Drug & supplement interaction

American Hellebore + Misoprostol

Misoprostol brand name: Cytotec.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between American Hellebore and Misoprostol in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Misoprostol states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

American Hellebore and Misoprostol

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Misoprostol and American Hellebore in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

American Hellebore safety at a glance

American Hellebore overall Avoid The plant is highly toxic and can cause life-threatening poisoning even at low doses.
Pregnancy Avoid Toxic alkaloids may harm the parent and fetus; do not use.
Breastfeeding Avoid Safety is unknown and the plant is poisonous; avoid use.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Misoprostol and American Hellebore? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Misoprostol

Interactions in our licensed database are recorded against drug classes, not just single drug names. Misoprostol is filed under a single classification — oral drugs. American Hellebore has documented interactions with 2 drug classes — the most serious being antihypertensive drugs (major) and qt interval-prolonging drugs (major) — and none of Misoprostol’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

American Hellebore Does Interact With Other Medications

American Hellebore has 328 major, known drug interactions in our database — Misoprostol isn’t one of them. If you take anything else, check it against the full list below.

Major 328 No known interaction 2,502 (incl. Misoprostol)
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.

What to actually watch for

No Interaction Found — But Data Suggests American Hellebore and Misoprostol May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Trouble swallowing Worth acting on Additional detail

    American Hellebore

    “Orally, American hellebore can cause depressed mental status, headache, lacrimation, salivation, dysphagia, paresthesias, vertigo, blindness, paralysis, and mild convulsions (17,18,13435,31101,31105,31110,31118,31123,31131,31132).”

    American Hellebore · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 17. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    3. 13435. Zagler B, Zelger A, Salvatore C, et al. Dietary poisoning with Veratrum album--a report of two cases. Wien Klin Wochenschr 2005;117:106-8. PubMed
    4. 31101. Prince, L. A. and Stork, C. M. Prolonged cardiotoxicity from poison lilly (Veratrum viride). Vet.Hum.Toxicol. 2000;42(5):282-285.
    5. 31105. ZUMOFF, B. Temporary atrioventricular conduction disturbance associated with ingestion of Veratrum viride. Am Heart J 1954;47(4):630-633. PubMed
    6. 31110. BRONSKY, D., BERNSTEIN, M., and CHESROW, E. J. Cardiac arrhythmia from Veratrum viride. Geriatrics 1957;12(6):389-393.

    Misoprostol

    Listed in the ADVERSE REACTIONS section of the FDA label for Misoprostol. Read the label on DailyMed ›

  • Low blood pressure Additional detail

    American Hellebore

    “Orally, American hellebore can cause arrhythmias, bradycardia, hypotension, heart block, and even death due to cardiac arrest or asphyxiation (17,18,13435,31101,31105,31110,31118,31123,31131,31132).”

    American Hellebore · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 17. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    3. 13435. Zagler B, Zelger A, Salvatore C, et al. Dietary poisoning with Veratrum album--a report of two cases. Wien Klin Wochenschr 2005;117:106-8. PubMed
    4. 31101. Prince, L. A. and Stork, C. M. Prolonged cardiotoxicity from poison lilly (Veratrum viride). Vet.Hum.Toxicol. 2000;42(5):282-285.
    5. 31105. ZUMOFF, B. Temporary atrioventricular conduction disturbance associated with ingestion of Veratrum viride. Am Heart J 1954;47(4):630-633. PubMed
    6. 31110. BRONSKY, D., BERNSTEIN, M., and CHESROW, E. J. Cardiac arrhythmia from Veratrum viride. Geriatrics 1957;12(6):389-393.

    Misoprostol

    Listed in the ADVERSE REACTIONS section of the FDA label for Misoprostol. Read the label on DailyMed ›

  • Dizziness / Headache Additional detail

    American Hellebore

    Recorded for American Hellebore in the same Natural Medicines adverse-effect record shown under Low blood pressure above.

    Misoprostol

    Listed in the ADVERSE REACTIONS section of the FDA label for Misoprostol. Read the label on DailyMed ›

  • Nausea / Diarrhea / Vomiting reported in 6.3% of FDA reports for Misoprostol Additional detail

    American Hellebore

    “Orally, American hellebore can cause burning sensations of the mouth and pharynx, diarrhea, nausea, and vomiting (17,18,13435,31101,31105,31110,31118,31123,31131,31132).”

