Drug & supplement interaction

Black Hellebore + Doripenem

Doripenem brand name: Doribax.

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

Doripenem falls into 2 drug categories that Black Hellebore can interact with; the most serious is rated moderate. Theoretically, concomitant use of macrolide antibiotics and black hellebore might increase risk of cardiac glycoside toxicity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Black Hellebore and Doripenem

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

Why Are There 2 Interactions?

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

Moderate

MACROLIDE ANTIBIOTICS

1 of 2

Why this applies to Doripenem

Doripenem falls under MACROLIDE ANTIBIOTICS — the group Black Hellebore interacts with.

Theoretically, concomitant use of macrolide antibiotics and black hellebore might increase risk of cardiac glycoside toxicity. Some of these drugs include erythromycin, azithromycin, and clarithromycin.
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

First things first: black hellebore is a genuinely toxic plant, and there's no safe reason to take it. On its own it can cause severe vomiting and dangerous heart rhythm changes, because it contains compounds that act on the heart much like the heart drugs known as cardiac glycosides.

The interaction on file was written for macrolide antibiotics (like azithromycin and clarithromycin), which can slow how those heart compounds clear and raise toxicity risk. Doripenem (Doribax) is actually a different family, a carbapenem, so this exact concern doesn't really apply to it the same way. It isn't a prodrug, and it doesn't share that liver-enzyme issue. Honestly, the bigger danger here is the hellebore itself. Please don't take it, and check with your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Moderate

TETRACYCLINE ANTIBIOTICS

2 of 2

Doripenem also falls under TETRACYCLINE ANTIBIOTICS.

Theoretically, concomitant use of tetracyclic antibiotics and black hellebore might increase the risk of cardiac glycoside toxicity.
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

First things first: Black Hellebore is genuinely toxic and isn't something I'd ever recommend taking, no matter what else you're on. It contains compounds that behave like cardiac glycosides, meaning they can throw off your heart rhythm even in small amounts.

The concern on file pairs it with tetracycline-type antibiotics. Doripenem (Doribax) is actually a carbapenem antibiotic given by IV, not a tetracycline, so this specific interaction may not even apply to it. The interaction itself is theoretical, based on pharmacology rather than real cases, and the worry is mainly about the hellebore stressing your heart, not about doripenem failing to work. Doripenem isn't a prodrug, so it doesn't get switched on or off by this. Bottom line: skip the hellebore and check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.

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

Black Hellebore Also Interacts With Other Medications

Black Hellebore has 132 moderate known drug interactions in our database — the Doripenem one above is among them. If you take anything else, check it against the full list below.

Moderate 132 No known interaction 2,698 (incl. Doripenem)
Taking anything else?

Check Another of Your Medications Against Black Hellebore

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

Everything else you take

See Every Supplement That Interacts With Doripenem

This page covers Black Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Doripenem page lists 84 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Oleander (major), Para-aminobenzoic Acid (paba) (major), Acerola (moderate), Alpha-lipoic Acid (moderate) and Bacillus Coagulans (moderate).

By severity: 2 major · 75 moderate · 7 minor.

From our pharmacist’s overview on the Doripenem page

“Two entries here matter more than all the others, and I would read them first. Doripenem (Doribax) is an intravenous antibiotic reserved for serious bacterial infections, which means anything that weakens treatment or piles on risk deserves genuine caution.”

Reviewed by 2 · Jul 18, 2026

Open the Doripenem interaction page

One more smart check

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

We hold 1 real supplement products containing Black Hellebore, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Hellebore. Your product may carry other ingredients that interact with Doripenem too, on top of Black Hellebore — 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 Black Hellebore and Doripenem 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 Black Hellebore
Top half

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

29 days ago today
Medication Doripenem
Steady interest

#2,547 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 Black Hellebore

What is Black Hellebore?

Black Hellebore
  • Constipation (historical purgative)
  • Mental and nervous disorders (historical)
  • Worm and parasite expulsion (historical)
  • Fluid retention (historical)
  • Heart conditions (historical, dangerous)

Black Hellebore is a highly toxic plant that was used in old folk medicine but has no proven, safe modern use. Because even small amounts can cause severe poisoning and dangerous heart rhythm problems, it should not be taken as a supplement. Talk to a doctor or pharmacist before considering any product that contains it.

Read the full Black Hellebore monograph & all interactions
Medication

About Doripenem Injection

What Is Doripenem Injection Used For?

Brand name: Doribax

  • Doripenem injection is used to treat serious infections of the urinary tract, kidney, and abdomen that are caused by bacteria. Doripenem injection is not approved by the Food and Drug Administration (FDA) to treat pneumonia that developed in people who were on a ventilator in a hospital. Doripenem injection is in a class of medications called carbapenem antibiotics. It works by killing bacteria.

  • Antibiotics such as doripenem injection will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

See full Doripenem Injection drug information
Keep checking

Other Drugs & Black Hellebore

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

0Major
132Moderate
0Minor
2,697No known interaction
132 Moderate 2,697 No interaction
Moderate

132 interactions

Showing 60 of 132 moderate interactions — see all 132 on the Black Hellebore page.

No interaction 2,697 drugs checked — show the list

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

Showing the 60 most looked-up of 2,697 medications checked with no known interaction — see the full Black Hellebore list.

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

Can you take Black Hellebore with Doripenem?
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 Black Hellebore and Doripenem?
Doripenem belongs to more than one drug category, and Black Hellebore 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 Black Hellebore and Doripenem 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 Doripenem and Black Hellebore?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.