Drug & supplement interaction

Berberine + Belladonna, Caffeine, Ergotamine, Pentobarbital

Belladonna, Caffeine, Ergotamine, Pentobarbital brand name: Micomp PB.

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

Belladonna, Caffeine, Ergotamine, Pentobarbital falls into 3 drug categories that Berberine can interact with; the most serious is rated moderate. Theoretically, berberine might increase the sedative effects of CNS depressants.

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

Berberine and Belladonna, Caffeine, Ergotamine, Pentobarbital

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

Why Are There 3 Interactions?

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

Moderate

CNS DEPRESSANTS

1 of 3

Why this applies to Belladonna, Caffeine, Ergotamine, Pentobarbital

Belladonna, Caffeine, Ergotamine, Pentobarbital falls under CNS DEPRESSANTS — the group Berberine interacts with.

Theoretically, berberine might increase the sedative effects of CNS depressants.
Animal research suggests that berberine may have sedative effects. Theoretically, use of berberine along with CNS depressants might produce additive therapeutic and adverse effects.
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

This combination product contains pentobarbital, a barbiturate that calms the nervous system, which is the part that matters here. Berberine has shown mild sedative effects in animal studies, so on paper, pairing it with a sedating medicine like this could add up. You might feel extra drowsy, foggy, lightheaded, or more relaxed than usual.

I want to be honest about the evidence though: this is based only on lab and animal research, not human studies, so it's more theoretical than proven. Still, since this medicine already includes a barbiturate and ergotamine, it's worth a quick chat with your pharmacist or doctor before adding berberine. Don't stop or change anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  2. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  3. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  4. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Belladonna, Caffeine, Ergotamine, Pentobarbital also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, berberine might increase serum levels of drugs metabolized by CYP3A4.
In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, use of berberine with drugs metabolized by CYP3A4 might increase drug levels and increase the risk of adverse effects.
Severity Moderate 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

This combination product contains several active ingredients, but the one I watch most closely here is ergotamine. Your liver clears ergotamine using an enzyme called CYP3A4, and berberine appears to slow that enzyme down. In plain terms, berberine could let ergotamine build up more than expected, which raises the chance of side effects like nausea, tingling or coldness in your fingers and toes, leg cramps, or in rare cases reduced blood flow to your hands and feet. The caffeine in this product may also linger a bit longer, leaving you jittery or sleepless.

To be fair, this is based mostly on lab work and early studies, so it's a possible concern, not a sure thing. Still, please run it by your pharmacist or doctor before adding berberine.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

PENTOBARBITAL (Nembutal)

3 of 3
Berberine might increase the sedative effect of pentobarbital.
Evidence from animal research shows that berberine can prolong pentobarbital-induced sleeping time. Theoretically, combining berberine and pentobarbital might increase the sedative effects of pentobarbital.
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

The combination product you're asking about contains pentobarbital, a barbiturate that calms the nervous system. That's the piece that matters here. In animal studies, berberine made pentobarbital's sleep-inducing effect last longer, so in theory the two together could leave you feeling more drowsy, groggy, or sluggish than the medicine alone.

I want to be honest about the evidence though. This is based on lab and animal research, not solid human studies, so it's a possible concern rather than a proven one. Still, since this product already has sedating ingredients, I'd play it safe. Before adding berberine, have a quick chat with your pharmacist or doctor, especially if you notice extra sleepiness, dizziness, or slowed thinking.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. 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

Berberine Also Interacts With Other Medications

Berberine has 1 major, 1,160 moderate known drug interactions in our database — the Belladonna, Caffeine, Ergotamine, Pentobarbital one above is among them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,160 No known interaction 1,669 (incl. Belladonna, Caffeine, Ergotamine, Pentobarbital)
Taking anything else?

Check Another of Your Medications Against Berberine

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

From our Q&A

Questions About Berberine or Belladonna, Caffeine, Ergotamine, Pentobarbital

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Berberine or Belladonna, Caffeine, Ergotamine, Pentobarbital, 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 Belladonna, Caffeine, Ergotamine, Pentobarbital

This page covers Berberine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Belladonna, Caffeine, Ergotamine, Pentobarbital page lists 290 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Ephedra (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 15 major · 227 moderate · 48 minor.

From our pharmacist’s overview on the Belladonna, Caffeine, Ergotamine, Pentobarbital page

“People who take Micomp PB for migraines are often the same people reaching for an herbal sleep aid or a caffeinated energy product during a rough stretch, and with four drugs in one tablet (belladonna, caffeine, ergotamine, pentobarbital) nearly everything clashes with something. The 290 supplement ingredients on file here earn genuine…”

Reviewed by 2 · Jul 18, 2026

Open the Belladonna, Caffeine, Ergotamine, Pentobarbital interaction page

One more smart check

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

We hold 908 real supplement products containing Berberine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Berberine. Your product may carry other ingredients that interact with Belladonna, Caffeine, Ergotamine, Pentobarbital too, on top of Berberine — 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 Berberine and Belladonna, Caffeine, Ergotamine, Pentobarbital 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 Berberine
Top 10%

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

29 days ago today
Medication Belladonna, Caffeine, Ergotamine, Pentobarbital
Top 5%

#93 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 Berberine

What is Berberine?

Berberine
  • Blood sugar control
  • High cholesterol
  • Heart and metabolic health
  • Digestive upset
  • Antimicrobial support
  • Weight management

Berberine is a yellow plant compound that has shown promise for lowering blood sugar and cholesterol in some studies, but the quality of research varies and it is not a replacement for prescribed medicine. It can cause stomach upset and should be avoided during pregnancy and breastfeeding. Always check with your pharmacist or doctor before starting it, especially if you take other medications.

Read the full Berberine monograph & all interactions
Keep checking

Other Drugs & Berberine

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

1Major
1,160Moderate
0Minor
1,668No known interaction
1 Major 1,160 Moderate 1,668 No interaction
Major

1 interaction

Moderate

1,160 interactions

Showing 60 of 1,160 moderate interactions — see all 1,160 on the Berberine page.

No interaction 1,668 drugs checked — show the list

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

Showing the 60 most looked-up of 1,668 medications checked with no known interaction — see the full Berberine list.

See the full Berberine interactions page
See every supplement checked against Belladonna, Caffeine, Ergotamine, Pentobarbital, 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
Berberine monograph › Uses, safety, and every drug interaction in one place Belladonna, Caffeine, Ergotamine, Pentobarbital supplement interactions › Every supplement checked against Belladonna, Caffeine, Ergotamine, Pentobarbital, 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 Berberine and Belladonna, Caffeine, Ergotamine, Pentobarbital Together: Common Questions

Can you take Berberine with Belladonna, Caffeine, Ergotamine, Pentobarbital?
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 Berberine and Belladonna, Caffeine, Ergotamine, Pentobarbital?
Belladonna, Caffeine, Ergotamine, Pentobarbital belongs to more than one drug category, and Berberine 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 Berberine and Belladonna, Caffeine, Ergotamine, Pentobarbital 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 Belladonna, Caffeine, Ergotamine, Pentobarbital and Berberine?

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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.