Drug & supplement interaction

Black Hellebore + Orlistat

Orlistat brand names: Xenical, Alli.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Black Hellebore and Orlistat in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Black Hellebore and Orlistat

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Orlistat and Black Hellebore in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Black Hellebore safety at a glance

Black Hellebore overall Avoid All parts are poisonous and can cause serious, potentially fatal harm.
Pregnancy Likely Unsafe When used orally because it can have menstrual stimulant or abortifacient effects; avoid using. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Orlistat and Black Hellebore? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Orlistat

Interactions in our licensed database are recorded against drug classes, not just single drug names. Orlistat is filed under 2 classifications — including oral drugs. Black Hellebore has documented interactions with 6 drug classes — the most serious being digoxin (lanoxin) (moderate), diuretic drugs (moderate) and macrolide antibiotics (moderate) — and none of Orlistat’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Black Hellebore Does Interact With Other Medications

Black Hellebore has 133 moderate known drug interactions in our database — Orlistat isn’t one of them. If you take anything else, check it against the full list below.

Moderate 133 No known interaction 2,697 (incl. Orlistat)
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.

What to actually watch for

No Interaction Found — But Data Suggests Black Hellebore and Orlistat May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Diarrhea / Vomiting / Nausea reported in 7.6% of FDA reports for Orlistat Additional detail

    Black Hellebore

    “Orally, black hellebore can cause GI irritation and an irregular heartbeat (18, 19). The symptoms of poisoning from black hellebore include scratchy throat or mouth, salivation, nausea, vomiting, diarrhea, dizziness, shortness of breath, spasm, and asphyxiation (18).

    Topically, the fresh plant may cause irritation or inflammation when handled (19).”

    Black Hellebore · Natural Medicines adverse-effect record, reported in diarrhea.

    2 sources cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    2. 19. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

    “Orally, black hellebore can cause GI irritation (19). The symptoms of poisoning from black hellebore include scratchy throat or mouth, nausea, vomiting, and diarrhea (18).”

    Black Hellebore · Natural Medicines adverse-effect record, reported in diarrhea.

    2 sources cited
    1. 19. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

    Orlistat

    Listed in the ADVERSE REACTIONS section of the FDA label for Orlistat, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Dizziness Additional detail

    Black Hellebore

    “Orally, the symptoms of poisoning from black hellebore include salivation and dizziness (18).”

    Black Hellebore · Natural Medicines adverse-effect record, reported in poisoning.

    1 source cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

    Orlistat

    Listed in the ADVERSE REACTIONS section of the FDA label for Orlistat. Read the label on DailyMed ›

Reported for Black Hellebore but not commonly for Orlistat: an irregular heartbeat, shortness of breath and sore throat.

Effects for Orlistat come from the ADVERSE REACTIONS section of its FDA label; effects for Black Hellebore come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 25,755 voluntary FDA FAERS reports for Orlistat that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Black Hellebore in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally because it can have menstrual stimulant or abortifacient effects; avoid using.

Lactation Likely Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Orlistat

This page covers Black Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Orlistat page lists 18 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Fish Oil (moderate) and Glucomannan (moderate).

By severity: 1 major · 8 moderate · 9 minor.

From our pharmacist’s overview on the Orlistat page

“People who take Orlistat (Xenical, Alli) for weight loss often browse the very supplement aisle where fiber products and fish oil sit, and both show up on this page, so it deserves genuine attention before you mix anything in. Nearly all 18 ingredients on file can change how oral medications absorb from the gut, and the single major-ra…”

Reviewed by 2 · Jul 18, 2026

Open the Orlistat 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. Even though Black Hellebore itself has no known interaction with Orlistat, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Black Hellebore and Orlistat 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
Steady interest

#1,139 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Orlistat
Top half

#896 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Black Hellebore reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Black Hellebore and Orlistat records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Helleborus niger · Ranunculaceae · Root and rhizome (historically) · Rarely sold today; historically dried root, powders, and tinctures

An interaction check asks whether these two react with each other — it does not ask whether Black Hellebore is a good idea for someone in your situation. Here is what our Black Hellebore record says about it on its own.

Black Hellebore: dosing

There is no safe or established dose of Black Hellebore. Because it is poisonous and the line between a historical "dose" and a toxic amount is very small, no responsible dosing guidance can be given.We do not recommend taking Black Hellebore in any form. If you come across a product that contains it, do not use it without first talking to a doctor or pharmacist.

From our Black Hellebore monograph — the full record covers uses, side effects and every documented interaction.

Read the full Black Hellebore monograph & all interactions
Medication

About Orlistat

What Is Orlistat Used For?

Brand names: Xenical, Alli

Xenical and prescription-strength orlistat are approved to help obese adults lose weight and keep it off when used with a reduced-calorie diet. They are intended for people with a body mass index (BMI) of 30 or higher, or 27 or higher if other risk factors such as high blood pressure, diabetes, or dyslipidemia (abnormal cholesterol or fat levels in the blood) are present.

Alli is the over-the-counter version, approved for weight loss in overweight adults 18 and older when used with a reduced-calorie, low-fat diet and exercise program.

Most-Reported Side Effects for Orlistat

From FAERS, the FDA’s public side-effect reporting system (25,755 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Rectal discharge 2,434 reports
Gastrointestinal disorder 2,186 reports
Constipation 1,991 reports
Diarrhea 1,960 reports
Weight increased 1,944 reports
See full Orlistat 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
133Moderate
0Minor
2,696No known interaction
133 Moderate 2,696 No interaction
Moderate

133 interactions

Showing 60 of 133 moderate interactions — see all 133 on the Black Hellebore page.

No interaction 2,696 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 2,696 medications checked with no known interaction — see the full Black Hellebore list.

See the full Black Hellebore interactions page
See every supplement checked against Orlistat, ranked by severity
Evidence & sources

Black Hellebore References

The 5 references that drive our Black Hellebore monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Tyler VE. Herbs of Choice. Binghamton, NY: Pharmaceutical Products Press, 1994.
  2. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Black Hellebore and Orlistat Together: Common Questions

Is it safe to take Black Hellebore with Orlistat?
We do not list a known interaction between Black Hellebore and Orlistat. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Black Hellebore and Orlistat have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Black Hellebore and Orlistat combination checked?
Interactions in our licensed database are recorded against drug classes. Orlistat is filed under 2 classifications, and Black Hellebore has documented interactions with 6 drug classes — none of Orlistat's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Black Hellebore interact with any other medications?
Yes. Black Hellebore has 133 documented drug interactions in our database — Orlistat is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Orlistat interact with any supplements?
Yes. Orlistat has documented interactions with 18 supplements in our database — Black Hellebore is not one of them. The Orlistat interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Black Hellebore monograph Uses, safety profile, and every drug interaction in one place Orlistat drug information The full plain-English guide to this medication Orlistat supplement interactions Every supplement checked against Orlistat, 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 References The 5 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Orlistat and Black Hellebore?

Our pharmacists answer your medication & supplement questions — free.

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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.