Drug & supplement interaction

Acacia Rigidula + Dorzolamide, Timolol

Dorzolamide, Timolol brand name: Cosopt.

Moderate Interaction
The bottom line Moderate

Acacia Rigidula has a moderate interaction with Dorzolamide, Timolol. Theoretically, Acacia rigidula products that are adulterated with beta-methylphenylethylamine (BMPEA) might increase the levels of CYP2D6 substrates.

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

Acacia Rigidula and Dorzolamide, Timolol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Dorzolamide, Timolol

Dorzolamide, Timolol falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Acacia Rigidula interacts with.

Theoretically, Acacia rigidula products that are adulterated with beta-methylphenylethylamine (BMPEA) might increase the levels of CYP2D6 substrates.
In vitro research shows that BMPEA, an adulterant found in many Acacia rigidula products, strongly inhibits CYP2D6 enzyme.
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 thing about your Cosopt eye drops: the timolol part is a beta blocker that your body breaks down using a liver enzyme called CYP2D6. Some Acacia rigidula products have been found spiked with a stimulant called BMPEA, and lab studies suggest BMPEA can block that very enzyme. If that happened, a little more timolol could end up circulating in your body than usual.

Even though these are just eye drops, some timolol gets absorbed, so in theory you might notice more beta blocker type effects like a slower heart rate, lightheadedness, or feeling tired. I want to be honest though: this is based only on test-tube research, not real people, so it's more of a caution than a proven problem. Still, given the safety concerns with these products, I'd run it by your pharmacist or doctor first.

References
  1. Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. 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

Acacia Rigidula Also Interacts With Other Medications

Acacia Rigidula has 812 moderate known drug interactions in our database — the Dorzolamide, Timolol one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Acacia Rigidula

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

Everything else you take

See Every Supplement That Interacts With Dorzolamide, Timolol

This page covers Acacia Rigidula only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dorzolamide, Timolol page lists 71 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Indian Snakeroot (major), 1,3-dmaa (moderate), Active Hexose Correlated Compound (ahcc) (moderate), Ayahuasca (moderate) and Berberine (moderate).

By severity: 1 major · 59 moderate · 11 minor.

From our pharmacist’s overview on the Dorzolamide, Timolol page

“Indian snakeroot is the one entry here I would treat as a genuine hazard with Cosopt (dorzolamide and timolol), the glaucoma eye drop. Its reserpine content plus a beta-blocker like timolol could slow the heart or drop blood pressure too far, and it holds the only major rating among the 71 supplements and herbs on file.”

Reviewed by 2 · Jul 18, 2026

Open the Dorzolamide, Timolol interaction page

How much people look this up

Where Acacia Rigidula and Dorzolamide, Timolol 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 Acacia Rigidula
Top half

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

29 days ago today
Medication Dorzolamide, Timolol
Top half

#752 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 Acacia Rigidula

What is Acacia Rigidula?

Acacia Rigidula
  • Weight loss
  • Energy and stimulation
  • Boosting metabolism
  • Appetite control
  • Pre-workout/athletic performance

Acacia rigidula is a shrub from Texas and Mexico that is marketed in weight-loss and energy supplements. There is very little reliable human evidence that it works, and some products have been found to contain an unapproved stimulant drug (BMPEA), which raises real safety concerns. Most people should avoid it and talk to a pharmacist or doctor before trying any product containing it.

Read the full Acacia Rigidula monograph & all interactions
Medication

About Dorzolamide and Timolol Ophthalmic

What Is Dorzolamide and Timolol Ophthalmic Used For?

Brand name: Cosopt

Dorzolamide and timolol ophthalmic eye drops are used to reduce elevated intraocular pressure (pressure inside the eye) in people with open-angle glaucoma or ocular hypertension (higher-than-normal eye pressure without signs of glaucoma damage). It is specifically intended for patients who have not responded well enough to beta-blocker eye drops alone.

This combination is available as Cosopt, Cosopt PF, and Dorzolamide Hydrochloride and Timolol Maleate eye drops. Cosopt PF is the preservative-free formulation, which may be preferred for people sensitive to preservatives.

See full Dorzolamide and Timolol Ophthalmic drug information
Keep checking

Other Drugs & Acacia Rigidula

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

0Major
812Moderate
0Minor
2,017No known interaction
Moderate

812 interactions

Showing 60 of 812 moderate interactions — see all 812 on the Acacia Rigidula page.

No interaction 2,017 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 Acacia Rigidula and Dorzolamide, Timolol Together: Common Questions

Can you take Acacia Rigidula with Dorzolamide, Timolol?
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.
How serious is the Acacia Rigidula and Dorzolamide, Timolol 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

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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.