Drug & supplement interaction

Boldo + Sodium Oxybate

Sodium Oxybate brand name: Xyrem.

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 Boldo and Sodium Oxybate 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 label for Sodium Oxybate states a food rule worth keeping to, and 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

Boldo and Sodium Oxybate

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 Sodium Oxybate and Boldo 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.

Boldo safety at a glance

Boldo overall Use caution May be used short-term in low doses, but the ascaridole in the leaf and oil can harm the liver.
Pregnancy Possibly Unsafe When used orally in medicinal amounts. In animals, boldo and the constituent boldine have abortive and teratogenic effects. Also, the ascaridole constituent of... Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally in medicinal amounts. In animals, boldo and the constituent boldine have abortive and teratogenic effects. Also, the ascaridole constituent of... 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 Sodium Oxybate and Boldo? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Sodium Oxybate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Sodium Oxybate is filed under 3 classifications — sodium-containing drugs, seizure threshold lowering drugs, oral drugs. Boldo has documented interactions with 5 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), hepatotoxic drugs (moderate) and lithium (moderate) — and none of Sodium Oxybate’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

Boldo Does Interact With Other Medications

Boldo has 482 moderate known drug interactions in our database — Sodium Oxybate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 482 No known interaction 2,348 (incl. Sodium Oxybate)
Taking anything else?

Check Another of Your Medications Against Boldo

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

What to actually watch for

No Interaction Found — But Data Suggests Boldo and Sodium Oxybate 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.

  • Weight loss Additional detail

    Boldo

    “In one report, a 39-year-old obese female developed palpitations and syncope after taking a weight loss supplement containing a combination of boldo, dandelion, and bladderwrack for 3 weeks. The patient was found to have prolonged QT-interval on ECG and frequent episodes of sustained polymorphic ventricular tachycardia.”

    Boldo · Natural Medicines adverse-effect record, reported in obesity.

    1 source cited
    1. 14321. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed

    Sodium Oxybate

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

  • Reduced appetite Additional detail

    Boldo

    “Orally, boldo is thought to potentially cause hepatotoxicity. The volatile oil from the boldo leaf contains the liver toxin, ascaridole. In one case report, a manufacturer of an herbal laxative reformulated their product to contain boldo.”

    Boldo · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    3 sources cited
    1. 13178. Piscaglia F, Leoni S, Venturi A, et al. Caution in the use of boldo in herbal laxatives: a case of hepatotoxicity. Scand J Gastroenterol 2005;40:236-9. PubMed
    2. 100304. Ribeiro RJ, Silvestre C, Duarte C. Hidden risks of alternative medicines: a case of boldo-induced hepatotoxicity. J Diet Suppl 2017;14(2):186-90. PubMed
    3. 106431. Oliveira Sá A, Pimentel T, Oliveira N. Boldo-Induced Hepatotoxicity: A Case of Unexplained Jaundice. Eur J Case Rep Intern Med 2020;7(12):002116. PubMed

    “In one case report, a manufacturer of an herbal laxative reformulated their product to contain boldo. Within 5 months of switching to this reformulated product, an 82-year-old male developed abdominal discomfort with gastrointestinal upset including heartburn.”

    Boldo · Natural Medicines adverse-effect record, reported in anorexia.

    2 sources cited
    1. 13178. Piscaglia F, Leoni S, Venturi A, et al. Caution in the use of boldo in herbal laxatives: a case of hepatotoxicity. Scand J Gastroenterol 2005;40:236-9. PubMed
    2. 100304. Ribeiro RJ, Silvestre C, Duarte C. Hidden risks of alternative medicines: a case of boldo-induced hepatotoxicity. J Diet Suppl 2017;14(2):186-90. PubMed

    Sodium Oxybate

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

  • Stomach pain Additional detail

    Boldo

    “Orally, boldo is generally well tolerated when used in amounts commonly found in foods. However, when used in medicinal amounts, boldo can cause significant adverse effects such as hepatotoxicity. There is currently a limited amount of information on the adverse effects of topical boldo;”

    Boldo · Natural Medicines adverse-effect record, reported in dermatitis.

