Drug & supplement interaction

Bulbine Natalensis + Digoxin

Digoxin brand names: Lanoxicaps, Lanoxin, Digitek.

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

Digoxin falls into 2 drug categories that Bulbine Natalensis can interact with; the most serious is rated moderate. Theoretically, Bulbine natalensis stem might increase the levels and clinical effects of p-glycoprotein substrates.

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

Bulbine Natalensis and Digoxin

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

Why Are There 2 Interactions?

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Digoxin

Digoxin falls under P-GLYCOPROTEIN SUBSTRATES — the group Bulbine Natalensis interacts with.

Theoretically, Bulbine natalensis stem might increase the levels and clinical effects of p-glycoprotein substrates.
In vitro research shows that Bulbine natalensis stem extract induces p-glycoprotein mRNA expression; however, effects on transporter expression were not evaluated.
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 situation with digoxin and Bulbine natalensis. Your body uses a kind of cellular pump called P-glycoprotein to move digoxin around and help clear it out. Lab research suggests Bulbine may nudge this pump to work a bit harder. If that happens in people, your body could push out digoxin faster, which might lower its level and make it less effective at controlling your heart rate or treating your heart failure.

I want to be honest though: this is theoretical, based only on a test-tube study, not real patients. Still, digoxin has a very narrow safety window, so even small shifts matter. Please don't change anything on your own. Just check in with your pharmacist or doctor before trying this supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Manda V, Alhusban M, et al. Modulation of CYP3A4 and CYP2C9 activity by Bulbine natalensis and its constituents: An assessment of HDI risk of B. natalensis containing supplements. Phytomedicine 2021;81:153416. PubMed
Moderate

DIGOXIN (Lanoxin)

2 of 2
Theoretically, Bulbine natalensis stem might increase the risk of adverse effects and toxicity when taken with digoxin.
Bulbine natalensis stem may contain cardiac glycosides, although it is unclear if these chemicals are present in clinically relevant concentrations.
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 this libido supplement and your digoxin. Bulbine natalensis may naturally contain cardiac glycosides, which are the same family of compounds that digoxin itself belongs to. If that's true, stacking the two could add up and push your digoxin effect higher than intended.

That matters because digoxin has a very narrow safety window. Too much can cause nausea, loss of appetite, blurry or yellow-tinged vision, confusion, and dangerous slow or irregular heartbeats. I want to be honest though: this warning is theoretical. We don't actually know whether Bulbine contains these compounds in amounts large enough to matter in people. To stay on the safe side, please check with your doctor or pharmacist before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Afolayan AJ, Yakubu MT. Effect of Bulbine natalensis Baker Stem Extract on the Functional Indices and Histology of the Liver and Kidney of Male Wistar Rats. J Med Food. 2009;12(4):814-820.

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

Bulbine Natalensis Also Interacts With Other Medications

Bulbine Natalensis has 918 moderate known drug interactions in our database — the Digoxin one above is among them. If you take anything else, check it against the full list below.

Moderate 918 No known interaction 1,912 (incl. Digoxin)
Taking anything else?

Check Another of Your Medications Against Bulbine Natalensis

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

From our Q&A

Questions About Bulbine Natalensis or Digoxin

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

This page covers Bulbine Natalensis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Digoxin page lists 113 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Aloe (major), Blue Flag (major), Danshen (major) and European Buckthorn (major).

By severity: 18 major · 79 moderate · 16 minor.

From our pharmacist’s overview on the Digoxin page

“Digoxin is a heart medicine with a narrow therapeutic index, meaning the gap between a helpful blood level and a harmful one is small, and few drugs give me more pause when supplements enter the picture. The most serious entries here are herbs that themselves contain digoxin-like cardiac glycosides, foxglove and lily-of-the-valley amon…”

Reviewed by 2 · Jul 18, 2026

Open the Digoxin interaction page

One more smart check

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

We hold 51 real supplement products containing Bulbine Natalensis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bulbine Natalensis. Your product may carry other ingredients that interact with Digoxin too, on top of Bulbine Natalensis — 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 Bulbine Natalensis and Digoxin 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 Bulbine Natalensis
Steady interest

#1,115 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Digoxin
Top half

#775 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 Bulbine Natalensis

What is Bulbine Natalensis?

  • Boosting testosterone
  • Improving libido
  • Muscle building and athletic performance
  • General male vitality

Bulbine natalensis is a South African plant marketed mainly as a testosterone-boosting and libido supplement, but the human evidence is essentially absent and most claims come from animal studies. Animal research has also raised concerns about possible liver and kidney harm at higher doses, so caution is warranted. Talk to your pharmacist or doctor before trying it.

Read the full Bulbine Natalensis monograph & all interactions
Medication

About Digoxin

What Is Digoxin Used For?

Brand names: Lanoxicaps, Lanoxin, Digitek

Digoxin tablets, oral solution, and injections (including Lanoxin brand) are all approved to treat mild to moderate heart failure in adults — improving symptoms like exercise tolerance and reducing hospitalizations, though it does not extend life. It is also approved to control the resting ventricular rate (how fast the lower chambers beat) in adults with chronic atrial fibrillation. The oral solution specifically notes it should not be used for multifocal atrial tachycardia.

In children with heart failure, digoxin is used to strengthen the heart's contractions (increase myocardial contractility). Digoxin is best used alongside a diuretic (water pill) and an ACE inhibitor when possible.

See full Digoxin drug information
Keep checking

Other Drugs & Bulbine Natalensis

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

0Major
918Moderate
0Minor
1,911No known interaction
918 Moderate 1,911 No interaction
Moderate

918 interactions

Showing 60 of 918 moderate interactions — see all 918 on the Bulbine Natalensis page.

No interaction 1,911 drugs checked — show the list

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

Showing the 60 most looked-up of 1,911 medications checked with no known interaction — see the full Bulbine Natalensis list.

See the full Bulbine Natalensis interactions page
See every supplement checked against Digoxin, 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
Bulbine Natalensis monograph › Uses, safety, and every drug interaction in one place Digoxin supplement interactions › Every supplement checked against Digoxin, ranked by severity Digoxin 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 Bulbine Natalensis and Digoxin Together: Common Questions

Can you take Bulbine Natalensis with Digoxin?
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 Bulbine Natalensis and Digoxin?
Digoxin belongs to more than one drug category, and Bulbine Natalensis 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 Bulbine Natalensis and Digoxin 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 Digoxin and Bulbine Natalensis?

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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.