Drug & supplement interaction

Asian Water Plantain + Hydrochlorothiazide, Spironolactone

Hydrochlorothiazide, Spironolactone brand names: Spirozine, Aldactazide, Aldactide 25, Aldactide 50.

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

Asian Water Plantain has a minor interaction with Hydrochlorothiazide, Spironolactone. Studies on animals have shown that Asian water plantain extract, which contains triterpenoids, is generally safe at doses up to 1440 mg/kg orally daily and does not cause harm to the body.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceA
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Asian Water Plantain and Hydrochlorothiazide, Spironolactone

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

Minor

Nephrotoxic Drugs

Why this applies to Hydrochlorothiazide, Spironolactone

Hydrochlorothiazide, Spironolactone falls under Nephrotoxic Drugs — the group Asian Water Plantain interacts with.

Studies on animals have shown that Asian water plantain extract, which contains triterpenoids, is generally safe at doses up to 1440 mg/kg orally daily and does not cause harm to the body. However, using a higher dose of the extract, at 33.3 grams/kg orally for 60 days, has been linked to kidney issues, as indicated by increased blood urea nitrogen levels, and enlargement of the liver and kidneys. Additionally, two components of Asian water plantain, alisol A and alisol B, when given in doses of 400 mg/kg daily and 500 mg/kg daily respectively for 6 months, have been found to increase the production of markers that suggest potential kidney damage from certain medications. While these findings suggest there is very little risk that Asian water plantain may interact with drugs that are harmful to the kidneys, caution is still advised if combined with known nephrotoxic drugs (source: pubmed.ncbi.nlm.nih.gov/28408883/)
Severity Minor Likelihood Unlikely Evidence A

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. Your blood pressure pill combines two water pills, hydrochlorothiazide and spironolactone, and both lean on your kidneys to do their job. Asian water plantain (Ze Xie) is itself a traditional diuretic, so the main concern is two things pushing your kidneys in the same direction at once.

The actual safety signal here is weak. It comes from animal studies using very high doses of the extract over long stretches, where they saw raised kidney markers. At normal human amounts the risk looks very small. Still, it's worth being a little cautious, since spironolactone can already raise potassium and both drugs can affect kidney function and fluid balance. Please check with your pharmacist or doctor before combining them, and don't change your medication on your own.

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

Asian Water Plantain Also Interacts With Other Medications

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

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

Check Another of Your Medications Against Asian Water Plantain

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

Everything else you take

See Every Supplement That Interacts With Hydrochlorothiazide, Spironolactone

This page covers Asian Water Plantain only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Spironolactone page lists 235 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 · 199 moderate · 26 minor.

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

“Hydrochlorothiazide with spironolactone (Aldactazide) deserves genuine care around supplements, and the ten major-rated interactions on this list of 235 are the ones to understand before anything else. Most entries either add to the drug's blood-pressure-lowering effect, sometimes enough to cause dizziness or fainting, or amplify its d…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Spironolactone interaction page

How much people look this up

Where Asian Water Plantain and Hydrochlorothiazide, Spironolactone 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 Asian Water Plantain
Top half

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

29 days ago today
Medication Hydrochlorothiazide, Spironolactone
Steady interest

#1,464 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 Asian Water Plantain

What is Asian Water Plantain?

Asian Water Plantain
  • Promoting urination (diuretic)
  • Fluid retention and swelling
  • Urinary discomfort
  • Cholesterol and heart health support
  • Kidney and bladder support

Asian water plantain (Ze Xie) is a rhizome long used in traditional Chinese medicine, mainly as a diuretic and for fluid retention. Modern evidence is mostly limited to laboratory and animal studies, so its benefits in people are not well proven, and quality human safety data are lacking. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Asian Water Plantain monograph & all interactions
Keep checking

Other Drugs & Asian Water Plantain

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

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

354 interactions

Showing 60 of 354 minor interactions — see all 354 on the Asian Water Plantain page.

No interaction 2,475 drugs checked — show the list

We also checked Asian Water Plantain 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 Asian Water Plantain list.

See the full Asian Water Plantain interactions page
See every supplement checked against Hydrochlorothiazide, Spironolactone, 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
Asian Water Plantain monograph › Uses, safety, and every drug interaction in one place Hydrochlorothiazide, Spironolactone supplement interactions › Every supplement checked against Hydrochlorothiazide, Spironolactone, 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 Asian Water Plantain and Hydrochlorothiazide, Spironolactone Together: Common Questions

Can you take Asian Water Plantain with Hydrochlorothiazide, Spironolactone?
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 Asian Water Plantain and Hydrochlorothiazide, Spironolactone 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 Hydrochlorothiazide, Spironolactone and Asian Water Plantain?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.