Drug & supplement interaction

American Spikenard + Hydralazine, Hydrochlorothiazide

Hydralazine, Hydrochlorothiazide brand names: Apresoline-Esidrix, Apresazide.

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

American Spikenard has a minor interaction with Hydralazine, Hydrochlorothiazide. American spikenard is purported to have diaphoretic properties.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Spikenard and Hydralazine, Hydrochlorothiazide

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

Minor

Diuretic Drugs

Why this applies to Hydralazine, Hydrochlorothiazide

Hydralazine, Hydrochlorothiazide falls under Diuretic Drugs — the group American Spikenard interacts with.

American spikenard is purported to have diaphoretic properties. Diaphoretic substances can increase sweating and fluid loss from the body, which may enhance the effects of diuretics. This interaction could potentially lead to excessive fluid loss and electrolyte imbalance, especially in individuals taking diuretic medications. Healthcare providers need to monitor patients closely for signs of dehydration or electrolyte disturbances if they are using both Aralia racemosa and diuretic drugs concurrently.
Severity Minor Likelihood Possible Evidence D

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

Your medicine pairs hydralazine (which relaxes blood vessels) with hydrochlorothiazide, a water pill that already makes you pee out extra fluid and salt. American spikenard has a traditional reputation as a diaphoretic, meaning it may make you sweat more. The thinking here is simple: if the herb adds extra fluid loss on top of what the water pill is already doing, you could lose a little too much water and minerals like potassium and sodium.

In real life this could show up as feeling lightheaded, extra thirsty, weak, or having muscle cramps, especially in hot weather. I want to be honest though, the evidence for this is very weak and mostly theoretical, so it is a minor concern for most people. Just stay hydrated and check with your pharmacist or doctor before combining them.

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 Spikenard Also Interacts With Other Medications

American Spikenard has 74 minor known drug interactions in our database — the Hydralazine, Hydrochlorothiazide one above is one of them. If you take anything else, check it against the full list below.

Minor 74 No known interaction 2,756 (incl. Hydralazine, Hydrochlorothiazide)
Taking anything else?

Check Another of Your Medications Against American Spikenard

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

Everything else you take

See Every Supplement That Interacts With Hydralazine, Hydrochlorothiazide

This page covers American Spikenard only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydralazine, Hydrochlorothiazide page lists 230 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), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 195 moderate · 25 minor.

From our pharmacist’s overview on the Hydralazine, Hydrochlorothiazide page

“Hydralazine with hydrochlorothiazide already pulls blood pressure down two ways, so most of the supplements on this page either push that drop further or drain more potassium and fluid than the diuretic alone would. A smaller set works against it, and a few do something stranger; calcium-rich products like dolomite can build to dangero…”

Reviewed by 2 · Jul 18, 2026

Open the Hydralazine, Hydrochlorothiazide interaction page

How much people look this up

Where American Spikenard and Hydralazine, Hydrochlorothiazide 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 Spikenard
Top half

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

29 days ago today
Medication Hydralazine, Hydrochlorothiazide
Top half

#1,294 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 Spikenard

What is American Spikenard?

American Spikenard
  • Cough and chest congestion
  • Common cold
  • Asthma symptoms
  • Promoting sweating
  • Skin and wound support (topical)

American spikenard is a traditional North American herb used mainly as an expectorant and to ease coughs and colds, but there is no reliable human research to confirm it works. If you choose to try it, use it short-term, follow the product label, and check with a pharmacist or doctor first—especially if you are pregnant, breastfeeding, or have a health condition.

Read the full American Spikenard monograph & all interactions
Keep checking

Other Drugs & American Spikenard

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

0Major
0Moderate
74Minor
2,755No known interaction
74 Minor 2,755 No interaction
Minor

74 interactions

Showing 60 of 74 minor interactions — see all 74 on the American Spikenard page.

No interaction 2,755 drugs checked — show the list

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

Showing the 60 most looked-up of 2,755 medications checked with no known interaction — see the full American Spikenard list.

See the full American Spikenard interactions page
See every supplement checked against Hydralazine, Hydrochlorothiazide, 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 Spikenard monograph › Uses, safety, and every drug interaction in one place Hydralazine, Hydrochlorothiazide supplement interactions › Every supplement checked against Hydralazine, Hydrochlorothiazide, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking American Spikenard and Hydralazine, Hydrochlorothiazide Together: Common Questions

Can you take American Spikenard with Hydralazine, Hydrochlorothiazide?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the American Spikenard and Hydralazine, Hydrochlorothiazide interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Hydralazine, Hydrochlorothiazide and American Spikenard?

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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.