    American Hellebore · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 17. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    3. 13435. Zagler B, Zelger A, Salvatore C, et al. Dietary poisoning with Veratrum album--a report of two cases. Wien Klin Wochenschr 2005;117:106-8. PubMed
    4. 31101. Prince, L. A. and Stork, C. M. Prolonged cardiotoxicity from poison lilly (Veratrum viride). Vet.Hum.Toxicol. 2000;42(5):282-285.
    5. 31105. ZUMOFF, B. Temporary atrioventricular conduction disturbance associated with ingestion of Veratrum viride. Am Heart J 1954;47(4):630-633. PubMed
    6. 31110. BRONSKY, D., BERNSTEIN, M., and CHESROW, E. J. Cardiac arrhythmia from Veratrum viride. Geriatrics 1957;12(6):389-393.

    Misoprostol

    Listed in the ADVERSE REACTIONS section of the FDA label for Misoprostol, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for American Hellebore but not commonly for Misoprostol: seizures, a slow heartbeat and loss of vision.

Effects for Misoprostol come from the ADVERSE REACTIONS section of its FDA label; effects for American Hellebore come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 16,478 voluntary FDA FAERS reports for Misoprostol that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Misoprostol Products Have a Food Rule — American Hellebore Should Not Break It

At least one FDA label for a product containing Misoprostol says to take it with food. If you take American Hellebore on an empty stomach out of habit, keep them separate — and take Misoprostol with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Misoprostol products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

DOSAGE AND ADMINISTRATION The recommended adult oral dose of Cytotec for reducing the risk of NSAID-induced gastric ulcers is 200 mcg four times daily with food.

From the Dosage and Administration section of the FDA label we read for Misoprostol — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Misoprostol

This page covers American Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Misoprostol page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Misoprostol page

“Misoprostol (Cytotec) is taken by mouth to protect the stomach lining from ulcers caused by NSAID pain relievers, and all 17 of its recorded supplement interactions come down to the same problem, something in the gut keeping the pill from being absorbed properly. That deserves genuine wariness, because misoprostol that never reaches th…”

Reviewed by 2 · Jul 18, 2026

Open the Misoprostol interaction page

How much people look this up

Where American Hellebore and Misoprostol 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
Top half

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

29 days ago today
Medication Misoprostol
Steady interest

#1,606 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every American Hellebore reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The American Hellebore and Misoprostol records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Veratrum viride · Melanthiaceae · Rhizome and root · Homeopathic preparations (highly diluted); historically tinctures

An interaction check asks whether these two react with each other — it does not ask whether American Hellebore is a good idea for someone in your situation. Here is what our American Hellebore record says about it on its own.

American Hellebore: dosing

There is no established safe dose of American Hellebore for self-care. Historically it was given only by trained practitioners using carefully measured tinctures, and even then poisonings occurred.The only products generally found today are homeopathic, which are extremely diluted. Never make or take a preparation from the raw plant.

From our American Hellebore monograph — the full record covers uses, side effects and every documented interaction.

Read the full American Hellebore monograph & all interactions
Medication

About Misoprostol

What Is Misoprostol Used For?

Brand name: Cytotec

Cytotec (misoprostol) tablets and misoprostol tablets are approved to reduce the risk of gastric ulcers (stomach ulcers) in patients who take NSAIDs — nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, or diclofenac — and who are at high risk of ulcer complications. High-risk patients include older adults, people with serious ongoing illnesses, and those with a history of stomach ulcers.

It is important to note that misoprostol has not been shown to reduce the risk of duodenal ulcers (ulcers in the first part of the small intestine) in people taking NSAIDs. It also does not relieve the stomach pain or discomfort that NSAIDs can cause.

Most-Reported Side Effects for Misoprostol

From FAERS, the FDA’s public side-effect reporting system (16,478 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Hemorrhage 1,322 reports
Abortion incomplete 1,159 reports
Nausea 1,031 reports
Arthralgia 977 reports
Rheumatoid arthritis 805 reports
See full Misoprostol 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.

328Major
0Moderate
0Minor
2,501No known interaction
328 Major 2,501 No interaction
Major

328 interactions

Showing 60 of 328 major interactions — see all 328 on the American Hellebore page.

