Drug & supplement interaction

Black Horehound + Opicapone

Opicapone brand name: Ongentys.

Moderate Interaction
The bottom line Moderate

Black Horehound has a moderate interaction with Opicapone. Theoretically, black horehound might have additive effects when used with dopamine agonists.

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

Black Horehound and Opicapone

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

Moderate

DOPAMINE AGONISTS

Why this applies to Opicapone

Opicapone falls under DOPAMINE AGONISTS — the group Black Horehound interacts with.

Theoretically, black horehound might have additive effects when used with dopamine agonists. Some constituents of black horehound bind to dopamine D2 receptors in vitro; however, this has not yet been reported in humans. Some dopamine agonists include bromocriptine (Parlodel), levodopa (Dopar, component of Sinemet), pramipexole (Mirapex), ropinirole (Requip), and others.
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 honest picture with Opicapone (Ongentys) and black horehound. Opicapone itself isn't a dopamine agonist, but it works hand in hand with your levodopa/carbidopa by helping more of that medicine reach your brain. So anything that nudges your dopamine system in the same direction is worth keeping an eye on.

In lab dishes, some compounds in black horehound seem to attach to dopamine D2 receptors. The worry is that this could add to your Parkinson's treatment and possibly bump up dopamine-related side effects like nausea, dizziness, low blood pressure when standing, or extra involuntary movements (dyskinesia). I'll stress that this is theoretical, seen only in test tubes, never reported in real people. Still, since this is your dopamine balance, please run it by your doctor or pharmacist before adding the herb.

References
  1. Daels-Rakotoarison DA, Seidel V, Gressier B, et al. Neurosedative and antioxidant activities of phenylpropanoids from Ballota nigra. Arzneimittelforschung 2000;50:16-23. 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

Black Horehound Also Interacts With Other Medications

Black Horehound has 22 moderate known drug interactions in our database — the Opicapone one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Black Horehound

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

Everything else you take

See Every Supplement That Interacts With Opicapone

This page covers Black Horehound only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Opicapone page lists 58 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), Ayahuasca (moderate), Bitter Melon (moderate) and Black Pepper (moderate).

By severity: 2 major · 39 moderate · 17 minor.

From our pharmacist’s overview on the Opicapone page

“If you take opicapone (Ongentys) alongside levodopa for Parkinson's disease, don't skim this page. Two entries can genuinely undercut your treatment: St.”

Reviewed by 2 · Jul 18, 2026

Open the Opicapone interaction page

How much people look this up

Where Black Horehound and Opicapone 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 Horehound
Steady interest

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

29 days ago today
Medication Opicapone
Top 25%

#496 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 Horehound

What is Black Horehound?

Black Horehound
  • Nausea and vomiting
  • Anxiety and nervous tension
  • Sleep problems
  • Mild digestive upset
  • Coughs and respiratory complaints

Black horehound is a traditional European herb mainly used for nausea, mild anxiety, and digestive upset, but high-quality human studies are lacking, so its effectiveness is largely unproven. It has a strong, unpleasant smell and taste, and its safety has not been well studied, so it should be avoided in pregnancy and breastfeeding and used cautiously by everyone else.

Read the full Black Horehound monograph & all interactions
Medication

About Opicapone

What Is Opicapone Used For?

Brand name: Ongentys

Ongentys (opicapone) is used alongside levodopa/carbidopa to treat Parkinson's disease in adults who experience 'off' episodes — periods when medication wears off and Parkinson's symptoms return before the next dose is due.

It is not used alone. Ongentys works as an add-on to help levodopa stay active longer, reducing the time patients spend in these 'off' states.

See full Opicapone drug information
Keep checking

Other Drugs & Black Horehound

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

0Major
22Moderate
0Minor
2,807No known interaction
Moderate

22 interactions

No interaction 2,807 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Black Horehound and Opicapone Together: Common Questions

Can you take Black Horehound with Opicapone?
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.
How serious is the Black Horehound and Opicapone 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

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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.