Drug & supplement interaction

Calabar Bean + Procainamide

Procainamide brand names: Pronestyl, Procanbid, Procan SR, Procan, Pronestyl-SR.

Minor Interaction
The bottom line Minor

Calabar Bean has a minor interaction with Procainamide. Theoretically, taking calabar bean might reduce the effects of anticholinergic drugs.

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

Calabar Bean and Procainamide

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

Minor

ANTICHOLINERGIC DRUGS

Why this applies to Procainamide

Procainamide falls under ANTICHOLINERGIC DRUGS — the group Calabar Bean interacts with.

Theoretically, taking calabar bean might reduce the effects of anticholinergic drugs.
Physostigmine, a constituent of calabar bean, reverses the effects of belladonna and other drugs with anticholinergic activity.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the idea behind this pairing. Procainamide is a heart rhythm medicine that, among other things, has some mild anticholinergic (acetylcholine-blocking) activity. Calabar bean contains physostigmine, which does the opposite. It boosts acetylcholine. So in theory, the bean could nudge against procainamide's effect a little.

I want to be straight with you, though. This is a theoretical concern only, based on how these chemicals behave, not on real patient reports, and it's rated minor and unlikely. The far bigger issue is that Calabar bean itself is genuinely poisonous and is not a safe supplement to take at all. Please don't use it. If you have questions about your procainamide, talk with your pharmacist or doctor.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 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

Calabar Bean Also Interacts With Other Medications

Calabar Bean has 194 minor known drug interactions in our database — the Procainamide 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 Calabar Bean

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

Everything else you take

See Every Supplement That Interacts With Procainamide

This page covers Calabar Bean only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Procainamide page lists 59 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 9 major · 39 moderate · 11 minor.

From our pharmacist’s overview on the Procainamide page

“Procainamide treats serious heart rhythm problems, and anything that nudges the heart's electrical timing further can turn a helpful drug into a hazard, so I would give this list genuine care. Nine of the 59 supplements on file carry a major rating, and the 13 QT prolongers are the ones to understand first.”

Reviewed by 2 · Jul 18, 2026

Open the Procainamide interaction page

How much people look this up

Where Calabar Bean and Procainamide 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 Calabar Bean
Steady interest

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

29 days ago today
Medication Procainamide
Top 10%

#242 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 Calabar Bean

What is Calabar Bean?

Calabar Bean
  • Source of physostigmine (a prescription drug ingredient)
  • Historically used in 'trial by ordeal' rituals
  • Traditional pain relief and anti-inflammatory uses
  • Historically used for eye conditions (glaucoma)
  • Historically used as a poison

Calabar bean is a highly poisonous West African seed that contains physostigmine, a powerful cholinesterase inhibitor. It is not a safe dietary supplement, and eating the bean can cause serious poisoning or death. Only the purified, regulated drug physostigmine has a legitimate medical use, and that must be prescribed and monitored by a doctor.

Read the full Calabar Bean monograph & all interactions
Medication

About Procainamide

What Is Procainamide Used For?

Brand names: Pronestyl, Procanbid, Procan SR, Procan, Pronestyl-SR

Procainamide hydrochloride injection is used to treat documented, life-threatening ventricular arrhythmias — most notably sustained ventricular tachycardia (a dangerously fast heart rhythm originating in the lower chambers of the heart). Because of its serious risk profile, it is reserved for situations where the benefit clearly outweighs the risk.

Procainamide is not recommended for minor or asymptomatic arrhythmias, and treatment should always be started in a hospital setting where close monitoring is possible. Antiarrhythmic drugs, including procainamide, have not been shown to improve survival in patients with arrhythmias that are not life-threatening.

See full Procainamide drug information
Keep checking

Other Drugs & Calabar Bean

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

0Major
0Moderate
194Minor
2,635No known interaction
Minor

194 interactions

Showing 60 of 194 minor interactions — see all 194 on the Calabar Bean page.

No interaction 2,635 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 Calabar Bean and Procainamide Together: Common Questions

Can you take Calabar Bean with Procainamide?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Calabar Bean and Procainamide interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.