Drug & supplement interaction

Birch + Metolazone

Metolazone brand names: Diulo, Zaroxolyn, Mykrox.

Minor Interaction
Medically reviewed by · Updated December 2024
The bottom line Minor

Birch has a minor interaction with Metolazone. Theoretically, birch might interfere with diuretic therapy.

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

Birch and Metolazone

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

Minor

DIURETIC DRUGS

Why this applies to Metolazone

Metolazone falls under DIURETIC DRUGS — the group Birch interacts with.

Theoretically, birch might interfere with diuretic therapy.
Severity Minor 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 thing to understand about pairing birch with metolazone: both nudge your body in the same direction. Metolazone is a water pill that tells your kidneys to flush out extra salt and water, and birch leaf has a mild diuretic reputation of its own. Stacking two diuretics, even a gentle herbal one, could in theory add up.

The concern isn't that birch blocks your medicine. It's the opposite, really, that you might lose a little too much fluid and salt together. Watch for signs like dizziness when standing, feeling unusually thirsty, muscle cramps, or low potassium. That said, this is a theoretical caution based on how the plant works, not strong human studies, so for most people it stays minor. Still, mention any birch product to your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.

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

Birch Also Interacts With Other Medications

Birch has 74 minor known drug interactions in our database — the Metolazone one above is one of them. If you take anything else, check it against the full list below.

Minor 74 No known interaction 2,756 (incl. Metolazone)
Taking anything else?

Check Another of Your Medications Against Birch

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

Everything else you take

See Every Supplement That Interacts With Metolazone

This page covers Birch only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metolazone page lists 222 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), Dolomite (major) and Lithium (major).

By severity: 8 major · 190 moderate · 24 minor.

Open the Metolazone interaction page

One more smart check

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

We hold 116 real supplement products containing Birch, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Birch. Your product may carry other ingredients that interact with Metolazone too, on top of Birch — 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 Birch and Metolazone 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 Birch
Top half

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

29 days ago today
Medication Metolazone
Top 25%

#634 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 Birch

What is Birch?

  • Urinary tract and 'flushing' support
  • Joint pain and arthritis
  • Mild fluid retention (diuretic)
  • Skin conditions (topical)
  • General detox or 'cleansing' tonics

Birch is a tree whose leaves, bark, and sap are used in traditional remedies, most often as a mild diuretic or for joint and urinary complaints. Solid human evidence is limited, and birch is a well-known source of pollen and contact allergies, so caution is important. Talk to a pharmacist or doctor before using birch products, especially if you are pregnant, breastfeeding, or have allergies.

Read the full Birch monograph & all interactions
Medication

About Metolazone

What Is Metolazone Used For?

Brand names: Diulo, Zaroxolyn, Mykrox

Metolazone tablets help your body get rid of extra salt and water. They are used for swelling (edema) caused by heart failure and by kidney diseases, including nephrotic syndrome and reduced kidney function.

They are also used to treat high blood pressure, either alone or with other blood pressure medicines from a different class. Mykrox tablets, a faster-acting form of metolazone, are meant for new patients with mild to moderate high blood pressure.

See full Metolazone drug information
Keep checking

Other Drugs & Birch

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

0Major
0Moderate
74Minor
2,755No known interaction
74 Minor 2,755 No interaction
Minor

74 interactions

Showing 60 of 74 minor interactions — see all 74 on the Birch page.

No interaction 2,755 drugs checked — show the list

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

Showing the 60 most looked-up of 2,755 medications checked with no known interaction — see the full Birch list.

See the full Birch interactions page
See every supplement checked against Metolazone, 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
Birch monograph › Uses, safety, and every drug interaction in one place Metolazone supplement interactions › Every supplement checked against Metolazone, ranked by severity Metolazone 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 Birch and Metolazone Together: Common Questions

Can you take Birch with Metolazone?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Birch and Metolazone interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Metolazone and Birch?

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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.