Herb & supplement monograph

Rhubarb Drug Interactions, Uses, Effectiveness, Safety & More

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

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

But these pages have grown well beyond that into a full monograph — what Rhubarb 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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Rhubarb Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Rhubarb drug interaction appears low for most people, especially with occasional or food-level use. None of the listed interactions are rated major, and every one is based on theoretical or animal evidence rather than well-documented human studies.

Interactions deserving the most attention

The combinations that deserve the most care involve medicines with a narrow safety margin. Heavy or frequent rhubarb use acts as a stimulant laxative and can deplete potassium and fluid, which could raise bleeding risk with warfarin and increase the chance of toxicity with digoxin. Animal research also suggests rhubarb might lower levels of the transplant drug cyclosporine, and rhubarb has been linked to some reports of liver injury, so caution is sensible alongside medicines that can stress the liver.

What the rest of the list means

The long list of interacting medications looks more alarming than it is. Most entries trace back to the same theoretical concern, that overusing rhubarb as a laxative could upset fluid and potassium balance, rather than to proven harm in people. Typical, moderate use of rhubarb has not been shown to cause meaningful problems with most of these medicines.

Check your medications against Rhubarb

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

Interaction report

Drugs that interact with Rhubarb

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

2,830 drugs
6-mercaptopurinePurinethol
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + 6-mercaptopurine interaction 6-mercaptopurine drug page: uses, dosage & side effects
Abacavir Sulfate, Dolutegravir, LamivudineTriumeq
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Abacavir Sulfate, Dolutegravir, Lamivudine interaction Abacavir Sulfate, Dolutegravir, Lamivudine drug page: uses, dosage & side effects
Abacavir, LamivudineEpzicom
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Abacavir, Lamivudine interaction
Abiraterone
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Abiraterone interaction Abiraterone drug page: uses, dosage & side effects
Abiraterone AcetateYonsa, Zytiga
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Abiraterone Acetate interaction Abiraterone Acetate drug page: uses, dosage & side effects
AcarboseGlucobay, Prandase, Precose
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acarbose interaction Acarbose drug page: uses, dosage & side effects
AcebutololRhotral, Sectral
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acebutolol interaction Acebutolol drug page: uses, dosage & side effects
AcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen interaction Acetaminophen drug page: uses, dosage & side effects
Acetaminophen, AspirinGemnisyn
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Brompheniramine, Phenylpropanolamine interaction
Acetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Butalbital interaction
Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Butalbital, Caffeine interaction Acetaminophen, Butalbital, Caffeine drug page: uses, dosage & side effects
Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Butalbital, Caffeine, Codeine interaction
Acetaminophen, Butalbital, CodeineBancap w/ Codeine
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Butalbital, Codeine interaction
Acetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Butalbital, Codeine Phosphate interaction
Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interaction
Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Caffeine, Codeine interaction
Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Caffeine, Codeine, Salicylamide interaction
Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Caffeine, Dihydrocodeine interaction
Acetaminophen, Caffeine, IsomethepteneMigralam
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Caffeine, Isometheptene interaction
Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Caffeine, Pyrilamine interaction
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interaction
Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interaction
Acetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Dextromethorphan interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
Moderate Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction
Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interaction
Acetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
Moderate Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full Rhubarb + Acetaminophen, Chlorpheniramine, Phenylephrine 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 Rhubarb 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 Rhubarb affects

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

All 8 drug categories Rhubarb interacts with
CorticosteroidsCyclosporine (neoral, Sandimmune)Digoxin (lanoxin)Diuretic DrugsHepatotoxic DrugsNephrotoxic DrugsStimulant LaxativesWarfarin (coumadin)
Corticosteroids

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia when taken with corticosteroids.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might compound corticosteroid-induced potassium loss.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, taking rhubarb with cyclosporine might reduce cyclosporine levels.
Animal research shows that co-administration of rhubarb decoction 0.25 or 1 gram/kg with cyclosporine 2.5 mg/kg, decreases cyclosporine maximum plasma concentration and overall exposure levels when compared with taking cyclosporine alone. The authors theorize that rhubarb might reduce cyclosporine bioavailability by inducing of P-glycoprotein and/or cytochrome P450 3A4. However, since rhubarb was administered as a single oral dose and enzyme induction usually occurs after multiple doses, it is possible that cyclosporine absorption was actually reduced via rhubarb's stimulant laxative effects. Also, the composition of the rhubarb decoction was not described.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, overuse of rhubarb might increase the risk of adverse effects when taken with digoxin.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion, increasing the risk of digoxin toxicity.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion and compound diuretic-induced potassium loss.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.

