Drug & supplement interaction

Beet + Verapamil

Verapamil brand names: Isoptin SR, Verelan, Isoptin, Calan SR, Verelan SR, and others.

Moderate Interaction
The bottom line Moderate

Verapamil falls into 3 drug categories that Beet can interact with; the most serious is rated moderate. Theoretically, beet might increase the levels of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beet and Verapamil

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Beet interacts with whole categories of medication. Verapamil falls into 3 of those categories, so it can interact with Beet in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 3

Why this applies to Verapamil

Verapamil falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Beet interacts with.

Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.
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 gist: your body relies on a liver enzyme called CYP3A4 to break down and clear verapamil. Lab studies hint that betanin (the red pigment in beets) might slow that enzyme down. If that happened in real life, verapamil could build up a bit, leading to stronger effects like lower blood pressure, a slower heart rate, dizziness, lightheadedness, or constipation.

Now, the important part: this is purely theoretical, based only on test-tube research, not on actual people. Everyday beet portions in your meals are very unlikely to cause trouble. Concentrated beetroot supplements are less certain. Since verapamil already affects heart rate and blood pressure, it's worth a quick chat with your pharmacist or doctor before adding regular beet supplements.

References
  1. Lim SH, Bae S, Lee HS, Han HK, Choi CI. Effect of Betanin, the Major Pigment of Red Beetroot (Beta vulgaris L.), on the Activity of Recombinant Human Cytochrome P450 Enzymes. Pharmaceuticals (Basel) 2023;16(9):1224. PubMed
Minor

Antihypertensive Drugs

2 of 3

Verapamil also falls under Antihypertensive Drugs.

Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.
Severity Minor Likelihood Possible Evidence A

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 simple version. Verapamil already relaxes your blood vessels and slows your heart rate to bring blood pressure down. Beets, especially as concentrated beetroot juice, are loaded with natural nitrates that the body turns into nitric oxide, which can widen blood vessels too. So in theory, pairing the two could nudge your blood pressure a little lower and stack on top of what your medication is already doing.

In practice, the effect from beets tends to be mild and short-lived, and good studies haven't shown a strong or lasting drop. Eating beets in normal food amounts is very unlikely to cause trouble. If you're drinking concentrated beet juice daily, just keep an eye out for dizziness, lightheadedness, or feeling unusually tired, and check in with your pharmacist or doctor before making it a habit.

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

3 of 3

Verapamil also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.
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

Here's the gist for beets and verapamil. Some early lab research hints that beet might rev up a liver enzyme called CYP1A2. If that enzyme also helps clear verapamil from your body, then in theory beets could lower verapamil levels a little, making it work less well. For you that might mean blood pressure creeping up, or less control over chest pain or an irregular heartbeat.

Honestly, though, this is very theoretical. It comes only from test-tube studies, and verapamil is mostly handled by a different enzyme (CYP3A4), so the real-world effect is likely tiny. Eating beets or drinking beetroot juice as food shouldn't be a worry. If you're thinking about concentrated beet supplements, just run it by your pharmacist or doctor first.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed

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

Beet Also Interacts With Other Medications

Beet has 642 moderate, 218 minor known drug interactions in our database — the Verapamil one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Beet

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

From our Q&A

Questions About Beet or Verapamil

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

This page covers Beet only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Verapamil page lists 295 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), Beer (major) and Coleus (major).

By severity: 10 major · 245 moderate · 40 minor.

From our pharmacist’s overview on the Verapamil page

“This is one of the longer interaction lists we publish, and with verapamil (Calan, Verelan) it warrants genuine care, starting with the ten major-rated entries. Verapamil lowers blood pressure and slows the heart, so most of the 295 ingredients on file either push that effect further than intended or change how much of the drug reaches…”

Reviewed by 2 · Jul 18, 2026

Open the Verapamil interaction page

One more smart check

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

We hold 4,785 real supplement products containing Beet, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Beet. Your product may carry other ingredients that interact with Verapamil too, on top of Beet — 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 Beet and Verapamil 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 Beet
Top 5%

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

29 days ago today
Medication Verapamil
Top half

#742 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 Beet

What is Beet?

Beet
  • High blood pressure
  • Exercise and athletic performance
  • Heart and circulation support
  • General antioxidant/anti-inflammatory support
  • Liver and digestive support

Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but supplement effects are modest and not a substitute for prescribed treatment, so talk with your pharmacist or doctor before relying on it.

Read the full Beet monograph & all interactions
Medication

About Verapamil

What Is Verapamil Used For?

Brand names: Isoptin SR, Verelan, Isoptin, Calan SR, Verelan SR, Calan, Covera HS, Verap, Veramil

Verapamil tablets and film-coated tablets are used to treat angina — including vasospastic (Prinzmetal's) angina, unstable angina, and chronic stable angina — as well as certain abnormal heart rhythms (arrhythmias) and high blood pressure (essential hypertension). For arrhythmias, regular-release tablets are used alongside digoxin to control heart rate in atrial flutter or atrial fibrillation, and to help prevent episodes of paroxysmal supraventricular tachycardia (SVT), a type of rapid heartbeat.

Extended-release and sustained-release oral forms (tablets and capsules) are indicated specifically for high blood pressure. Verapamil hydrochloride injection is used in hospital settings for rapid conversion of SVT to normal rhythm and for temporary control of fast heart rates in atrial flutter or atrial fibrillation.

See full Verapamil drug information
Keep checking

Other Drugs & Beet

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

0Major
642Moderate
218Minor
1,969No known interaction
Moderate

642 interactions

Showing 60 of 642 moderate interactions — see all 642 on the Beet page.

Minor

218 interactions

Showing 60 of 218 minor interactions — see all 218 on the Beet page.

No interaction 1,969 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 Beet and Verapamil Together: Common Questions

Can you take Beet with Verapamil?
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.
Why are there 3 interactions listed for Beet and Verapamil?
Verapamil belongs to more than one drug category, and Beet interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Beet and Verapamil 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 Verapamil and Beet?

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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.