Drug & supplement interaction

Chanca Piedra + Bisoprolol, Hydrochlorothiazide

Bisoprolol, Hydrochlorothiazide brand name: Ziac.

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

Bisoprolol, Hydrochlorothiazide falls into 2 drug categories that Chanca Piedra can interact with; the most serious is rated moderate. Theoretically, concomitant use of chanca piedra with diuretics might increase diuresis.

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

Chanca Piedra and Bisoprolol, Hydrochlorothiazide

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

Why Are There 2 Interactions?

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

Moderate

DIURETIC DRUGS

1 of 2

Why this applies to Bisoprolol, Hydrochlorothiazide

Bisoprolol, Hydrochlorothiazide falls under DIURETIC DRUGS — the group Chanca Piedra interacts with.

Theoretically, concomitant use of chanca piedra with diuretics might increase diuresis.
Some preliminary clinical research in adults with hypertension shows that chanca piedra has diuretic properties. However, higher quality research in adults with kidney stones shows taking chanca piedra does not increase urine volume when compared with placebo. Until more is known, use cautiously in patients taking diuretic drugs.
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. Your Ziac contains hydrochlorothiazide, a water pill, plus bisoprolol for blood pressure. Some early research hints that chanca piedra may act as a mild diuretic too. So in theory, taking them together might add up and make you urinate a bit more than usual.

If that happened, you could feel lightheaded, dizzy when standing, more thirsty, or unusually tired, and your potassium or sodium could drift. I want to be honest though: this concern is theoretical, based on how the herb might work, and one good study in people with kidney stones found it did not actually raise urine output. So it may well be a non-issue. Still, since you're on a real blood pressure combo, check with your pharmacist or doctor before adding chanca piedra, and watch for dizziness.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Srividya N, Periwal S. Diuretic, hypotensive and hypoglycaemic effect of Phyllanthus amarus. Indian J Exp Biol 1995; 33:861-4.
  2. Nishiura, J. L., Campos, A. H., Boim, M. A., Heilberg, I. P., and Schor, N. Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients. Urol.Res 2004;32(5):362-366. PubMed
Minor

ANTIHYPERTENSIVE DRUGS

2 of 2

Bisoprolol, Hydrochlorothiazide also falls under ANTIHYPERTENSIVE DRUGS.

Theoretically, concomitant use of chanca piedra with antihypertensive drugs might have additive blood pressure lowering effects.
Animal research suggests that chanca piedra can decrease blood pressure. However, this effect was not observed in most hypertensive patients treated with chanca piedra for 10 days.
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 gist with Ziac (bisoprolol plus hydrochlorothiazide) and chanca piedra. Your Ziac already works to bring blood pressure down, the bisoprolol by slowing the heart and the water pill by helping you shed extra fluid. The concern on file is simply that chanca piedra might nudge blood pressure down a little further, adding to what your medicine is already doing.

Honestly, this is mostly theoretical. Animal studies hinted at a blood-pressure-lowering effect, but in people taking it for about 10 days, that effect wasn't really seen. So the odds of a problem are low. Still, if you notice dizziness, lightheadedness, or feeling faint when standing up, check in with your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Srividya N, Periwal S. Diuretic, hypotensive and hypoglycaemic effect of Phyllanthus amarus. Indian J Exp Biol 1995; 33:861-4.
  2. Amaechina, F. C. and Omogbai, E. K. Hypotensive effect of aqueous extract of the leaves of Phyllanthus amarus Schum and Thonn (Euphorbiaceae). Acta Pol.Pharm. 2007;64(6):547-552.

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

Chanca Piedra Also Interacts With Other Medications

Chanca Piedra has 872 moderate, 149 minor known drug interactions in our database — the Bisoprolol, Hydrochlorothiazide one above is among them. If you take anything else, check it against the full list below.

Moderate 872 Minor 149 No known interaction 1,809 (incl. Bisoprolol, Hydrochlorothiazide)
Taking anything else?

Check Another of Your Medications Against Chanca Piedra

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

Everything else you take

See Every Supplement That Interacts With Bisoprolol, Hydrochlorothiazide

This page covers Chanca Piedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bisoprolol, Hydrochlorothiazide page lists 276 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: 11 major · 234 moderate · 31 minor.

From our pharmacist’s overview on the Bisoprolol, Hydrochlorothiazide page

“This is one of the supplement lists I would read closely before adding anything alongside bisoprolol and hydrochlorothiazide (Ziac). The combination already lowers blood pressure two ways, and most of these interactions push on those same levers, either dropping pressure further or acting like extra diuretics that compound potassium an…”

Reviewed by 2 · Jul 18, 2026

Open the Bisoprolol, Hydrochlorothiazide interaction page

One more smart check

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

We hold 355 real supplement products containing Chanca Piedra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chanca Piedra. Your product may carry other ingredients that interact with Bisoprolol, Hydrochlorothiazide too, on top of Chanca Piedra — 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 Chanca Piedra and Bisoprolol, Hydrochlorothiazide 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 Chanca Piedra
Top 25%

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

29 days ago today
Medication Bisoprolol, Hydrochlorothiazide
Top 25%

#470 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 Chanca Piedra

What is Chanca Piedra?

Chanca Piedra
  • Kidney stones
  • Gallstones
  • Liver support
  • Urinary tract health
  • Digestive complaints

Chanca piedra is a tropical herb traditionally used as a 'stone breaker' for kidney and gallstones, and for liver and urinary health. Human evidence for these uses is limited and mostly small or preliminary, so it should not replace proven treatments. Talk with your pharmacist or doctor before using it, especially if you have a medical condition or take medications.

Read the full Chanca Piedra monograph & all interactions
Keep checking

Other Drugs & Chanca Piedra

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

0Major
872Moderate
149Minor
1,808No known interaction
872 Moderate 149 Minor 1,808 No interaction
Moderate

872 interactions

Showing 60 of 872 moderate interactions — see all 872 on the Chanca Piedra page.

Minor

149 interactions

Showing 60 of 149 minor interactions — see all 149 on the Chanca Piedra page.

No interaction 1,808 drugs checked — show the list

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

Showing the 60 most looked-up of 1,808 medications checked with no known interaction — see the full Chanca Piedra list.

See the full Chanca Piedra interactions page
See every supplement checked against Bisoprolol, Hydrochlorothiazide, 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
Chanca Piedra monograph › Uses, safety, and every drug interaction in one place Bisoprolol, Hydrochlorothiazide supplement interactions › Every supplement checked against Bisoprolol, Hydrochlorothiazide, 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 Chanca Piedra and Bisoprolol, Hydrochlorothiazide Together: Common Questions

Can you take Chanca Piedra with Bisoprolol, Hydrochlorothiazide?
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 Chanca Piedra and Bisoprolol, Hydrochlorothiazide?
Bisoprolol, Hydrochlorothiazide belongs to more than one drug category, and Chanca Piedra 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 Chanca Piedra and Bisoprolol, Hydrochlorothiazide 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.