Likelihood Possible Evidence D
Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
The anthraquinone constituents of rhubarb have been shown to induce nephrotoxicity in animal research. Additionally, in a case report, a 23-year old female presented with kidney failure after taking 6 tablets of a proprietary slimming agent (found to contain the anthraquinones emodin and aloe-emodin from rhubarb) daily for 6 weeks and then adding diclofenac 25 mg 4 times daily for 2 days. The authors postulate that the anthraquinone constituents of rhubarb contributed to the renal dysfunction, and the addition of diclofenac, a nephrotoxic drug, led to renal failure. Until more is known, advise patients to avoid taking rhubarb if they are taking other potentially nephrotoxic drugs.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, rhubarb might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Rhubarb has stimulant laxative effects. Concomitant use with stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, excessive use of rhubarb might increase the risk of bleeding when taken with warfarin.
Rhubarb has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of rhubarb.

Likelihood Possible Evidence D
Monograph

Rhubarb: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality evidence, and the root can cause cramping and diarrhea. The leaves are toxic and should never be eaten, and rhubarb supplements are best avoided in pregnancy and breastfeeding.

Rhubarb
Scientific name
Rheum officinale
Family
Polygonaceae
Part used
Root, rhizome, and edible stalk (leaves are toxic and not used)
Common forms
Dried root powder, capsules, tablets, tinctures, teas, and culinary stalks
People commonly use it for
  • Constipation
  • Digestive upset
  • Menopausal symptoms
  • Kidney and liver conditions (traditional)
  • Pancreatitis (hospital/traditional use)

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

Safety at a glance
OverallUse caution

The stalks are a safe food, but the root used as a laxative can cause cramping and should not be used long-term.

PregnancyPossibly Unsafe

When used in medicinal amounts, rhubarb root is a stimulant laxative; avoid using.

Read the full pregnancy detail
BreastfeedingPossibly Unsafe

When used in medicinal amounts, rhubarb root is a stimulant laxative; 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

Rhubarb is a leafy plant in the buckwheat family (Polygonaceae). Several species are used, including Rheum officinale and Rheum palmatum, often called Chinese rhubarb or Da Huang. It grows in parts of Asia, especially China and the Himalayas, and garden varieties are grown in cooler climates around the world.

The thick red or green stalks are a familiar food used in pies, jams, and sauces. In traditional medicine, however, it is the root and rhizome that are dried and used. These have been part of Chinese medicine for centuries, mainly as a laxative and for digestive complaints.

Importantly, the leaves are toxic because they contain high levels of oxalic acid and related compounds. Only the stalks and the medicinal root are used; the leaves should never be eaten.

How it works

Rhubarb root contains compounds called anthraquinones (such as emodin, aloe-emodin, and rhein). These stimulate the lining of the large intestine, which speeds up bowel movements and produces the laxative effect.

The root also contains tannins, which have an astringent, mildly binding effect. This is one reason rhubarb is sometimes described as both a laxative in larger amounts and an anti-diarrheal in smaller amounts.

Laboratory and animal studies suggest some rhubarb compounds may have anti-inflammatory or antioxidant activity. These findings are early and do not prove the same effects happen in people taking rhubarb.

Effectiveness

Does Rhubarb work?

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

Evidence overview · 18 uses evaluated
2 Possibly effective 16 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.
Possibly Effective Menopausal symptoms
Rating & evidence shown verbatim from Natural Medicines

Oral rhubarb root extract seems to help improve symptoms of menopause.

Possibly Effective Pancreatitis
Rating & evidence shown verbatim from Natural Medicines

Oral or rectal rhubarb might improve symptoms and duration of hospital stay in individuals with acute pancreatitis. It is unclear if oral rhubarb helps to prevent pancreatitis in individuals undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Also studied for 16 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Acute respiratory distress syndrome (ARDS)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral rhubarb reduces ARDS.

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

Oral rhubarb has only been evaluated in combination with other ingredients for use in pediatric appendiceal abscess; its effect when used alone is unclear.

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

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

Insufficient Reliable Evidence To Rate Chronic kidney disease (CKD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral rhubarb prevents the progression of CKD or improves markers of kidney function.

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

It is unclear if rhubarb is beneficial for constipation.

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

It is unclear if oral rhubarb reduces dysmenorrhea.

