Drug & supplement interaction

Butcher's Broom + Epinephrine

Epinephrine brand names: Epifrin, EpiPen, Primatene Mist (OTC Epinephrine Inhaler), Anapen, Anapen Junior, and others.

Moderate Interaction
The bottom line Moderate

Butcher's Broom has a moderate interaction with Epinephrine. Theoretically, butcher's broom might increase the effects and adverse effects of alpha-adrenergic agonists.

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

Butcher's Broom and Epinephrine

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

Moderate

ALPHA-ADRENERGIC AGONISTS

Why this applies to Epinephrine

Epinephrine falls under ALPHA-ADRENERGIC AGONISTS — the group Butcher's Broom interacts with.

Theoretically, butcher's broom might increase the effects and adverse effects of alpha-adrenergic agonists.
Animal and in vitro studies show that butcher's broom has alpha-adrenergic agonist effects.
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 idea behind this one. Lab and animal studies suggest butcher's broom can act a little like an alpha-adrenergic agonist, meaning it may help tighten blood vessels. Epinephrine (like in your EpiPen) works partly the same way, narrowing blood vessels and raising blood pressure. So in theory, stacking the two could nudge epinephrine's effects up a bit, possibly adding to things like a faster heart rate, jitteriness, or higher blood pressure.

I want to be honest though: this is theoretical, based on pharmacology and not real-world reports in people. And in a true emergency, you should never hesitate to use your epinephrine. If you take butcher's broom regularly for leg circulation, just give your pharmacist or doctor a heads-up so they can keep an eye on your blood pressure.

References
  1. Redman DA. Ruscus aculeatus (butcher's broom) as a potential treatment for orthostatic hypotension, with a case report. J Altern Complement Med 2000;6:539-49..
  2. European Medicines Agency. Assessment report on Ruscus Aculeatus L rhizome. EMEA/HMPC/261939/2007. London, September 4, 2008. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_HMPC_assessment_report/2009/12/WC500018288.pdf. Acces

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

Butcher's Broom Also Interacts With Other Medications

Butcher's Broom has 157 moderate known drug interactions in our database — the Epinephrine 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 Butcher's Broom

Covers the 2,830 medications we’ve checked against Butcher's Broom. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Epinephrine

This page covers Butcher's Broom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epinephrine page lists 18 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 8 moderate · 9 minor.

From our pharmacist’s overview on the Epinephrine page

“Epinephrine is the drug inside an EpiPen, the shot that reverses anaphylaxis, so anything that could blunt it deserves genuine respect. Of the 18 supplements and herbs with interactions on file, activated charcoal is the single major-rated entry, and it stands apart because it can lower drug levels even when a medicine is not swallowed.”

Reviewed by 2 · Jul 18, 2026

Open the Epinephrine interaction page

One more smart check

Taking Butcher's Broom as Part of a Dietary Supplement Product? Check It for Interactions

We hold 439 real supplement products containing Butcher's Broom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Butcher's Broom. Your product may carry other ingredients that interact with Epinephrine too, on top of Butcher's Broom — 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 Butcher's Broom and Epinephrine 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 Butcher's Broom
Top half

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

29 days ago today
Medication Epinephrine
Steady interest

#2,074 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 Butcher's Broom

What is Butcher's Broom?

Butcher's Broom
  • Chronic venous insufficiency
  • Varicose veins
  • Leg swelling and heaviness
  • Hemorrhoids
  • Circulation problems

Butcher's broom is a plant extract most often used for circulation problems in the legs, such as chronic venous insufficiency, where some evidence suggests it may help reduce swelling and discomfort. Quality and dosing vary widely between products, and it should not replace proven treatments. Talk with your pharmacist or doctor before starting it, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Butcher's Broom monograph & all interactions
Medication

About Epinephrine Injection

What Is Epinephrine Injection Used For?

Brand names: Epifrin, EpiPen, Primatene Mist (OTC Epinephrine Inhaler), Anapen, Anapen Junior, EpiPen Jr, Auvi-Q, Symjepi

Epinephrine injection is used for the emergency treatment of anaphylaxis — a severe, potentially life-threatening allergic reaction. Triggers can include stings from bees, wasps, hornets, yellow jackets, and fire ants; bites from insects like mosquitoes; foods; drugs; diagnostic agents; allergen immunotherapy; or exercise. It is also used for anaphylaxis with no identified trigger (idiopathic anaphylaxis).

AUVI-Q (available in 0.3 mg and 0.15 mg strengths) is specifically indicated for patients at increased risk of anaphylaxis, including those with a history of anaphylactic reactions. It is intended for immediate emergency use only — not as a substitute for follow-up medical care.

See full Epinephrine Injection drug information
Keep checking

Other Drugs & Butcher's Broom

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

0Major
157Moderate
0Minor
2,672No known interaction
Moderate

157 interactions

Showing 60 of 157 moderate interactions — see all 157 on the Butcher's Broom page.

No interaction 2,672 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 Butcher's Broom and Epinephrine Together: Common Questions

Can you take Butcher's Broom with Epinephrine?
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 Butcher's Broom and Epinephrine 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 Epinephrine and Butcher's Broom?

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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.