No interaction 2,501 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 2,501 medications checked with no known interaction — see the full American Hellebore list.

See the full American Hellebore interactions page
See every supplement checked against Misoprostol, ranked by severity
Evidence & sources

American Hellebore References

The 15 references that drive our American Hellebore 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. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Zagler B, Zelger A, Salvatore C, et al. Dietary poisoning with Veratrum album--a report of two cases. Wien Klin Wochenschr 2005;117:106-8. PubMed
  4. Prince, L. A. and Stork, C. M. Prolonged cardiotoxicity from poison lilly (Veratrum viride). Vet.Hum.Toxicol. 2000;42(5):282-285.
  5. ZUMOFF, B. Temporary atrioventricular conduction disturbance associated with ingestion of Veratrum viride. Am Heart J 1954;47(4):630-633. PubMed
  6. BRONSKY, D., BERNSTEIN, M., and CHESROW, E. J. Cardiac arrhythmia from Veratrum viride. Geriatrics 1957;12(6):389-393.
  7. GOURZIS, J. and BAUER, R. O. Chronic toxicity of a purified extract of Veratrum viride. Proc.Soc.Exp Biol Med 1951;76(4):767-770. DOI
  8. NEWMAN, A. J. Intoxication with Veratrum viride. J Pediatr 1952;40(2):233-234. PubMed
  9. Assali, N. S., Brust, A. A., Garber, S. T., and Ferris, E. B. COMPARATIVE STUDY OF THE EFFECTS OF TETRAETHYL-AMMONIUM CHLORIDE AND VERATRUM VIRIDE ON BLOOD PRESSURE IN NORMAL AND TOXEMIC PREGNANCY. J Clin Invest 1950;29(3):290-296. PubMed
  10. Jaffe, A. M., Gephardt, D., and Courtemanche, L. Poisoning due to ingestion of Veratrum viride (false hellebore). J.Emerg.Med. 1990;8(2):161-167. PubMed
  11. Komchatov, IuN and Nasirov, G. S. [Poisoning by a tincture of false hellebore]. Sud.Med.Ekspert. 1988;31(1):51-52.
  12. Crummett, D., Bronstein, D., and Weaver, Z., III. Accidental Veratrum viride poisoning in three "ramp" foragers. N.C.Med.J. 1985;46(9):469-471.
  13. Garnier, R., Carlier, P., Hoffelt, J., and Savidan, A. [Acute dietary poisoning by white hellebore (Veratrum album L.). Clinical and analytical data. A propos of 5 cases]. Ann.Med.Interne (Paris) 1985;136(2):125-128.
  14. Bechtel LK, Lawrence DT, Haverstick D, et al. Ingestion of false hellebore plants can cross-react with a digoxin clinical chemistry assay. Clin Toxicol (Phila). 2010;48(5):435-42. PubMed
  15. Forrester JD, Price JH, Holstege CP. Intoxication with a ramp (Allium tricocca) mimicker. False hellebore (Veratrum viride) ingestion. Wilderness Environ Med. 2010;21(1):61-3.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking American Hellebore and Misoprostol Together: Common Questions

Is it safe to take American Hellebore with Misoprostol?
We do not list a known interaction between American Hellebore and Misoprostol. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do American Hellebore and Misoprostol have any of the same side effects?
Yes — our sources link each of them separately to 7 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take American Hellebore and Misoprostol at the same time of day?
At least one FDA label for a product containing Misoprostol says to take it with food. If you take American Hellebore on an empty stomach out of habit, keep them separate and take Misoprostol with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Misoprostol products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the American Hellebore and Misoprostol combination checked?
Interactions in our licensed database are recorded against drug classes. Misoprostol is filed under 1 classification, and American Hellebore has documented interactions with 2 drug classes — none of Misoprostol's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does American Hellebore interact with any other medications?
Yes. American Hellebore has 328 documented drug interactions in our database — Misoprostol is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Misoprostol interact with any supplements?
Yes. Misoprostol has documented interactions with 17 supplements in our database — American Hellebore is not one of them. The Misoprostol interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

American Hellebore monograph Uses, safety profile, and every drug interaction in one place Misoprostol drug information The full plain-English guide to this medication Misoprostol supplement interactions Every supplement checked against Misoprostol, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Misoprostol 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.