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

It is unclear if spraying rhubarb powder with a gastroscope reduces gastrointestinal bleeding.

Insufficient Reliable Evidence To Rate Herpes labialis (cold sores)
Rating & evidence shown verbatim from Natural Medicines

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

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

It is unclear if oral rhubarb helps to lower cholesterol levels.

Insufficient Reliable Evidence To Rate Malignant pleural effusions
Rating & evidence shown verbatim from Natural Medicines

Topical rhubarb powder has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

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

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

Insufficient Reliable Evidence To Rate Nonalcoholic fatty liver disease (NAFLD)
Rating & evidence shown verbatim from Natural Medicines

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

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

It is unclear if oral rhubarb is beneficial for weight loss.

Insufficient Reliable Evidence To Rate Organophosphorus pesticide poisoning
Rating & evidence shown verbatim from Natural Medicines

It is unclear if giving rhubarb by gastric tube, nasal feeding, or enema is beneficial for organophosphorus pesticide poisoning.

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

It is unclear if oral rhubarb is beneficial for sepsis.

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

Oral rhubarb 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

Eating rhubarb stalks as food is generally considered safe for most people. Using the root medicinally as a laxative carries more risk and should only be done short-term.

Never eat the leaves. They contain oxalic acid and can cause serious poisoning, including kidney damage.

People who should be cautious or avoid medicinal rhubarb include those with kidney stones (because of its oxalate content), inflammatory bowel disease, intestinal blockage, or unexplained belly pain. Children should not use rhubarb laxatives without medical advice.

Pregnancy and breastfeeding: Avoid medicinal amounts of rhubarb root. It may stimulate the uterus and bowels, and laxative compounds can pass into breast milk. Eating normal amounts of cooked stalks as food is generally considered acceptable, but talk to your doctor or pharmacist if unsure.

Side effects

The most common side effects of medicinal rhubarb root are abdominal cramping, diarrhea, and stomach upset. Using laxative amounts for a long time can lead to dehydration and loss of important minerals such as potassium.

Long-term use may also cause a harmless darkening of the colon lining (seen during a colonoscopy) and can make the bowel dependent on laxatives. Rhubarb may turn the urine a yellow or reddish color.

Because of its oxalate content, people prone to kidney stones may be at higher risk. Serious poisoning is associated with eating the toxic leaves, not the stalks or properly used root.

Rhubarb: Reported Adverse Effects

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

Orally, rhubarb root and stalk are well tolerated when used in food amounts and seem to be well tolerated when used in medicinal amounts. Rhubarb leaf contains oxalic acid and can be toxic. Topically, rhubarb seems to be well tolerated.

Most Common Adverse Effects:

Orally: Cramps, diarrhea, gastrointestinal discomfort, nausea, vomiting.

Topically: Rash.

Serious Adverse Effects (Rare):

Orally: Anaphylaxis.

Reports by condition
Albuminuria Renal

Orally, chronic use or abuse of rhubarb can cause electrolyte loss (especially potassium), albuminuria, hematuria, dehydration, and nephropathies. There is one case report of renal failure in a patient who took a product containing rhubarb for six weeks. The patient presented with renal failure two days after starting diclofenac, which is known to have nephrotoxic effects. It is hypothesized that the combination of diclofenac with the anthraquinone constituents of rhubarb precipitated renal dysfunction.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
Albuminuria Endocrine

Orally, chronic use or abuse of rhubarb can cause electrolyte loss (especially potassium), hyperaldosteronism, albuminuria, and edema.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Arrhythmia Cardiovascular

Orally, chronic use or abuse of rhubarb can cause arrhythmias.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Cancer Gastrointestinal

Orally, rhubarb can cause cramp-like or spasmodic gastrointestinal discomfort, watery diarrhea, and uterine contractions. Rhubarb, alone or in combination with other ingredients, has also been reported to cause bloating, nausea, diarrhea, vomiting, and stomach upset or pain in clinical studies. Diarrhea is more common with a starting dose of at least 3 grams of extract. Chronic use or abuse of rhubarb can cause inhibition of gastric motility and pseudomelanosis coli (pigment spots in the intestinal mucosa).

