Drug & supplement interaction

Berberine + Diclofenac Sodium

Diclofenac Sodium brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, and others.

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

Diclofenac Sodium falls into 2 drug categories that Berberine can interact with; the most serious is rated moderate. Theoretically, berberine might increase serum levels of drugs metabolized by CYP2C9.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Berberine and Diclofenac Sodium

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Berberine interacts with whole categories of medication. Diclofenac Sodium falls into 2 of those categories, so it can interact with Berberine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Diclofenac Sodium

Diclofenac Sodium falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Berberine interacts with.

Theoretically, berberine might increase serum levels of drugs metabolized by CYP2C9.
Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, taking berberine with drugs metabolized by CYP2C9 might increase drug levels and increase the risk of adverse effects.
Severity Moderate Likelihood Possible Evidence B

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 with berberine and diclofenac. Your liver uses an enzyme called CYP2C9 to clear diclofenac out of your system. Early research suggests berberine can slow that enzyme down. If it does, diclofenac may hang around at higher levels than usual, which could nudge up the chance of typical NSAID side effects like stomach upset, heartburn, stomach irritation or bleeding, fluid retention, or raised blood pressure.

I want to keep this in perspective. The evidence is mostly theoretical and based on limited, lower-quality studies, so this isn't a sure thing. Still, if you're taking concentrated berberine supplements (not just a little in food), it's worth a quick chat with your pharmacist or doctor before combining them, especially if you use diclofenac regularly.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Diclofenac Sodium also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, berberine might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
In vitro and in vivo research suggest that berberine can inhibit platelet aggregation. Theoretically, berberine might have additive effects when used with anticoagulant and antiplatelet drugs and increase the risk of bleeding.
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 with diclofenac and berberine. Diclofenac is an NSAID, and like other drugs in that family it can thin the blood a little and irritate the stomach lining, which raises bleeding risk on its own. Lab and animal studies suggest berberine may also make platelets (the cells that help blood clot) a bit less sticky. Put the two together and, in theory, you could nudge that bleeding risk up.

I want to be honest about the evidence: this is theoretical, based on test tube and animal work, not solid human studies. So it's worth a mention, not a panic. Still, keep an eye out for things like unusual bruising, dark or bloody stools, stomach pain, or bleeding that won't stop. If you take both, just loop in your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  2. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.

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, 1,158 moderate known drug interactions in our database — the Diclofenac Sodium one above is among them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,158 No known interaction 1,671 (incl. Diclofenac Sodium)
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 Diclofenac Sodium

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 Diclofenac Sodium, 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 Diclofenac Sodium

This page covers Berberine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac Sodium page lists 308 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

By severity: 7 major · 266 moderate · 35 minor.

From our pharmacist’s overview on the Diclofenac Sodium page

“Diclofenac (Voltaren), a daily mainstay for arthritis and joint pain, comes with a supplement list that calls for real vigilance. Of the 308 ingredients on file, 7 rate major, and roughly two hundred entries share a single theme: anything with blood-thinning activity adds to diclofenac's own bleeding risk, especially in the stomach.”

Reviewed by 2 · Jul 18, 2026

Open the Diclofenac Sodium 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 Diclofenac Sodium 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 Diclofenac Sodium 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%

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

29 days ago today
Medication Diclofenac Sodium
Top 25%

#366 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
Medication

About Diclofenac

What Is Diclofenac Used For?

Brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, Diclo SR, Voltarol, Acoflam, Defenac, Dicloflex, Diclovol, Diclozip, Fenactol, Flamrase, Volraman, Diclomax SR, Diclomax Retard, Motifene 75 mg, Voltarol 75 mg SR, Acoflam 75 SR, Defenac SR, Dexomon 75 SR, Dicloflex 75 SR, Diclovol SR, Fenactol 75 mg SR, Flamatak 75 MR, Flamrase SR, Flexotard MR 75, Rheumatac Retard 75, Rhumalgan CR, Slofenac SR, Volsaid Retard 75, Voltarol Retard, Acoflam Retard, Defenac Retard, Dexomon Retard 100, Dicloflex Retard, Diclovol Retard, Fenactol Retard 100 mg, Flamatak 100 MR, Volsaid Retard 100, Voltarol Ophtha Multidose, Voltarol Ophtha, Pennsaid, Voltaren Emulgel, Dyloject

Diclofenac sodium topical gel is used to treat actinic keratoses (AK) — rough, scaly skin patches that form after years of sun exposure. These patches are considered precancerous, meaning they can develop into skin cancer if left untreated.

This is a topical gel, meaning it is applied directly to the skin over the affected area rather than taken by mouth. It belongs to the NSAID (nonsteroidal anti-inflammatory drug) family.

See full Diclofenac drug information
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
1,158Moderate
0Minor
1,670No known interaction
1 Major 1,158 Moderate 1,670 No interaction
Major

1 interaction

Moderate

1,158 interactions

Showing 60 of 1,158 moderate interactions — see all 1,158 on the Berberine page.

No interaction 1,670 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 1,670 medications checked with no known interaction — see the full Berberine list.

See the full Berberine interactions page
See every supplement checked against Diclofenac Sodium, 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 Diclofenac Sodium supplement interactions › Every supplement checked against Diclofenac Sodium, ranked by severity Diclofenac 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 Berberine and Diclofenac Sodium Together: Common Questions

Can you take Berberine with Diclofenac Sodium?
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 2 interactions listed for Berberine and Diclofenac Sodium?
Diclofenac Sodium 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 Diclofenac Sodium 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 Diclofenac Sodium 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.