Drug & supplement interaction

Asarabacca + Trandolapril

Trandolapril brand name: Mavik.

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

Asarabacca has a major interaction with Trandolapril. Asarabacca, a herbaceous plant, is often contaminated with aristolochic acid, a compound known for its nephrotoxic effects.

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

Asarabacca and Trandolapril

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

Major

Nephrotoxic Drugs

Why this applies to Trandolapril

Trandolapril falls under Nephrotoxic Drugs — the group Asarabacca interacts with.

Asarabacca, a herbaceous plant, is often contaminated with aristolochic acid, a compound known for its nephrotoxic effects. Aristolochic acid can damage the kidneys and is deemed unsafe by the FDA, leading to the classification of products containing it as adulterated. When considering medications that may also pose a risk of kidney damage, caution is advised when combining them with asarabacca due to potential additive nephrotoxicity. It is advisable to consult healthcare professionals before using asarabacca alongside nephrotoxic drugs to minimize the risk of adverse effects on kidney function.
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 concern with pairing asarabacca with trandolapril (Mavik). Asarabacca comes from a plant family that's often contaminated with aristolochic acid, a substance known to seriously harm the kidneys. Trandolapril, like other ACE inhibitors, already affects how blood flows through your kidneys, and in some people it can nudge kidney function down. Stack a kidney-damaging herb on top of that, and you may be doubling up on the risk.

If the kidneys get stressed, you might see rising creatinine, higher potassium, swelling, or feeling unusually tired. The evidence here is more about caution than hard proof, but since aristolochic acid is genuinely unsafe, I'd avoid asarabacca entirely. Please talk with your doctor or pharmacist before mixing the two.

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

Asarabacca Also Interacts With Other Medications

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

Major 354 No known interaction 2,476 (incl. Trandolapril)
Taking anything else?

Check Another of Your Medications Against Asarabacca

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

Everything else you take

See Every Supplement That Interacts With Trandolapril

This page covers Asarabacca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Trandolapril page lists 149 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), Siberian Cocklebur (major) and Tyramine (major).

By severity: 6 major · 119 moderate · 24 minor.

From our pharmacist’s overview on the Trandolapril page

“Trandolapril (Mavik) treats high blood pressure, and I'd want anyone taking it to read this list of 149 supplements and herbs carefully, with the six major entries first (another 119 are rated moderate and 24 minor). Most of what's here either adds to trandolapril's pressure-lowering effect and can drop you too far, or pushes back agai…”

Reviewed by 2 · Jul 18, 2026

Open the Trandolapril interaction page

One more smart check

Taking Asarabacca as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Asarabacca, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Asarabacca. Your product may carry other ingredients that interact with Trandolapril too, on top of Asarabacca — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Asarabacca and Trandolapril 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 Asarabacca
Top half

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

29 days ago today
Medication Trandolapril
Steady interest

#2,706 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 Asarabacca

What is Asarabacca?

Asarabacca
  • Sinus and nasal congestion
  • Coughs and bronchial complaints
  • Inducing sweating
  • Inducing vomiting (emetic)
  • Digestive upset

Asarabacca is a European woodland plant traditionally used to clear the nose, cause sweating, or trigger vomiting, but it is rarely used today. It belongs to a plant family that often contains aristolochic acid, a substance the FDA considers unsafe because it can cause serious kidney damage and cancer, so we do not recommend using it.

Read the full Asarabacca monograph & all interactions
Medication

About Trandolapril

What Is Trandolapril Used For?

Brand name: Mavik

Trandolapril tablets are used to treat high blood pressure (hypertension). They can be used on their own or combined with other blood pressure medicines such as hydrochlorothiazide.

Trandolapril tablets are also used in stable patients who have reduced heart pumping function (left-ventricular systolic dysfunction) or heart failure that developed within the first few days after a heart attack. In Caucasian patients, trandolapril has been shown to lower the risk of cardiovascular death and reduce hospitalizations related to heart failure.

See full Trandolapril drug information
Keep checking

Other Drugs & Asarabacca

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

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

354 interactions

Showing 60 of 354 major interactions — see all 354 on the Asarabacca page.

No interaction 2,475 drugs checked — show the list

We also checked Asarabacca 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 Asarabacca list.

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

Can you take Asarabacca with Trandolapril?
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 Asarabacca and Trandolapril 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 Trandolapril and Asarabacca?

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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.