    Sodium Oxybate

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

  • Nausea / Vomiting reported in 7.5% of FDA reports for Sodium Oxybate Additional detail

    Boldo

    Recorded for Boldo in the same Natural Medicines adverse-effect record shown under Stomach pain above.

    Sodium Oxybate

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

Reported for Boldo but not commonly for Sodium Oxybate: an irregular heartbeat, stomach upset, liver problems and a fast or pounding heartbeat.

Effects for Sodium Oxybate come from the ADVERSE REACTIONS section of its FDA label; effects for Boldo come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 65,315 voluntary FDA FAERS reports for Sodium Oxybate 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

Boldo in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Unsafe

When used orally in medicinal amounts. In animals, boldo and the constituent boldine have abortive and teratogenic effects. Also, the ascaridole constituent of boldo is a liver toxin.

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

How to take them

Some Sodium Oxybate Products Have a Food Rule — Boldo Should Not Break It

At least one FDA label for a product containing Sodium Oxybate says to take it with food. If you take Boldo on an empty stomach out of habit, keep them separate — and take Sodium Oxybate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Sodium Oxybate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

• Allow 2 hours after eating before dosing ( 2.3 ).

From the Dosage and Administration section of the FDA label we read for Sodium Oxybate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Boldo or Sodium Oxybate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Boldo or Sodium Oxybate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sodium Oxybate

This page covers Boldo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sodium Oxybate page lists 25 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Biofeedback (moderate), Coffee Charcoal (moderate), Dendrobium (moderate) and European Mandrake (moderate).

By severity: 1 major · 15 moderate · 9 minor.

From our pharmacist’s overview on the Sodium Oxybate page

“Activated charcoal is the single major-rated interaction with sodium oxybate (Xyrem), and it earns that rating because the drug only works if each dose is fully absorbed; charcoal can bind it in the gut and weaken the nighttime control it provides for narcolepsy. Treat this list with genuine care, since 17 of the 25 ingredients on file…”

Reviewed by 2 · Jul 18, 2026

Open the Sodium Oxybate interaction page

One more smart check

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

We hold 173 real supplement products containing Boldo, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Boldo. Even though Boldo itself has no known interaction with Sodium Oxybate, 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 Boldo and Sodium Oxybate 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 Boldo
Top half

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

29 days ago today
Medication Sodium Oxybate
Top half

#747 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 Boldo reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Boldo and Sodium Oxybate records this page draws on were last updated July 10, 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 Boldo

What is Boldo?

Boldo
  • Indigestion and bloating
  • Mild constipation
  • Liver and gallbladder support
  • Appetite stimulation
  • Urinary complaints

Boldo is a South American shrub whose leaves are traditionally used for digestive and gallbladder complaints, but good human evidence is very limited. The leaves and oil contain ascaridole, which can be toxic to the liver, so only ascaridole-free products should be used and only for short periods. Talk to your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Peumus boldus · Monimiaceae · Leaves and essential oil · Tea, dried leaf, tincture, capsules, essential oil

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

Boldo: dosing

There is no well-established standardized dose for boldo, and products vary widely in strength and in how much ascaridole they contain. Because of this, it is best to follow the directions on the product label and use it only for short periods.Choose products labeled as ascaridole-free when possible, and avoid the pure essential oil.

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

Read the full Boldo monograph & all interactions
Medication

About Sodium Oxybate

What Is Sodium Oxybate Used For?

Brand name: Xyrem

Sodium oxybate treats two major symptoms of narcolepsy: cataplexy (sudden muscle weakness triggered by emotion) and excessive daytime sleepiness (EDS). It is available in several products, each approved for these uses.

Xyrem (oral solution) and the generic sodium oxybate oral solution are approved for cataplexy or EDS in patients with narcolepsy. Lumryz (extended-release oral suspension) is specifically approved for cataplexy or EDS in patients 7 years of age and older with narcolepsy. The generic sodium oxybate oral solution label does not include the pediatric indication due to marketing exclusivity held by Xyrem.

