Drug & supplement interaction

Berberine + Dorzolamide, Timolol

Dorzolamide, Timolol brand name: Cosopt.

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

Berberine has a moderate interaction with Dorzolamide, Timolol. Theoretically, berberine might increase serum levels of drugs metabolized by CYP2D6.

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

Berberine and Dorzolamide, Timolol

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Dorzolamide, Timolol

Dorzolamide, Timolol falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Berberine interacts with.

Theoretically, berberine might increase serum levels of drugs metabolized by CYP2D6.
In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6. Theoretically, use of berberine with drugs metabolized by CYP2D6 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 thing with Cosopt: you put it right in your eye as drops, so very little of it gets into your bloodstream to begin with. The concern on file is that berberine can slow down a liver enzyme called CYP2D6, which helps clear the timolol (the beta blocker) part of these drops. In theory, that could let a little more timolol build up in your system.

If that happened, you might notice timolol-type effects like a slower heart rate, lower blood pressure, tiredness, or trouble breathing in folks with asthma or lung issues. Honestly, this is mostly theoretical and based on lab and early studies, so for most people it's a small worry. Still, since berberine is a concentrated supplement, it's worth a quick chat with your pharmacist or doctor before you start it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  2. 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
  3. 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

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 Dorzolamide, Timolol one above is one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,158 No known interaction 1,671 (incl. Dorzolamide, Timolol)
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 Dorzolamide, Timolol

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 Dorzolamide, Timolol, 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 Dorzolamide, Timolol

This page covers Berberine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dorzolamide, Timolol page lists 71 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Indian Snakeroot (major), 1,3-dmaa (moderate), Acacia Rigidula (moderate), Active Hexose Correlated Compound (ahcc) (moderate) and Ayahuasca (moderate).

By severity: 1 major · 59 moderate · 11 minor.

From our pharmacist’s overview on the Dorzolamide, Timolol page

“Indian snakeroot is the one entry here I would treat as a genuine hazard with Cosopt (dorzolamide and timolol), the glaucoma eye drop. Its reserpine content plus a beta-blocker like timolol could slow the heart or drop blood pressure too far, and it holds the only major rating among the 71 supplements and herbs on file.”

Reviewed by 2 · Jul 18, 2026

Open the Dorzolamide, Timolol 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 Dorzolamide, Timolol 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 Dorzolamide, Timolol 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 Dorzolamide, Timolol
Top 25%

#687 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 Dorzolamide and Timolol Ophthalmic

What Is Dorzolamide and Timolol Ophthalmic Used For?

Brand name: Cosopt

Dorzolamide and timolol ophthalmic eye drops are used to reduce elevated intraocular pressure (pressure inside the eye) in people with open-angle glaucoma or ocular hypertension (higher-than-normal eye pressure without signs of glaucoma damage). It is specifically intended for patients who have not responded well enough to beta-blocker eye drops alone.

This combination is available as Cosopt, Cosopt PF, and Dorzolamide Hydrochloride and Timolol Maleate eye drops. Cosopt PF is the preservative-free formulation, which may be preferred for people sensitive to preservatives.

See full Dorzolamide and Timolol Ophthalmic 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 Dorzolamide, Timolol, 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 Dorzolamide, Timolol supplement interactions › Every supplement checked against Dorzolamide, Timolol, ranked by severity Dorzolamide and Timolol Ophthalmic 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 Dorzolamide, Timolol Together: Common Questions

Can you take Berberine with Dorzolamide, Timolol?
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.
How serious is the Berberine and Dorzolamide, Timolol 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 Dorzolamide, Timolol 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.