Or Pill 24 Tablet(s) View ingredients & interactions 40+ Every Woman's One Daily Whole Food Multivitamin by New Chapter Tablet Or Pill 96 Vegetarian Tablet(s) View ingredients & interactions 40+ Every Woman's One Daily Whole-Food Multivitamin by New Chapter Tablet Or Pill 72 Vegetarian Tablet(s) View ingredients & interactions 40+ Every Woman's One Daily Whole-Food Multivitamin by New Chapter Tablet Or Pill 48 Vegetarian Tablet(s) View ingredients & interactions 40+ Every Women's One Daily Multi by New Chapter Tablet Or Pill 72 Vegetarian Tablet(s) View ingredients & interactions 50+ Men Multivitamin + Supporting Herbs Iron Free by Super Nutrition SimplyOne Tablet Or Pill 30 Tablet(s) View ingredients & interactions 50+ Men Multivitamin + Supporting Herbs Iron Free by Super Nutrition SimplyOne Tablet Or Pill 90 Tablet(s) View ingredients & interactions 50+ Women Multivitamin + Supporting Herbs by Super Nutrition SimplyOne Tablet Or Pill 90 Tablet(s) View ingredients & interactions 50+ Women's Daily by ecoNugenics Capsule 240 Vegetarian Capsule(s) View ingredients & interactions A.Vogel Cardiaforce Heart Drops by Bioforce Liquid 1.7 fl. Oz. · 50 mL View ingredients & interactions A.Vogel Cardiaforce Tonic by Bioforce Liquid 6.8 fl. Oz. · 200 mL View ingredients & interactions A.Vogel Heart & Circulatory Health Capsules by Bioforce Capsule 60 Capsule(s) View ingredients & interactions Accelerator+ by Plexus Capsule 60 Capsule(s) View ingredients & interactions Active Multi by FINAFLEX Capsule 240 Capsule(s) View ingredients & interactions Active Multi by FINAFLEX Capsule 120 Capsule(s) View ingredients & interactions ActiVit Body Toning Formula by Beachbody Nutritionals Tablet Or Pill 60 Tablet(s) View ingredients & interactions ActiVit Metabolism Formula by Beachbody Nutritionals Tablet Or Pill 60 Tablet(s) View ingredients & interactions
Pharmacist Counseling Corner

Hawthorn: Common Questions

What is Hawthorn used for, and does it work?
People use Hawthorn for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Hawthorn interact with prescription medications?
Yes. We list 191 medications with a known interaction with Hawthorn, including 14 rated major. Use the checker above to see how Hawthorn interacts with a specific drug.
How are Hawthorn interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Hawthorn with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Hawthorn interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Hawthorn used for?
Hawthorn is most often used for heart-related complaints, such as symptoms of mild heart failure, high blood pressure, and chest pain. It is also used traditionally for digestion and anxiety, though the evidence for most uses is limited.
Is Hawthorn safe to take?
Hawthorn is generally well tolerated in studies for short-term use, but people with heart conditions should only use it under medical supervision. Always check with your pharmacist or doctor first.
Can Hawthorn replace my heart or blood pressure medicine?
No. Hawthorn should never replace prescribed medications. If you want to add it to your routine, talk to your doctor or pharmacist so they can monitor you safely.
Can I take Hawthorn while pregnant or breastfeeding?
There is not enough safety information for these situations, so it is best to avoid Hawthorn during pregnancy and while breastfeeding.

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

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Products that contain Hawthorn

A rotating sample of real supplements in our database that list Hawthorn — open any to see its full ingredients and every drug interaction we check.

See all 2,656 products with Hawthorn →
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