Drug & supplement interaction

Berberine + Verapamil

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

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

Verapamil 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 Verapamil

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. Verapamil 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 Verapamil

Verapamil 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

Here's the simple version: berberine seems to gently lower blood pressure on its own. Verapamil already does that job by relaxing your blood vessels and slowing your heart rate. Put them together and the effects can stack up, so your blood pressure could dip lower than you expect.

If that happens, you might feel dizzy, lightheaded, unusually tired, or notice your heartbeat running slow, especially when you stand up quickly. I want to be honest about the evidence though: this is mostly based on animal studies and a small human trial using a different blood pressure pill (amlodipine), not verapamil specifically. So it's a real possibility, not a sure thing. Don't change anything on your own. Just give your pharmacist or doctor a heads-up before adding berberine so they can keep an eye on your numbers.

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 3A4 (CYP3A4) SUBSTRATES

2 of 2

Verapamil 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

Here's the gist with berberine and verapamil: your liver uses an enzyme called CYP3A4 to break verapamil down and clear it out. Berberine appears to slow that enzyme down a bit, so the verapamil in your system can build up higher than expected. Verapamil is already an active drug (not a prodrug that needs switching on), so more of it means a stronger effect.

In real terms, that could mean your blood pressure or heart rate dips too low, leaving you dizzy, tired, or constipated, which is a common verapamil complaint. The research here is partly theoretical, so I don't want to alarm you. Still, since verapamil affects your heart rhythm, please loop in your pharmacist or doctor before adding berberine rather than changing anything on your own.

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

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 Verapamil 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. Verapamil)
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 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 Berberine 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 Berberine 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 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 Verapamil 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 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 Berberine
Top 10%

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

29 days ago today
Medication Verapamil
Top 25%

#695 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 Verapamil

What Is Verapamil Used For?

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

Verapamil is used for high blood pressure, angina and some fast heart rhythms. Which uses apply depends on the product.

Immediate-release verapamil tablets are used for angina, certain rhythm problems and high blood pressure. Extended-release tablets and capsules are used for high blood pressure. Verapamil injection is given in a medical setting for fast heart rhythms.

See full Verapamil 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
1,160Moderate
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 Verapamil, 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 Verapamil supplement interactions › Every supplement checked against Verapamil, ranked by severity Verapamil 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 Verapamil Together: Common Questions

Can you take Berberine 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 2 interactions listed for Berberine and Verapamil?
Verapamil 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 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 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.