Drug & supplement interaction

American Hellebore + Nadolol

Nadolol brand names: Corgard, Nadolol.

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

American Hellebore has a major interaction with Nadolol. American hellebore can have potent cardiovascular effects due to the toxic steroid ester alkaloids it contains.

Read the full interaction report
SeverityMajor
LikelihoodLikely
EvidenceA
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Hellebore and Nadolol

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

Major

Antihypertensive Drugs

Why this applies to Nadolol

Nadolol falls under Antihypertensive Drugs — the group American Hellebore interacts with.

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 thing to understand: nadolol already slows your heart rate and lowers your blood pressure, and American Hellebore does the very same thing through its toxic plant alkaloids. Put the two together and those effects stack on top of each other. That can push your heart rate and blood pressure dangerously low.

In real terms, you could feel very dizzy, lightheaded, faint, weak, or unusually tired, and your pulse could drop too far. American Hellebore is genuinely poisonous even in small amounts, so this isn't a small worry. Please don't combine these. If you've taken any product containing this plant, or are even considering it, talk with your pharmacist or doctor first, and seek medical help right away if you feel faint or your heartbeat seems very slow.

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

Major 327 No known interaction 2,503 (incl. Nadolol)
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 Nadolol

This page covers American Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nadolol page lists 145 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Mistletoe (major), Green Tea (major), Indian Snakeroot (major) and Tyramine (major).

By severity: 6 major · 119 moderate · 20 minor.

From our pharmacist’s overview on the Nadolol page

“If you take nadolol (Corgard) for blood pressure, angina, or heart rhythm, treat this list with real care, and green tea is the surprise at the top. In a clinical study, green tea cut nadolol blood levels by roughly 85 percent, which can quietly leave you undertreated.”

Reviewed by 2 · Jul 18, 2026

Open the Nadolol interaction page

How much people look this up

Where American Hellebore and Nadolol 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 Nadolol
Steady interest

#1,419 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 Nadolol

What Is Nadolol Used For?

Brand names: Corgard, Nadolol

Nadolol tablets are used for two main conditions: high blood pressure (hypertension) and angina pectoris (ongoing chest pain caused by reduced blood flow to the heart). Lowering high blood pressure reduces the risk of stroke and heart attack.

For high blood pressure, nadolol may be prescribed on its own or combined with other blood pressure medications, especially thiazide-type diuretics (water pills). For angina, it is used for long-term management to help reduce how often chest pain occurs.

See full Nadolol 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 Nadolol, 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

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Pharmacist Counseling Corner

Taking American Hellebore and Nadolol Together: Common Questions

Can you take American Hellebore with Nadolol?
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.
How serious is the American Hellebore and Nadolol 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 Nadolol 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.