Drug & supplement interaction

Black Horehound + Rotigotine

Rotigotine brand name: Neupro.

Moderate Interaction
The bottom line Moderate

Black Horehound has a moderate interaction with Rotigotine. 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 Rotigotine

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

Moderate

DOPAMINE AGONISTS

Why this applies to Rotigotine

Rotigotine 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 for your Neupro (rotigotine) patch. Rotigotine works by acting like dopamine in the brain, and some compounds in black horehound have been shown to attach to those same dopamine receptors in a test tube. The concern is that the two could add together and push the dopamine signal a little harder than intended.

I want to be clear that this is a theoretical worry only. It has been seen in lab dishes, not in real people, so I wouldn't lose sleep over it. Still, if you did notice more nausea, dizziness, lightheadedness when standing, drowsiness, or unusual sleepiness, that would be worth mentioning. Before adding this herb, just run it by your pharmacist or doctor so they can keep an eye on things.

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 Rotigotine 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 Rotigotine

This page covers Black Horehound only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rotigotine page lists 7 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Ayahuasca (moderate), Dimethylsulfoxide (dmso) (moderate), Syrian Rue (moderate), Turpentine Oil (moderate) and Vitex Agnus-castus (moderate).

By severity: 6 moderate · 1 minor.

From our pharmacist’s overview on the Rotigotine page

“Rotigotine (Neupro) treats Parkinson's disease and restless legs through a skin patch, and the seven supplement interactions on file split along those two facts. None rates major, six are moderate and one minor, so this reads as a watch list rather than a stop list.”

Reviewed by 2 · Jul 18, 2026

Open the Rotigotine interaction page

How much people look this up

Where Black Horehound and Rotigotine 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
Top half

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

29 days ago today
Medication Rotigotine
Top half

#725 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 Rotigotine Transdermal Patch

What Is Rotigotine Transdermal Patch Used For?

Brand name: Neupro

Neupro (rotigotine transdermal patch) is approved to treat Parkinson's disease — both early-stage and advanced-stage. It helps manage the movement-related symptoms of Parkinson's by stimulating dopamine receptors in the brain.

Neupro is also approved to treat moderate-to-severe primary Restless Legs Syndrome (RLS) — an uncomfortable urge to move the legs, often worse at night, that isn't caused by another medical condition.

See full Rotigotine Transdermal Patch 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 Rotigotine Together: Common Questions

Can you take Black Horehound with Rotigotine?
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 Rotigotine 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.