Drug & supplement interaction

Boxwood + Loperamide

Loperamide brand names: Imodium, Loperamide.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Boxwood has a moderate interaction with Loperamide. Evidence from in vitro research suggests that boxwood extract can inhibit acetylcholinesterase activity.

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

Boxwood and Loperamide

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

Moderate

ANTICHOLINERGIC DRUGS

Why this applies to Loperamide

Loperamide falls under ANTICHOLINERGIC DRUGS — the group Boxwood interacts with.

Evidence from in vitro research suggests that boxwood extract can inhibit acetylcholinesterase activity. Theoretically, concurrent use of anticholinergic drugs and boxwood might decrease the effectiveness of boxwood or the anticholinergic agent.
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 gist of what we have on file for boxwood and loperamide (Imodium). In test-tube studies, compounds in boxwood appear to block an enzyme called acetylcholinesterase. When that enzyme is blocked, more of the body's signal chemical (acetylcholine) sticks around, and that can act against drugs like loperamide that work by quieting gut movement. So in theory, boxwood could nudge loperamide to work a little less well, meaning your diarrhea might not settle as much as you'd hope.

I want to be straight with you though: this is only a lab-based idea, not something seen in real people, so it may not amount to much in practice. The bigger concern is that raw boxwood is toxic. Before mixing the two, please check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Orhan, I., Sener, B., Choudhary, M. I., and Khalid, A. Acetylcholinesterase and butyrylcholinesterase inhibitory activity of some Turkish medicinal plants. J Ethnopharmacol 2004;91(1):57-60. 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

Boxwood Also Interacts With Other Medications

Boxwood has 218 moderate known drug interactions in our database — the Loperamide one above is one of them. If you take anything else, check it against the full list below.

Moderate 218 No known interaction 2,612 (incl. Loperamide)
Taking anything else?

Check Another of Your Medications Against Boxwood

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

From our Q&A

Questions About Boxwood or Loperamide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Boxwood or Loperamide, 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 Loperamide

This page covers Boxwood only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Loperamide page lists 82 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Henbane (major), Scopolia (major), St. John's Wort (major) and Angel's Trumpet (moderate).

By severity: 4 major · 59 moderate · 19 minor.

From our pharmacist’s overview on the Loperamide page

“Loperamide (Imodium) works safely in part because a gut transporter, P-glycoprotein, keeps most of each dose out of the bloodstream, and the biggest group on this list, 37 ingredients, acts on that transporter. St.”

Reviewed by 2 · Jul 18, 2026

Open the Loperamide interaction page

One more smart check

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

We hold 7 real supplement products containing Boxwood, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Boxwood. Your product may carry other ingredients that interact with Loperamide too, on top of Boxwood — 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 Boxwood and Loperamide 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 Boxwood
Steady interest

#1,441 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Loperamide
Top 25%

#485 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 Boxwood

What is Boxwood?

Boxwood
  • HIV/immune support
  • Malaria
  • Arthritis
  • Diabetes
  • Skin conditions
  • Fever

Boxwood is an evergreen shrub whose leaves have been used in folk medicine, most notably in some early studies looking at HIV. The whole plant is toxic, so only processed extracts are used, and solid evidence for any health benefit is very limited. Because of real safety concerns, talk with a pharmacist or doctor before trying boxwood.

Read the full Boxwood monograph & all interactions
Medication

About Loperamide

What Is Loperamide Used For?

Brand names: Imodium, Loperamide

Loperamide controls the symptoms of diarrhea, including traveler's diarrhea, in adults and children 2 years and older. It is available as tablets, capsules, oral solution, and oral suspension across many brand names.

Loperamide Hydrochloride and Loperamide HCl capsules are also approved for chronic diarrhea in adults associated with inflammatory bowel disease, and for reducing the volume of discharge from an ileostomy (a surgical opening in the abdomen that drains waste).

See full Loperamide drug information
Keep checking

Other Drugs & Boxwood

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

0Major
218Moderate
0Minor
2,611No known interaction
218 Moderate 2,611 No interaction
Moderate

218 interactions

Showing 60 of 218 moderate interactions — see all 218 on the Boxwood page.

No interaction 2,611 drugs checked — show the list

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

Showing the 60 most looked-up of 2,611 medications checked with no known interaction — see the full Boxwood list.

See the full Boxwood interactions page
See every supplement checked against Loperamide, ranked by severity
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

Keep exploring
Boxwood monograph › Uses, safety, and every drug interaction in one place Loperamide supplement interactions › Every supplement checked against Loperamide, ranked by severity Loperamide drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Boxwood and Loperamide Together: Common Questions

Can you take Boxwood with Loperamide?
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 Boxwood and Loperamide 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 Loperamide and Boxwood?

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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.