Drug & supplement interaction

Castor Bean + Reserpine, Trichlormethiazide

Reserpine, Trichlormethiazide brand names: Naquival, Metatensin #2, Metatensin #4.

Moderate Interaction
The bottom line Moderate

Castor Bean has a moderate interaction with Reserpine, Trichlormethiazide. Theoretically, castor oil might increase the risk of hypokalemia when taken with diuretic drugs.

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

Castor Bean and Reserpine, Trichlormethiazide

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

Moderate

DIURETIC DRUGS

Why this applies to Reserpine, Trichlormethiazide

Reserpine, Trichlormethiazide falls under DIURETIC DRUGS — the group Castor Bean interacts with.

Theoretically, castor oil might increase the risk of hypokalemia when taken with diuretic drugs.
There is some concern that overuse of castor oil might compound diuretic-induced potassium loss.
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. One of the medicines in your combo, trichlormethiazide, is a water pill (diuretic) that already pulls potassium out of your body through your urine. Castor oil works the other end of things: as a stimulant laxative, it can cause loose, watery stools, and frequent diarrhea also drains potassium. So the worry is that the two together could lower your potassium more than either one alone.

Low potassium can leave you feeling tired, crampy, weak, or with an irregular heartbeat. Keep in mind this is a theoretical concern based on how these products work, mostly tied to overusing castor oil rather than an occasional dose. Before using castor oil with this prescription, just check with your pharmacist or doctor so they can keep an eye on your potassium.

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

Castor Bean Also Interacts With Other Medications

Castor Bean has 74 moderate known drug interactions in our database — the Reserpine, Trichlormethiazide 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 Castor Bean

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

Everything else you take

See Every Supplement That Interacts With Reserpine, Trichlormethiazide

This page covers Castor Bean only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Reserpine, Trichlormethiazide page lists 228 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 · 193 moderate · 25 minor.

From our pharmacist’s overview on the Reserpine, Trichlormethiazide page

“American hellebore is the entry I would flag first on this page. Even small amounts can drive blood pressure down hard, and reserpine with trichlormethiazide (Naquival, Metatensin) is already a two-drug combination built to lower it.”

Reviewed by 2 · Jul 18, 2026

Open the Reserpine, Trichlormethiazide interaction page

How much people look this up

Where Castor Bean and Reserpine, Trichlormethiazide 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 Castor Bean
Top half

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

29 days ago today
Medication Reserpine, Trichlormethiazide
Top half

#1,122 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 Castor Bean

What is Castor Bean?

  • Constipation relief
  • Skin and hair care
  • Labor induction (folk use)
  • Topical anti-inflammatory packs
  • Joint and muscle massage

Castor bean is the source of castor oil, a well-known stimulant laxative, but the raw seeds contain ricin, a potent and potentially deadly poison. The processed oil is generally considered safe when used as directed, while the whole or chewed seeds should never be eaten. Always talk to a pharmacist or doctor before using castor oil, especially during pregnancy or for children.

Read the full Castor Bean monograph & all interactions
Keep checking

Other Drugs & Castor Bean

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

0Major
74Moderate
0Minor
2,755No known interaction
Moderate

74 interactions

Showing 60 of 74 moderate interactions — see all 74 on the Castor Bean page.

No interaction 2,755 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 Castor Bean and Reserpine, Trichlormethiazide Together: Common Questions

Can you take Castor Bean with Reserpine, Trichlormethiazide?
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 Castor Bean and Reserpine, Trichlormethiazide 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.