Although some research suggests that rhubarb and other anthranoid laxatives might increase the risk of colorectal cancer due to pseudomelanosis coli, more recent research suggests that this condition is harmless, typically reversed with rhubarb discontinuation, and not associated with an increased risk for colorectal adenoma or carcinoma.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Fan, J. G. Evaluating the efficacy and safety of Danning Pian in the short-term treatment of patients with non-alcoholic fatty liver disease: a multicenter clinical trial. Hepatobiliary.Pancreat.Dis.Int 2004;3(3):375-380.
  3. Zhang, J. H., Li, L. S., and Zhang, M. Clinical effects of rheum and captopril on preventing progression of chronic renal failure. Chin Med J (Engl.) 1990;103(10):788-793.
  4. Mitsuma, T., Yokozawa, T., Oura, H., and Terasawa, K. [Rhubarb therapy in patients with chronic renal failure (Part 2)]. Nippon Jinzo Gakkai Shi 1987;29(2):195-207.
  5. Wu, C. X. [A preliminary study on the effect of a single Rheum officinale in heavy doses in the treatment of acute icteric hepatitis]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(2):88-89.
  6. Jiao, D. H. [Clinical research on the hemostatic effect of rhubarb on peptic ulcer with acute bleeding]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(10):597-600, 579.
  7. Jiao, D. H., Ma, Y. H., Chen, S. J., Liu, C. T., Shu, H. N., and Chu, C. M. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-130.
  8. Zhang, JH, Yao, XD, Song, Y, and et al. [Long-term treating effects of rhubarb and captopril in delaying the progression of renal failure]. Chinese Kidney Disease Journal 1993;9(4):197-201.
  9. Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. 2015 Mar;12(1):61-9.
  10. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  11. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5.
  12. Siegers, C. P., Hertzberg-Lottin, E., Otte, M., and Schneider, B. Anthranoid laxative abuse--a risk for colorectal cancer? Gut 1993;34(8):1099-1101.
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 standardized dose for rhubarb supplements, and the right amount depends on the product and the form. Strengths of capsules, powders, and tinctures vary widely.

If you use a commercial product, follow the directions on the label and do not exceed the recommended amount or use it longer than directed. Laxative use should be short-term only.

Because rhubarb root can cause significant side effects, it is best to check with a pharmacist or doctor before starting it, especially if you have any health conditions or take other medicines.

Pregnancy & Breastfeeding

Rhubarb & Pregnancy

Possibly Unsafe

When used in medicinal amounts, rhubarb root is a stimulant laxative; avoid using.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

Rhubarb & Breastfeeding

Possibly Unsafe

When used in medicinal amounts, rhubarb root is a stimulant laxative; avoid using.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
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 20 references that drive our Rhubarb 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. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  6. Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
  7. Fairbairn JW. The anthraquinone laxatives. Biological assay and its relation to chemical structure. Pharmacology 1976;14:48-61. PubMed
  8. Siegers, C. P., Hertzberg-Lottin, E., Otte, M., and Schneider, B. Anthranoid laxative abuse--a risk for colorectal cancer? Gut 1993;34(8):1099-1101. PubMed
  9. Fan, J. G. Evaluating the efficacy and safety of Danning Pian in the short-term treatment of patients with non-alcoholic fatty liver disease: a multicenter clinical trial. Hepatobiliary.Pancreat.Dis.Int 2004;3(3):375-380.
  10. Yan, M., Zhang, L. Y., Sun, L. X., Jiang, Z. Z., and Xiao, X. H. Nephrotoxicity study of total rhubarb anthraquinones on Sprague Dawley rats using DNA microarrays. J Ethnopharmacol. 4-15-2006; PubMed
  11. Zhang, J. H., Li, L. S., and Zhang, M. Clinical effects of rheum and captopril on preventing progression of chronic renal failure. Chin Med J (Engl.) 1990;103(10):788-793.
  12. Mitsuma, T., Yokozawa, T., Oura, H., and Terasawa, K. [Rhubarb therapy in patients with chronic renal failure (Part 2)]. Nippon Jinzo Gakkai Shi 1987;29(2):195-207.
  13. Wu, C. X. [A preliminary study on the effect of a single Rheum officinale in heavy doses in the treatment of acute icteric hepatitis]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(2):88-89.
  14. Jiao, D. H. [Clinical research on the hemostatic effect of rhubarb on peptic ulcer with acute bleeding]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(10):597-600, 579.
  15. Jiao, D. H., Ma, Y. H., Chen, S. J., Liu, C. T., Shu, H. N., and Chu, C. M. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-130.
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 Rhubarb

261 brands in our database make a supplement containing Rhubarb.

