Drug & supplement interaction

Clubmoss + Edrophonium, Atropine

Edrophonium, Atropine brand name: Enlon-Plus.

Moderate Interaction
The bottom line Moderate

Edrophonium, Atropine falls into 3 drug categories that Clubmoss can interact with; the most serious is rated moderate. Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Clubmoss and Edrophonium, Atropine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Clubmoss interacts with whole categories of medication. Edrophonium, Atropine falls into 3 of those categories, so it can interact with Clubmoss in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICHOLINERGIC DRUGS

1 of 3

Why this applies to Edrophonium, Atropine

Edrophonium, Atropine falls under ANTICHOLINERGIC DRUGS — the group Clubmoss interacts with.

Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity. Theoretically, concurrent use of anticholinergic drugs and clubmoss might decrease the effectiveness of club moss or the anticholinergic agent. Some anticholinergic drugs include atropine, benztropine (Cogentin), biperiden (Akineton), procyclidine (Kemadrin), and trihexyphenidyl (Artane).
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. Clubmoss seems to block an enzyme called acetylcholinesterase, which means it acts a bit like a cholinergic agent (it boosts the chemical acetylcholine). The atropine part of Enlon-Plus does the opposite. It's an anticholinergic that works by blocking acetylcholine. So in theory, these two could fight each other and partly cancel each other out. If atropine is being used to dry secretions, raise a slow heart rate, or counter side effects, clubmoss might blunt how well it works.

That said, this is only a theory from test-tube research, not from people. Enlon-Plus is given by a doctor in a monitored setting, so this isn't really a take-at-home combo. Still, always tell your care team about any supplement like clubmoss before a procedure.

References
  1. Orhan, I., Terzioglu, S., and Sener, B. Alpha-onocerin: an acetylcholinesterase inhibitor from Lycopodium clavatum. Planta Med. 2003;69(3):265-267.
Moderate

ACETYLCHOLINESTERASE (AChE) INHIBITORS

2 of 3

Edrophonium, Atropine also falls under ACETYLCHOLINESTERASE (AChE) INHIBITORS.

Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity. Theoretically, concurrent use of clubmoss with other acetylcholinesterase (AChE) inhibitors might have additive effects and increase the risk of cholinergic side effects. AChE inhibitors and cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).
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 gist. Clubmoss has been shown, in lab dish studies only, to block the same enzyme (acetylcholinesterase) that edrophonium blocks. Edrophonium is itself a short-acting cholinesterase inhibitor, often paired with atropine in Enlon-Plus during procedures like reversing muscle relaxants. So in theory, stacking clubmoss on top could add to that cholinergic push and bring on more of those side effects: a slow heartbeat, extra saliva and watery eyes, sweating, belly cramps, or trouble breathing.

I want to be honest about the strength here. This is test-tube evidence, not proven in people, so it stays theoretical. Edrophonium is also a quick, controlled drug given by a clinician, who watches you closely. Still, given clubmoss can be toxic, please mention any supplement use to your doctor or pharmacist beforehand.

References
  1. Orhan, I., Terzioglu, S., and Sener, B. Alpha-onocerin: an acetylcholinesterase inhibitor from Lycopodium clavatum. Planta Med. 2003;69(3):265-267.
Moderate

CHOLINERGIC DRUGS

3 of 3

Edrophonium, Atropine also falls under CHOLINERGIC DRUGS.

Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity. Theoretically, concurrent use of clubmoss with other cholinergic drugs might have additive effects and increase the risk of cholinergic side effects. AChE inhibitors and cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).
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 gist for this combo. Lab studies hint that clubmoss can block acetylcholinesterase, the same enzyme that edrophonium blocks. When you slow that enzyme, the body's own acetylcholine piles up and its effects get stronger. So in theory, stacking clubmoss on top of edrophonium could push cholinergic effects too far, things like a slow heartbeat, watery eyes, drooling, sweating, nausea, cramping, or trouble breathing.

I'll be honest with you though: this is only test-tube evidence, not human studies, so it's more of a caution than a proven problem. The atropine paired with edrophonium actually works in the opposite direction to balance things out. Clubmoss also carries its own toxic alkaloids. Please loop in your doctor or pharmacist before mixing them.

References
  1. Orhan, I., Terzioglu, S., and Sener, B. Alpha-onocerin: an acetylcholinesterase inhibitor from Lycopodium clavatum. Planta Med. 2003;69(3):265-267.

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

Clubmoss Also Interacts With Other Medications

Clubmoss has 218 moderate known drug interactions in our database — the Edrophonium, Atropine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Clubmoss

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

Everything else you take

See Every Supplement That Interacts With Edrophonium, Atropine

This page covers Clubmoss only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Edrophonium, Atropine page lists 34 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Henbane (major), Scopolia (major), Angel's Trumpet (moderate), Arenaria Rubra (moderate) and Bacopa (moderate).

By severity: 2 major · 29 moderate · 3 minor.

From our pharmacist’s overview on the Edrophonium, Atropine page

“Enlon-Plus combines edrophonium, which raises levels of the nerve messenger acetylcholine, with atropine, which tempers its side effects, and the supplements listed below can tip that balance in either direction. I read this list with real caution.”

Reviewed by 2 · Jul 18, 2026

Open the Edrophonium, Atropine interaction page

How much people look this up

Where Clubmoss and Edrophonium, Atropine 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 Clubmoss
Top half

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

29 days ago today
Medication Edrophonium, Atropine
Top half

#1,113 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 Clubmoss

What is Clubmoss?

Clubmoss
  • Bladder and kidney complaints
  • Digestive upset
  • Skin irritation and chafing
  • Respiratory problems
  • Used in homeopathy

Clubmoss (Lycopodium clavatum) is a primitive plant with a long history in folk medicine and homeopathy, but there is very little reliable human research to show it works for any health condition. It contains potentially toxic alkaloids, so it should be used with great caution, and people who are pregnant or breastfeeding should avoid it. Talk with a pharmacist or doctor before trying it.

Read the full Clubmoss monograph & all interactions
Keep checking

Other Drugs & Clubmoss

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

0Major
218Moderate
0Minor
2,611No known interaction
Moderate

218 interactions

Showing 60 of 218 moderate interactions — see all 218 on the Clubmoss page.

No interaction 2,611 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 Clubmoss and Edrophonium, Atropine Together: Common Questions

Can you take Clubmoss with Edrophonium, Atropine?
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 3 interactions listed for Clubmoss and Edrophonium, Atropine?
Edrophonium, Atropine belongs to more than one drug category, and Clubmoss 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 Clubmoss and Edrophonium, Atropine 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.