Drug & supplement interaction

Butternut + Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine brand names: Ser-Ap-Es, Unipres, Uniserp.

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

Butternut has a moderate interaction with Hydralazine, Hydrochlorothiazide, Reserpine. Butternut has stimulant laxative effects.

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

Butternut and Hydralazine, Hydrochlorothiazide, Reserpine

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

Moderate

DIURETIC DRUGS

Why this applies to Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine falls under DIURETIC DRUGS — the group Butternut interacts with.

Butternut has stimulant laxative effects. Theoretically, overuse of butternut might compound diuretic-induced potassium loss. There is some concern that people receiving butternut along with potassium-depleting diuretics might be at an increased risk for hypokalemia.
Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), 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

Your combination pill contains hydrochlorothiazide, a water pill that already nudges your body to lose potassium through the urine. Butternut bark acts as a stimulant laxative, and anything that moves your bowels harder can also flush out potassium. Put the two together and, at least in theory, your potassium could dip lower than it should.

I want to be honest about the evidence here: this is a theoretical concern based on how each works, not something proven in studies. Still, low potassium can leave you feeling weak, crampy, tired, or cause an irregular heartbeat, so it is worth respecting. Occasional butternut is unlikely to be a big deal, but regular use is where I'd worry. Please check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Butternut Also Interacts With Other Medications

Butternut has 121 moderate known drug interactions in our database — the Hydralazine, Hydrochlorothiazide, Reserpine one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Hydralazine, Hydrochlorothiazide, Reserpine)
Taking anything else?

Check Another of Your Medications Against Butternut

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

Everything else you take

See Every Supplement That Interacts With Hydralazine, Hydrochlorothiazide, Reserpine

This page covers Butternut only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydralazine, Hydrochlorothiazide, Reserpine page lists 231 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 196 moderate · 25 minor.

From our pharmacist’s overview on the Hydralazine, Hydrochlorothiazide, Reserpine page

“Ser-Ap-Es combines three blood pressure drugs, hydralazine, hydrochlorothiazide, and reserpine, so this list deserves real attention before you add a supplement. Most of the 231 ingredients on file either push blood pressure down further than intended or pile onto the diuretic and drag potassium and fluid levels with it.”

Reviewed by 2 · Jul 18, 2026

Open the Hydralazine, Hydrochlorothiazide, Reserpine interaction page

One more smart check

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

We hold 168 real supplement products containing Butternut, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Butternut. Your product may carry other ingredients that interact with Hydralazine, Hydrochlorothiazide, Reserpine too, on top of Butternut — 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 Butternut and Hydralazine, Hydrochlorothiazide, Reserpine 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 Butternut
Steady interest

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

29 days ago today
Medication Hydralazine, Hydrochlorothiazide, Reserpine
Steady interest

#2,097 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 Butternut

What is Butternut?

  • Constipation (laxative)
  • Digestive complaints
  • Skin conditions
  • Traditional 'liver' or 'cleansing' remedy
  • Mild laxative in herbal blends

Butternut (Juglans cinerea) is a North American tree whose inner bark was traditionally used as a mild laxative and folk remedy. Modern scientific evidence supporting any of its uses is very limited, and it can cause stomach cramping and other effects, so it should be used cautiously and only with guidance from a healthcare professional.

Read the full Butternut monograph & all interactions
Keep checking

Other Drugs & Butternut

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Butternut page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Butternut list.

See the full Butternut interactions page
See every supplement checked against Hydralazine, Hydrochlorothiazide, Reserpine, 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
Butternut monograph › Uses, safety, and every drug interaction in one place Hydralazine, Hydrochlorothiazide, Reserpine supplement interactions › Every supplement checked against Hydralazine, Hydrochlorothiazide, Reserpine, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Butternut and Hydralazine, Hydrochlorothiazide, Reserpine Together: Common Questions

Can you take Butternut with Hydralazine, Hydrochlorothiazide, Reserpine?
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 Butternut and Hydralazine, Hydrochlorothiazide, Reserpine 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 Hydralazine, Hydrochlorothiazide, Reserpine and Butternut?

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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.