Drug & supplement interaction

Blue Cohosh + Triamterene

Triamterene brand name: Dyrenium.

Moderate Interaction
The bottom line Moderate

Blue Cohosh has a moderate interaction with Triamterene. Constituents in blue cohosh might increase blood pressure by causing coronary vasoconstriction.

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

Blue Cohosh and Triamterene

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Triamterene

Triamterene falls under ANTIHYPERTENSIVE DRUGS — the group Blue Cohosh interacts with.

Constituents in blue cohosh might increase blood pressure by causing coronary vasoconstriction. Theoretically, concomitant use might decrease the effectiveness of drugs used for angina and high blood pressure; use with caution. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many 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 concern with pairing blue cohosh and triamterene (Dyrenium). Triamterene is a water pill that helps your body get rid of extra fluid, and it's sometimes part of a plan to manage blood pressure and swelling from heart or liver problems. Blue cohosh contains compounds that, at least in lab and animal work, may tighten blood vessels and nudge blood pressure upward. If that happens in people, it could work against what your triamterene is trying to do, making it less effective at controlling fluid or pressure.

I'll be honest with you: this is a theoretical interaction based on how the herb behaves, not on solid human studies. Still, blue cohosh carries real safety worries of its own, especially for the heart. I'd skip it unless your doctor or pharmacist okays it.

References
  1. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 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

Blue Cohosh Also Interacts With Other Medications

Blue Cohosh has 258 moderate known drug interactions in our database — the Triamterene 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 Blue Cohosh

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

Everything else you take

See Every Supplement That Interacts With Triamterene

This page covers Blue Cohosh only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Triamterene page lists 165 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), Asarabacca (major) and Siberian Cocklebur (major).

By severity: 6 major · 136 moderate · 23 minor.

From our pharmacist’s overview on the Triamterene page

“Because triamterene (Dyrenium) both lowers blood pressure and hangs onto potassium, its supplement list calls for real vigilance. Six of the 165 ingredients on file carry a major rating, and those six deserve your attention before any others.”

Reviewed by 2 · Jul 18, 2026

Open the Triamterene interaction page

One more smart check

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

We hold 126 real supplement products containing Blue Cohosh, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Blue Cohosh. Your product may carry other ingredients that interact with Triamterene too, on top of Blue Cohosh — 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 Blue Cohosh and Triamterene 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 Blue Cohosh
Steady interest

#1,066 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Triamterene
Steady interest

#2,656 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 Blue Cohosh

What is Blue Cohosh?

  • Inducing labor or starting menstruation
  • Menstrual cramps and irregular periods
  • Symptoms of menopause
  • Pelvic or uterine discomfort
  • Traditional Native American remedy

Blue cohosh is a traditional herb historically used by Native Americans and midwives to bring on labor or menstruation, but it carries serious safety concerns, especially for the heart and during pregnancy. There is very little reliable human evidence that it works, and reports of harm—including serious problems in newborns—make it an herb most people should avoid without close professional supervision.

Read the full Blue Cohosh monograph & all interactions
Medication

About Triamterene

What Is Triamterene Used For?

Brand name: Dyrenium

Triamterene capsules are used to treat edema — excess fluid buildup in the body — linked to several conditions, including congestive heart failure, cirrhosis of the liver, and nephrotic syndrome (a kidney disorder causing protein loss and swelling). It is also used for steroid-induced edema, idiopathic edema (fluid retention with no clear cause), and edema due to secondary hyperaldosteronism (overproduction of a hormone that causes the body to hold onto sodium and water).

It can be used on its own or alongside other diuretics, either to boost fluid removal or to help preserve potassium levels. Both Dyrenium and Triamterene capsules share the same approved uses as described above.

See full Triamterene drug information
Keep checking

Other Drugs & Blue Cohosh

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

0Major
258Moderate
0Minor
2,571No known interaction
Moderate

258 interactions

Showing 60 of 258 moderate interactions — see all 258 on the Blue Cohosh page.

No interaction 2,571 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 Blue Cohosh and Triamterene Together: Common Questions

Can you take Blue Cohosh with Triamterene?
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 Blue Cohosh and Triamterene 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 Triamterene and Blue Cohosh?

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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.