Drug & supplement interaction

American Hellebore + Naratriptan

Naratriptan brand name: Amerge.

Major Interaction
The bottom line Major

American Hellebore has a major interaction with Naratriptan. 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
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Hellebore and Naratriptan

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

Major

Qt Interval-Prolonging Drugs

Why this applies to Naratriptan

Naratriptan 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 simple version. American Hellebore is a genuinely poisonous plant that can throw off your heart's electrical timing (what doctors call the QT interval) and cause dangerous heart rhythm problems. Naratriptan, your migraine medicine, can also nudge that same timing on its own. Stacking the two together may add up and raise the risk of a serious irregular heartbeat called torsades de pointes.

To be straight with you, this is rated as a possible concern based on limited evidence, not something proven to happen often. But honestly, the bigger issue is that American Hellebore is unsafe to take at all. I would not combine these. 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 Naratriptan 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 American Hellebore

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

From our Q&A

Questions About American Hellebore or Naratriptan

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers American Hellebore or Naratriptan, 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 Naratriptan

This page covers American Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naratriptan page lists 50 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 8 major · 31 moderate · 11 minor.

From our pharmacist’s overview on the Naratriptan page

“Naratriptan (Amerge) treats migraines by acting on serotonin receptors, so it matters that 20 of the 50 supplements flagged for it can also push serotonin activity higher, raising the risk of serotonin syndrome, a dangerous overload. This is a list to approach with real caution, not a quick skim.”

Reviewed by 2 · Jul 18, 2026

Open the Naratriptan interaction page

How much people look this up

Where American Hellebore and Naratriptan 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

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

29 days ago today
Medication Naratriptan
Top 25%

#448 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 Naratriptan

What Is Naratriptan Used For?

Brand name: Amerge

Naratriptan tablets are used to treat migraine attacks as they happen — with or without aura (the visual or sensory changes that can come before a migraine). It works during an active attack, not as a daily preventive medication.

It is not approved to prevent migraines from starting, and it has not been shown to work for cluster headaches. A confirmed diagnosis of migraine should be in place before using it.

See full Naratriptan 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

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Pharmacist Counseling Corner

Taking American Hellebore and Naratriptan Together: Common Questions

Can you take American Hellebore with Naratriptan?
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 Naratriptan 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 Naratriptan 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.