Drug & supplement interaction

Aristolochia + Hydrochlorothiazide

Hydrochlorothiazide brand names: Esidrix, Hydro, Microzide, HydroDiuril, Hydro-D, and others.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Aristolochia has a moderate interaction with Hydrochlorothiazide. Aristolochia is nephrotoxic. There are numerous cases of nephropathy and renal failure associated with aristolochia use.

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

Aristolochia and Hydrochlorothiazide

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

Moderate

NEPHROTOXIC DRUGS

Why this applies to Hydrochlorothiazide

Hydrochlorothiazide falls under NEPHROTOXIC DRUGS — the group Aristolochia interacts with.

Aristolochia is nephrotoxic. There are numerous cases of nephropathy and renal failure associated with aristolochia use. Theoretically, combining aristolochia with potentially nephrotoxic drugs might have additive adverse effects on kidney function. However, this interaction has not yet been reported in humans. Close monitoring of renal function in patients taking aristolochia with nephrotoxic drugs may be warranted.
Some potentially nephrotoxic drugs include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.
Severity Moderate 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

Here's the heart of it: Aristolochia is genuinely toxic to the kidneys. It contains aristolochic acid, which has caused serious kidney damage, kidney failure, and even cancer in real people. Honestly, this is a supplement you should steer clear of entirely, no matter what else you take.

Now, with hydrochlorothiazide, the worry is added strain on your kidneys. HCTZ flushes out water and salt, which can leave you a little dehydrated and can shift your potassium and sodium levels. Pile a kidney toxin on top of that and you could see problems like reduced urine output, swelling, dizziness, or worsening kidney numbers on bloodwork. This particular combo is theoretical (based on how the drugs work, not proven cases), but given Aristolochia's track record, I'd urge you to talk with your doctor or pharmacist before going anywhere near it.

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

Aristolochia Also Interacts With Other Medications

Aristolochia has 354 moderate known drug interactions in our database — the Hydrochlorothiazide one above is one of them. If you take anything else, check it against the full list below.

Moderate 354 No known interaction 2,476 (incl. Hydrochlorothiazide)
Taking anything else?

Check Another of Your Medications Against Aristolochia

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

From our Q&A

Questions About Aristolochia or Hydrochlorothiazide

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

This page covers Aristolochia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the 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 Hydrochlorothiazide page

“Hydrochlorothiazide sits at the strong end of the caution scale for supplement interactions, and the small group of major-rated entries deserves a careful read before everything else on the page. Most of what appears here either adds to the pill's blood-pressure-lowering effect or piles onto its diuretic action, pushing fluid and potas…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide interaction page

How much people look this up

Where Aristolochia and 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 Aristolochia
Steady interest

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

29 days ago today
Medication Hydrochlorothiazide
Top 5%

#119 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 Aristolochia

What is Aristolochia?

Aristolochia
  • Promoting menstruation
  • Aphrodisiac
  • Immune stimulation
  • Snakebite remedies
  • Pain and inflammation

Aristolochia contains aristolochic acid, a potent toxin linked to severe kidney damage and cancer, and it is not safe to take. The FDA and other health authorities have warned against any product containing aristolochic acid. Despite its history in traditional medicine, no proven benefit outweighs these serious dangers.

Read the full Aristolochia monograph & all interactions
Medication

About Hydrochlorothiazide

What Is Hydrochlorothiazide Used For?

Brand names: Esidrix, Hydro, Microzide, HydroDiuril, Hydro-D, Oretic, Aquazide H, Aquazide, HCTZ

Hydrochlorothiazide treats high blood pressure (hypertension) in adults and children, either alone or combined with other blood pressure medicines. Lowering blood pressure reduces the risk of strokes and heart attacks.

It also treats edema (fluid buildup) linked to congestive heart failure, hepatic cirrhosis (liver scarring), and kidney conditions including nephrotic syndrome. Hydrochlorothiazide tablets are additionally indicated for edema caused by corticosteroid or estrogen therapy, and edema from acute glomerulonephritis or chronic renal failure. Inzirqo (the oral suspension) is specifically approved for both hypertension and edema in adult and pediatric patients.

See full Hydrochlorothiazide drug information
Keep checking

Other Drugs & Aristolochia

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

0Major
354Moderate
0Minor
2,475No known interaction
354 Moderate 2,475 No interaction
Moderate

354 interactions

Showing 60 of 354 moderate interactions — see all 354 on the Aristolochia page.

No interaction 2,475 drugs checked — show the list

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

Showing the 60 most looked-up of 2,475 medications checked with no known interaction — see the full Aristolochia list.

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

Can you take Aristolochia with Hydrochlorothiazide?
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 Aristolochia and Hydrochlorothiazide 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 Hydrochlorothiazide and Aristolochia?

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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.