Drug & supplement interaction

Buchu + Diclofenac Potassium

Diclofenac Potassium brand names: Voltaren Rapide, Cataflam, Cataflam IR, Voltarol Rapid, Cambia.

Moderate Interaction
The bottom line Moderate

Diclofenac Potassium falls into 2 drug categories that Buchu can interact with; the most serious is rated moderate. Buchu contains pulegone, a known hepatotoxin.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Buchu and Diclofenac Potassium

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Buchu interacts with whole categories of medication. Diclofenac Potassium falls into 2 of those categories, so it can interact with Buchu in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Diclofenac Potassium

Diclofenac Potassium falls under HEPATOTOXIC DRUGS — the group Buchu interacts with.

Buchu contains pulegone, a known hepatotoxin. There is some concern that buchu may adversely affect the liver, especially when the leaf is used in large doses or the oil is ingested. Theoretically, concomitant use with hepatotoxic drugs might increase the risk of liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (Tricor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo)
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 simple version: this isn't about buchu changing how your body handles diclofenac. It's about two things that can both be hard on the liver showing up at the same time. Diclofenac is a common anti-inflammatory, and on its own it can occasionally stress the liver and bump up liver enzymes. Buchu contains a compound called pulegone, which in larger amounts (especially as the concentrated oil) is known to be tough on the liver too.

The concern is mostly theoretical and based on the chemistry, not on real cases in people, so I don't want you to panic. A leaf tea now and then is very different from swallowing the oil daily. Still, since both touch the liver, it's worth running this combo past your pharmacist or doctor first.

References
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Moolla A, Viljoen AM. 'Buchu' - Agathosma betulina and Agathosma crenulata (Retaceae): a review. J Ethnopharmacol 2008;119(3):413-9.
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Diclofenac Potassium also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Buchu may have antiplatelet effects. Theoretically, buchu may enhance the effects of anticoagulant or antiplatelet drugs and increase the risk of bleeding in some patients. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), 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 gist with Buchu and diclofenac potassium. Diclofenac is an NSAID, and like most NSAIDs it already has a mild blood-thinning effect because it slows down platelets, the cells that help your blood clot. Buchu is thought to nudge platelets in the same direction. Stack the two together and, in theory, you could bruise more easily, take longer to stop bleeding from a small cut, or have a higher chance of stomach upset or stomach bleeding, which is a known risk with diclofenac.

I'll be honest, this concern rests on very thin evidence, mostly tradition rather than real studies, so for most people it's a small worry. Still, if you're on diclofenac regularly, take other blood thinners, or have a sensitive stomach, check with your pharmacist or doctor before adding buchu.

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

Buchu Also Interacts With Other Medications

Buchu has 480 moderate known drug interactions in our database — the Diclofenac Potassium one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Buchu

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

From our Q&A

Questions About Buchu or Diclofenac Potassium

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

This page covers Buchu only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac Potassium page lists 306 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

Open the Diclofenac Potassium interaction page

One more smart check

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

We hold 128 real supplement products containing Buchu, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Buchu. Your product may carry other ingredients that interact with Diclofenac Potassium too, on top of Buchu — 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 Buchu and Diclofenac Potassium 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 Buchu
Top 25%

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

29 days ago today
Medication Diclofenac Potassium
Top half

#814 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 Buchu

What is Buchu?

Buchu
  • Urinary tract complaints
  • Diuretic (increasing urine flow)
  • Bloating and fluid retention
  • Mild digestive upset
  • Antimicrobial/antiseptic use
  • Flavoring and fragrance

Buchu is a fragrant South African shrub whose leaves are traditionally used for urinary and bladder complaints and as a diuretic. Solid human studies are lacking, so its benefits are largely unproven, and it should be avoided in pregnancy and breastfeeding. Talk to a pharmacist or doctor before using it, especially if you have kidney or liver problems.

Read the full Buchu monograph & all interactions
Medication

About Diclofenac

What Is Diclofenac Used For?

Brand names: Voltaren Rapide, Cataflam, Cataflam IR, Voltarol Rapid, Cambia

Diclofenac sodium topical gel is used to treat actinic keratoses (AK) — rough, scaly skin patches that form after years of sun exposure. These patches are considered precancerous, meaning they can develop into skin cancer if left untreated.

This is a topical gel, meaning it is applied directly to the skin over the affected area rather than taken by mouth. It belongs to the NSAID (nonsteroidal anti-inflammatory drug) family.

See full Diclofenac drug information
Keep checking

Other Drugs & Buchu

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

0Major
480Moderate
0Minor
2,349No known interaction
Moderate

480 interactions

Showing 60 of 480 moderate interactions — see all 480 on the Buchu page.

No interaction 2,349 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

Keep exploring
Pharmacist Counseling Corner

Taking Buchu and Diclofenac Potassium Together: Common Questions

Can you take Buchu with Diclofenac Potassium?
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.
Why are there 2 interactions listed for Buchu and Diclofenac Potassium?
Diclofenac Potassium belongs to more than one drug category, and Buchu interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Buchu and Diclofenac Potassium 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.