Drug & supplement interaction

American Ivy + Metolazone

Metolazone brand names: Diulo, Zaroxolyn, Mykrox.

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

American Ivy has a moderate interaction with Metolazone. The berries of American ivy contain up to 2% oxalic acid, which can be toxic because it has the potential to cause kidney failure by precipitating solid calcium oxalate.

Read the full interaction report
SeverityModerate
LikelihoodUnlikely
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Ivy and Metolazone

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

Moderate

Thiazide Diuretics

Why this applies to Metolazone

Metolazone falls under Thiazide Diuretics — the group American Ivy interacts with.

The berries of American ivy contain up to 2% oxalic acid, which can be toxic because it has the potential to cause kidney failure by precipitating solid calcium oxalate. Thiazide diuretics are often prescribed to decrease urinary calcium levels and prevent the formation of calcium oxalate kidney stones. Consequently, the berries of American ivy and thiazide diuretics may have opposing effects in this context, as the diuretics work to lower urinary calcium levels while the oxalic acid in the berries could potentially increase the risk of kidney stone formation. It is important to note that medicinal supplements utilizing American ivy generally only make use of the bark, not the berries.
Severity Moderate Likelihood Unlikely Evidence C

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the simple version for Metolazone: one job this water pill can do is lower the amount of calcium in your urine, which helps keep calcium oxalate kidney stones from forming. The catch is that American ivy berries contain oxalic acid, which pushes in the opposite direction and could raise the risk of those same stones. So the two may work against each other when it comes to your kidneys.

The good news: this is a theoretical concern with limited evidence, and most American ivy supplements use the bark, not the toxic berries. The berries themselves are considered poisonous and shouldn't be eaten at all. If you're taking metolazone and considering this supplement, check with your pharmacist or doctor first.

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 Ivy Also Interacts With Other Medications

American Ivy has 55 moderate known drug interactions in our database — the Metolazone one above is one of them. If you take anything else, check it against the full list below.

Moderate 55 No known interaction 2,775 (incl. Metolazone)
Taking anything else?

Check Another of Your Medications Against American Ivy

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

Everything else you take

See Every Supplement That Interacts With Metolazone

This page covers American Ivy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metolazone page lists 222 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 8 major · 190 moderate · 24 minor.

Open the Metolazone interaction page

How much people look this up

Where American Ivy and Metolazone 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 Ivy
Top half

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

29 days ago today
Medication Metolazone
Top half

#868 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 Ivy

What is American Ivy?

American Ivy
  • Digestive upset
  • To stimulate sweating
  • Traditional tonic use
  • Skin and swelling complaints (topical folk use)

American Ivy (Virginia creeper) is mainly an ornamental climbing vine with a long history of folk use for digestion and sweating, but there is very little human evidence to support any health benefit. Its berries contain oxalic acid and are considered poisonous, and the plant can irritate the skin. Because safety data is limited, talk with your pharmacist or doctor before using it.

Read the full American Ivy monograph & all interactions
Medication

About Metolazone

What Is Metolazone Used For?

Brand names: Diulo, Zaroxolyn, Mykrox

Metolazone tablets are used to treat edema (excess fluid buildup) linked to congestive heart failure or kidney diseases — including nephrotic syndrome and conditions with reduced kidney function. They are also used to treat high blood pressure (hypertension), either alone or alongside other blood pressure medications.

Metolazone tablets may also be used during pregnancy when edema is caused by a medical condition rather than normal pregnancy changes — but routine use in otherwise healthy pregnant women is not appropriate.

See full Metolazone drug information
Keep checking

Other Drugs & American Ivy

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

0Major
55Moderate
0Minor
2,774No known interaction
55 Moderate 2,774 No interaction
Moderate

55 interactions

No interaction 2,774 drugs checked — show the list

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

Showing the 60 most looked-up of 2,774 medications checked with no known interaction — see the full American Ivy list.

See the full American Ivy interactions page
See every supplement checked against Metolazone, 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 Ivy monograph › Uses, safety, and every drug interaction in one place Metolazone supplement interactions › Every supplement checked against Metolazone, ranked by severity Metolazone 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 Ivy and Metolazone Together: Common Questions

Can you take American Ivy with Metolazone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the American Ivy and Metolazone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Metolazone and American Ivy?

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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.