Drug & supplement interaction

Berberine + Hydrochlorothiazide, Propranolol

Hydrochlorothiazide, Propranolol brand name: Inderide.

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

Hydrochlorothiazide, Propranolol falls into 2 drug categories that Berberine can interact with; the most serious is rated moderate. Theoretically, berberine might have additive effects with antihypertensive drugs.

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

Berberine and Hydrochlorothiazide, Propranolol

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. Hydrochlorothiazide, Propranolol 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

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Hydrochlorothiazide, Propranolol

Hydrochlorothiazide, Propranolol falls under ANTIHYPERTENSIVE DRUGS — the group Berberine interacts with.

Theoretically, berberine might have additive effects with antihypertensive drugs.
Animal research suggests that berberine can have hypotensive effects. Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone.
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

Your Inderide combo already does two things to lower blood pressure: the hydrochlorothiazide piece helps you shed extra fluid, and the propranolol piece (a beta-blocker) slows your heart and eases its workload. Berberine isn't fighting either of these drugs. Instead, lab and some early human studies suggest it may gently nudge blood pressure down on its own, which could add to what your medication is already doing.

In plain terms, the two together might lower your numbers more than expected. Watch for signs your pressure dropped too far: dizziness, lightheadedness when you stand, unusual tiredness, or feeling faint. This evidence is still fairly weak, so it may not happen at all. Still, please check with your pharmacist or doctor before adding berberine, and keep an eye on your blood pressure readings if you do.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  2. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  3. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 2

Hydrochlorothiazide, Propranolol also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

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

This combo pill pairs propranolol (a beta-blocker) with hydrochlorothiazide (a water pill). The part that matters here is the propranolol, since your liver clears it partly through an enzyme called CYP2D6. Berberine appears to slow that enzyme down a bit, so in theory propranolol could build up in your blood and act a little stronger than expected.

If that happens, you might notice a slower heart rate, lower blood pressure, lightheadedness, tiredness, or cold hands and feet. To be clear, this is mostly theoretical and based on lab work and weak human data, so it may not amount to much for many people. Still, please run it past your pharmacist or doctor before adding berberine, and let them know if you feel unusually dizzy or sluggish.

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 Hydrochlorothiazide, Propranolol 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. Hydrochlorothiazide, Propranolol)
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 Hydrochlorothiazide, Propranolol

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 Hydrochlorothiazide, Propranolol, 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 Hydrochlorothiazide, Propranolol

This page covers Berberine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Propranolol page lists 324 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: 11 major · 273 moderate · 40 minor.

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

“Inderide combines hydrochlorothiazide, a water pill, with propranolol, a beta blocker, so a supplement that also lowers blood pressure or pulls potassium out of the body hits the drug on its own turf. That describes most of this list, and I'd approach it with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Propranolol 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 Hydrochlorothiazide, Propranolol 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 Hydrochlorothiazide, Propranolol 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%

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

29 days ago today
Medication Hydrochlorothiazide, Propranolol
Steady interest

#1,593 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
1,158Moderate
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 Hydrochlorothiazide, Propranolol, 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 Hydrochlorothiazide, Propranolol supplement interactions › Every supplement checked against Hydrochlorothiazide, Propranolol, 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 Hydrochlorothiazide, Propranolol Together: Common Questions

Can you take Berberine with Hydrochlorothiazide, Propranolol?
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 Hydrochlorothiazide, Propranolol?
Hydrochlorothiazide, Propranolol 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 Hydrochlorothiazide, Propranolol 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 Hydrochlorothiazide, Propranolol 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.