Drug & supplement interaction

American Hellebore + Isradipine

Isradipine brand name: Dynacirc CR.

Major Interaction
The bottom line Major

Isradipine 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?
Know someone taking this? Share
Interaction report

American Hellebore and Isradipine

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. Isradipine 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 Isradipine

Isradipine 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 American Hellebore with your isradipine (Dynacirc CR). This plant is genuinely toxic, and its alkaloids can slow your heart and drop your blood pressure on their own. They may also stretch out the heart's electrical cycle (called QT prolongation), which can trigger a dangerous rhythm. Isradipine already relaxes blood vessels and lowers blood pressure, so stacking these together could leave you feeling lightheaded, faint, or with a too-slow or irregular heartbeat.

This isn't a prodrug issue. It's more about two things pushing your heart and blood pressure in the same risky direction. Honestly, American Hellebore isn't a safe self-care supplement to begin with. Please check with your pharmacist or doctor before using anything containing it.

Major

Antihypertensive Drugs

2 of 2

Isradipine 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 simple version: Isradipine already lowers your blood pressure by relaxing your blood vessels. American Hellebore does something similar on its own. Its toxic plant alkaloids can drop blood pressure, slow the heart rate, and calm down the nervous system. So when you put the two together, the effects can stack up and go too far.

For you, that could mean feeling dizzy or lightheaded, fainting, an unusually slow heartbeat, or a blood pressure that crashes lower than is safe. This isn't a far-fetched, theoretical worry. American Hellebore is genuinely poisonous, even in small amounts, so I would not combine it with isradipine. Please talk with your pharmacist or doctor before using any product that contains it.

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 Isradipine one above is among them. If you take anything else, check it against the full list below.

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 Isradipine

This page covers American Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Isradipine page lists 239 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 Coleus (major).

By severity: 11 major · 187 moderate · 41 minor.

From our pharmacist’s overview on the Isradipine page

“Grapefruit is the first thing I mention to anyone taking isradipine (Dynacirc CR). This blood pressure medicine is cleared by an enzyme called CYP3A4, and grapefruit blocks that enzyme, so drug levels can climb and blood pressure can fall further than intended.”

Reviewed by 2 · Jul 18, 2026

Open the Isradipine interaction page

How much people look this up

Where American Hellebore and Isradipine 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

#1,093 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Isradipine
Top half

#1,258 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 Isradipine

What Is Isradipine Used For?

Brand name: Dynacirc CR

Isradipine capsules are used to treat high blood pressure (hypertension). Bringing blood pressure down reduces the strain on your heart and blood vessels over time.

It can be used on its own or alongside a thiazide-type diuretic (a water pill that also lowers blood pressure).

See full Isradipine 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
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
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
Pharmacist Counseling Corner

Taking American Hellebore and Isradipine Together: Common Questions

Can you take American Hellebore with Isradipine?
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 Isradipine?
Isradipine 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 Isradipine 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 Isradipine and American Hellebore?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.