Drug & supplement interaction

Aristolochia + Hydrochlorothiazide, Propranolol

Hydrochlorothiazide, Propranolol brand name: Inderide.

Moderate Interaction
The bottom line Moderate

Aristolochia has a moderate interaction with Hydrochlorothiazide, Propranolol. 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, Propranolol

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

Moderate

NEPHROTOXIC DRUGS

Why this applies to Hydrochlorothiazide, Propranolol

Hydrochlorothiazide, Propranolol 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

Let me start with the big picture: Aristolochia is a supplement you really should not be taking at all. It contains aristolochic acid, which is directly toxic to the kidneys and has been tied to kidney failure and cancer. That concern stands on its own, no matter what medicine you pair it with.

Your combo pill, Inderide, holds hydrochlorothiazide (a water pill) and propranolol (a beta blocker). The worry here is mostly with the hydrochlorothiazide side, since water pills lean on your kidneys and can shift your fluid balance. Stacking a kidney-damaging herb on top could, in theory, add extra strain and may show up as dizziness, weakness, or changes in urination. To be fair, this particular pairing is theoretical and has not been reported in people. Even so, please skip the Aristolochia and check with your pharmacist or doctor.

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, Propranolol 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 Aristolochia

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

Everything else you take

See Every Supplement That Interacts With Hydrochlorothiazide, Propranolol

This page covers Aristolochia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Propranolol page lists 324 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: 11 major · 273 moderate · 40 minor.

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

“Inderide combines hydrochlorothiazide, a water pill, with propranolol, a beta blocker, so a supplement that also lowers blood pressure or pulls potassium out of the body hits the drug on its own turf. That describes most of this list, and I'd approach it with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Propranolol interaction page

How much people look this up

Where Aristolochia and Hydrochlorothiazide, Propranolol 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

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

29 days ago today
Medication Hydrochlorothiazide, Propranolol
Top half

#962 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
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
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
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 Aristolochia and Hydrochlorothiazide, Propranolol Together: Common Questions

Can you take Aristolochia with Hydrochlorothiazide, Propranolol?
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, Propranolol 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

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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.