Most-Reported Side Effects for Sodium Oxybate

From FAERS, the FDA’s public side-effect reporting system (65,536 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 4,928 reports
Anxiety 3,979 reports
Somnolence 3,965 reports
Insomnia 3,371 reports
Feeling abnormal 3,223 reports
See full Sodium Oxybate drug information
Keep checking

Other Drugs & Boldo

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

0Major
482Moderate
0Minor
2,347No known interaction
482 Moderate 2,347 No interaction
Moderate

482 interactions

Showing 60 of 482 moderate interactions — see all 482 on the Boldo page.

No interaction 2,347 drugs checked — show the list

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

Showing the 60 most looked-up of 2,347 medications checked with no known interaction — see the full Boldo list.

See the full Boldo interactions page
See every supplement checked against Sodium Oxybate, ranked by severity
Evidence & sources

Boldo References

The 10 references that drive our Boldo 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. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
  3. Piscaglia F, Leoni S, Venturi A, et al. Caution in the use of boldo in herbal laxatives: a case of hepatotoxicity. Scand J Gastroenterol 2005;40:236-9. PubMed
  4. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  5. Teng, C. M., Hsueh, C. M., Chang, Y. L., Ko, F. N., Lee, S. S., and Liu, K. C. Antiplatelet effects of some aporphine and phenanthrene alkaloids in rabbits and man. J Pharm Pharmacol 1997;49(7):706-711. PubMed
  6. Carbajal R, Yisfalem A, Pradhan N, et al. Case report: Boldo (Peumus boldus) and tacrolimus interaction in a renal transplant patient. Transplant Proc 2014;46(7):2400-2. PubMed
  7. Almeida ER, Melo AM, Xavier H. Toxicological evaluation of the hydro-alcohol extract of the dry leaves of Peumus boldus and boldine in rats. Phytother Res 2000;14(2):99-102. DOI
  8. Ribeiro RJ, Silvestre C, Duarte C. Hidden risks of alternative medicines: a case of boldo-induced hepatotoxicity. J Diet Suppl 2017;14(2):186-90. PubMed
  9. Oliveira Sá A, Pimentel T, Oliveira N. Boldo-Induced Hepatotoxicity: A Case of Unexplained Jaundice. Eur J Case Rep Intern Med 2020;7(12):002116. PubMed
  10. Valdes R, Feuereisen A, Bellinghausen M. Allergic Contact Dermatitis to Boldo. Dermatitis 2021;32(2):e31-e32. PubMed

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 Boldo and Sodium Oxybate Together: Common Questions

Is it safe to take Boldo with Sodium Oxybate?
We do not list a known interaction between Boldo and Sodium Oxybate. 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 Boldo and Sodium Oxybate have any of the same side effects?
Yes — our sources link each of them separately to 5 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.
Should I take Boldo and Sodium Oxybate at the same time of day?
At least one FDA label for a product containing Sodium Oxybate says to take it with food. If you take Boldo on an empty stomach out of habit, keep them separate and take Sodium Oxybate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Sodium Oxybate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Boldo and Sodium Oxybate combination checked?
Interactions in our licensed database are recorded against drug classes. Sodium Oxybate is filed under 3 classifications, and Boldo has documented interactions with 5 drug classes — none of Sodium Oxybate'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 Boldo interact with any other medications?
Yes. Boldo has 482 documented drug interactions in our database — Sodium Oxybate 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 Sodium Oxybate interact with any supplements?
Yes. Sodium Oxybate has documented interactions with 25 supplements in our database — Boldo is not one of them. The Sodium Oxybate 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

Boldo monograph Uses, safety profile, and every drug interaction in one place Sodium Oxybate drug information The full plain-English guide to this medication Sodium Oxybate supplement interactions Every supplement checked against Sodium Oxybate, 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 10 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Sodium Oxybate and Boldo?

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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.