Drug & supplement interaction

American Hellebore + Indapamide

Indapamide brand names: Lozol, Lozide.

Major Interaction
Medically reviewed by · Updated February 2024
The bottom line Major

Indapamide falls into 2 drug categories that American Hellebore can interact with; the most serious is rated major. American hellebore, also known as Veratrum viride, contains alkaloids that can potentially prolong the QT interval on an electrocardiogram (ECG).

Read the full interaction report
SeverityMajor
LikelihoodPossible
Interactions2
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Hellebore and Indapamide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

American Hellebore interacts with whole categories of medication. Indapamide falls into 2 of those categories, so it can interact with American Hellebore in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

Qt Interval-Prolonging Drugs

1 of 2

Why this applies to Indapamide

Indapamide falls under Qt Interval-Prolonging Drugs — the group American Hellebore interacts with.

American hellebore, also known as Veratrum viride, contains alkaloids that can potentially prolong the QT interval on an electrocardiogram (ECG). This effect is similar to that of certain medications known as QT-prolonging drugs, which can increase the risk of a serious heart rhythm disorder called torsades de pointes (source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728534/). Combining American hellebore with other drugs that cause QT-prolongation can increase the risk of adverse effects.
Severity Major Likelihood Possible Evidence C

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 concern with pairing indapamide and American hellebore. Indapamide is a water pill that can lower potassium and magnesium levels in your blood. When those minerals drop, your heart's electrical timing (the QT interval) can stretch out. American hellebore carries its own heart risks and may also prolong that same QT interval, so stacking the two could raise the odds of a dangerous rhythm called torsades de pointes.

This isn't a metabolism issue, it's two things nudging your heart rhythm in the same risky direction. The evidence here is fairly limited, but the potential outcome is serious. On top of that, American hellebore is genuinely poisonous and not a safe supplement. Please don't combine them without talking to your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
Major

Antihypertensive Drugs

2 of 2

Indapamide also falls under Antihypertensive Drugs.

American hellebore can have potent cardiovascular effects due to the toxic steroid ester alkaloids it contains. The alkaloids in this plant notably reduce blood pressure even in small doses. Additionally, the alkaloids can exhibit cardiac depressant, bradycardic, and sedative effects. These alkaloids inhibit the inactivation of sodium-ion channels in excitable cells, particularly those regulating cardiac activity. Furthermore, American hellebore's alkaloids induce vasodilation and block beta-adrenergic activity, potentially influencing the effectiveness or side effects of antihypertensive medications (source https://pubmed.ncbi.nlm.nih.gov/5457326/). Patients should exercise caution and consult healthcare professionals before using American hellebore for any reason.
Severity Major Likelihood Likely Evidence A

Well-controlled human studies have demonstrated the likely existence of this interaction.

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

Here's the key thing to understand: indapamide already lowers your blood pressure by helping your kidneys flush out extra salt and water. American hellebore also drives blood pressure down hard, and on top of that it can slow your heart rate and act as a cardiac depressant. Put the two together and those effects can stack up.

What that can look like in real life is dizziness, lightheadedness, feeling faint when you stand up, a slow or irregular pulse, and dangerously low blood pressure. Remember that this plant is genuinely poisonous, so even small amounts are risky on their own. This isn't a casual combination. Please talk with your pharmacist or doctor before going anywhere near a product that contains it.

Contact Dr. Brian directly if you have additional questions on this interaction

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

American Hellebore Also Interacts With Other Medications

American Hellebore has 327 major, known drug interactions in our database — the Indapamide one above is among them. If you take anything else, check it against the full list below.

Major 327 No known interaction 2,503 (incl. Indapamide)
Taking anything else?

Check Another of Your Medications Against American Hellebore

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

Everything else you take

See Every Supplement That Interacts With Indapamide

This page covers American Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Indapamide page lists 215 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Mistletoe (major), Arsenic (major), Cesium (major) and Dolomite (major).

By severity: 13 major · 179 moderate · 23 minor.

From our pharmacist’s overview on the Indapamide page

“A water pill like indapamide (Lozol) lowers blood pressure and pulls potassium down, and most of the 215 supplements and herbs on file press on those same levers. Thirteen entries rate major, so this is a list to read with real care rather than skim.”

Reviewed by 2 · Jul 18, 2026

Open the Indapamide interaction page

How much people look this up

Where American Hellebore and Indapamide 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 American Hellebore
Steady interest

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

29 days ago today
Medication Indapamide
Steady interest

#1,767 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 American Hellebore

What is American Hellebore?

American Hellebore
  • High blood pressure
  • Slowing heart rate
  • Toxemia of pregnancy (historical)
  • Convulsions (historical)
  • Pain relief (traditional)

American Hellebore (Veratrum viride) is a highly poisonous plant whose root contains toxic alkaloids that can cause dangerous drops in heart rate and blood pressure, even in small amounts. It is not a safe self-care supplement, and any non-homeopathic product carries a serious risk of poisoning. Do not use it without medical supervision, and talk to a pharmacist or doctor before considering any product that contains it.

Read the full American Hellebore monograph & all interactions
Medication

About Indapamide

What Is Indapamide Used For?

Brand names: Lozol, Lozide

Indapamide tablets are used to treat high blood pressure (hypertension), either on their own or together with other blood pressure medications. Lowering blood pressure helps reduce the risk of related complications.

Indapamide tablets are also used to treat salt and fluid retention (edema) associated with congestive heart failure. In certain cases, indapamide may also be appropriate during pregnancy when swelling is caused by a medical condition rather than normal pregnancy changes — but routine use in otherwise healthy pregnant women is not recommended.

See full Indapamide drug information
Keep checking

Other Drugs & American Hellebore

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

327Major
0Moderate
0Minor
2,502No known interaction
327 Major 2,502 No interaction
Major

327 interactions

Showing 60 of 327 major interactions — see all 327 on the American Hellebore page.

No interaction 2,502 drugs checked — show the list

We also checked American Hellebore against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,502 medications checked with no known interaction — see the full American Hellebore list.

See the full American Hellebore interactions page
See every supplement checked against Indapamide, ranked by severity
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

Keep exploring
American Hellebore monograph › Uses, safety, and every drug interaction in one place Indapamide supplement interactions › Every supplement checked against Indapamide, ranked by severity Indapamide drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking American Hellebore and Indapamide Together: Common Questions

Can you take American Hellebore with Indapamide?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for American Hellebore and Indapamide?
Indapamide belongs to more than one drug category, and American Hellebore interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the American Hellebore and Indapamide interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Indapamide and American Hellebore?

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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.