Product directory

Supplement products with Rhubarb

965 products in our database contain Rhubarb. Open any to see its full ingredient list and every drug interaction we check.

+Cleanse 7-Day Healthy Cleanse by Shaklee Other (e.g. Tea Bag) 7 Packet(s) View ingredients & interactions +Cleanse 7-Day Healthy Cleanse by Shaklee Other (e.g. Tea Bag) 7 Daily Morning & Night Packet(s) View ingredients & interactions +Digestive Herb-Lax by Shaklee Tablet Or Pill 240 Tablet(s) View ingredients & interactions +Digestive Herb-Lax by Shaklee Tablet Or Pill 240 Tablet(s) View ingredients & interactions 10-Day Acai Berry Easy-Cleanse by Applied Nutrition Tablet Or Pill 40 Tablet(s) View ingredients & interactions 3 Eliminate With Colon Cleanse by Renew Life Capsule 14 Capsule(s) View ingredients & interactions 3-Day Cleanse 2 Evening Formula by Renew Life Capsule 6 Vegetable Capsule(s) View ingredients & interactions 3-Day Cleanse 2 Evening Formula by Renew Life Capsule 6 Vegetable Capsule(s) View ingredients & interactions 3-Day Cleanse Evening Formula by Renew Life Capsule 6 Vegetarian Capsule(s) View ingredients & interactions 3-Day Cleanse Evening Formula by Renew Life Capsule 6 Vegetarian Capsule(s) View ingredients & interactions 30 Day Night Slim Skinny Tea by Totally Products Other (e.g. Tea Bag) 30 Tea Bag(s) View ingredients & interactions 7 Day Cleanse 900 mg by AN Amazing Nutrition Amazing Formulas Capsule 120 Capsule(s) View ingredients & interactions 7 Day Detox by Premium Certified Capsule 21 Capsule(s) View ingredients & interactions Activate by Modere Powder 0.9 oz · 27 Gram(s) View ingredients & interactions Advanced Rapid Cleanse 7-Day Program Part 3 by Renew Life Capsule 14 Vegetable Capsule(s) View ingredients & interactions African Mango Cleanse by NewtonEverett Capsule 60 Vegetarian Capsule(s) View ingredients & interactions African Mango Cleanse by NewtonEverett Capsule 60 Vegetarian Capsule(s) View ingredients & interactions African Mango Cleanse by NewtonEverett Capsule 60 Capsule(s) View ingredients & interactions Airaide by Nu Century Herbs Capsule 90 Capsule(s) View ingredients & interactions Akebia Moist Heat by Health Concerns Tablet Or Pill 90 Tablet(s) View ingredients & interactions Alkalize-Me-Now by Remedys Nutrition Capsule 60 Vcap(s) View ingredients & interactions Alkalize-Me-Now 1000 mg by Remedys Nutrition Capsule 60 Vcap(s) View ingredients & interactions Aloe Vera Plus by Country Life Realfood Organics Liquid 32 Fluid Ounce(s) · 1 Quart(s) · 944 mL View ingredients & interactions AM/PM Full Body Cleanse by Greens First Pro Capsule 20 Veggie Capsule(s) View ingredients & interactions
Pharmacist Counseling Corner

Rhubarb: Common Questions

What is Rhubarb used for, and does it work?
People use Rhubarb for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Rhubarb for Menopausal symptoms and Pancreatitis. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Rhubarb interact with prescription medications?
Yes. We list 658 medications with a known interaction with Rhubarb. Use the checker above to see how Rhubarb interacts with a specific drug.
How are Rhubarb 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 Rhubarb 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 Rhubarb 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.
Can I eat Rhubarb from my garden?
Yes, the cooked stalks are a common food and are generally safe to eat. Never eat the leaves, however, because they are toxic and can cause poisoning.
Is Rhubarb a good laxative?
Rhubarb root contains natural compounds that stimulate the bowel, so it does work as a laxative. It can cause cramping and should only be used short-term, so talk to a pharmacist first.
Is Rhubarb safe during pregnancy or breastfeeding?
It is best to avoid medicinal Rhubarb root during pregnancy and breastfeeding, since it may stimulate the uterus and bowels and pass into breast milk. Eating normal amounts of cooked stalks as food is generally considered acceptable.
Why are Rhubarb leaves dangerous?
The leaves contain high amounts of oxalic acid and related compounds that can cause severe stomach upset, kidney damage, and other serious effects. Only the stalks and medicinal root should be used.

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

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Products that contain Rhubarb

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

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