Drug & supplement interaction

Alder Buckthorn + Spironolactone

Spironolactone brand names: Aldactone, Spiroton, Carospir.

Moderate Interaction
The bottom line Moderate

Alder Buckthorn has a moderate interaction with Spironolactone. Alder buckthorn has stimulant laxative effects.

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

Alder Buckthorn and Spironolactone

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

Moderate

DIURETIC DRUGS

Why this applies to Spironolactone

Spironolactone falls under DIURETIC DRUGS — the group Alder Buckthorn interacts with.

Alder buckthorn has stimulant laxative effects. Theoretically, overuse of alder buckthorn might compound diuretic-induced potassium loss. There is some concern that people taking alder buckthorn along with potassium depleting diuretics might have an increased risk for hypokalemia.
Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), and hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide), and others.
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 a twist worth knowing about. The general warning links stimulant laxatives like alder buckthorn with diuretics that flush out potassium. But spironolactone is different from the usual diuretics listed (furosemide, hydrochlorothiazide, and so on). It's a potassium-sparing diuretic, meaning it actually holds onto potassium rather than dumping it.

So for spironolactone specifically, this concern doesn't translate the same way. If anything, overusing alder buckthorn could lower your potassium, which might partly tug against spironolactone's potassium-holding effect, but this is purely theoretical and not well studied. The bigger real-world issue is that combining a laxative with any diuretic can leave you dehydrated and throw off your salt and fluid balance, leaving you dizzy or weak. Please check with your pharmacist before using alder buckthorn alongside spironolactone.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Alder Buckthorn Also Interacts With Other Medications

Alder Buckthorn has 121 moderate known drug interactions in our database — the Spironolactone 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 Alder Buckthorn

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

From our Q&A

Questions About Alder Buckthorn or Spironolactone

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

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

Everything else you take

See Every Supplement That Interacts With Spironolactone

This page covers Alder Buckthorn only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Spironolactone page lists 206 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 174 moderate · 25 minor.

From our pharmacist’s overview on the Spironolactone page

“Potassium is the supplement I check first for anyone on spironolactone (Aldactone, Carospir), because this water pill works by holding potassium in the body, and supplementing more on top of that can push blood levels too high. It is one of 206 supplement and herbal ingredients with documented interactions here, and the list warrants g…”

Reviewed by 2 · Jul 18, 2026

Open the Spironolactone interaction page

One more smart check

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

We hold 19 real supplement products containing Alder Buckthorn, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Alder Buckthorn. Your product may carry other ingredients that interact with Spironolactone too, on top of Alder Buckthorn — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Alder Buckthorn and Spironolactone 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 Alder Buckthorn
Top half

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

29 days ago today
Medication Spironolactone
Top 10%

#278 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 Alder Buckthorn

What is Alder Buckthorn?

Alder Buckthorn
  • Constipation
  • Bowel cleansing before procedures
  • Occasional irregularity

Alder buckthorn bark is a stimulant laxative traditionally used for short-term relief of constipation. It can work, but it carries real risks with prolonged use, including bowel damage, and should only be used briefly, if at all, after checking with a pharmacist or doctor.

Read the full Alder Buckthorn monograph & all interactions
Medication

About Spironolactone

What Is Spironolactone Used For?

Brand names: Aldactone, Spiroton, Carospir

Spironolactone tablets (including Aldactone) are used to treat moderate-to-severe heart failure, high blood pressure, and fluid retention (edema) caused by liver cirrhosis or nephrotic syndrome. They are also used to diagnose and manage primary hyperaldosteronism — a condition where the adrenal glands produce too much of the hormone aldosterone.

Spironolactone oral suspension shares several of these uses — heart failure, high blood pressure, and edema from liver cirrhosis — but is not the same as Aldactone and is not therapeutically interchangeable with it. Your prescriber will choose the right form for your situation.

See full Spironolactone drug information
Keep checking

Other Drugs & Alder Buckthorn

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

0Major
121Moderate
0Minor
2,708No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Alder Buckthorn page.

No interaction 2,708 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 Alder Buckthorn and Spironolactone Together: Common Questions

Can you take Alder Buckthorn with Spironolactone?
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 Alder Buckthorn and Spironolactone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Spironolactone and Alder Buckthorn?

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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.