Drug & supplement interaction

English Ivy + Propranolol Hydrochloride

Propranolol Hydrochloride brand name: Hemangeol.

Moderate Interaction
The bottom line Moderate

Propranolol Hydrochloride falls into 2 drug categories that English Ivy can interact with; the most serious is rated moderate. Theoretically, English ivy might increase the levels of drugs metabolized by CYP2C19.

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

English Ivy and Propranolol Hydrochloride

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 2

Why this applies to Propranolol Hydrochloride

Propranolol Hydrochloride falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group English Ivy interacts with.

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2C19.
In vitro research shows that English ivy inhibits CYP2C19 enzymes. So far, this interaction has not been reported in humans.
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: lab studies suggest English ivy may slow down a liver enzyme called CYP2C19, which is one of the pathways your body uses to break down propranolol. If that pathway is blocked, propranolol could build up a little more than expected. Propranolol isn't a prodrug, so more drug in the body means a stronger beta-blocker effect, things like a slower heart rate, lower blood pressure, or a sleepy, sluggish baby.

That said, this is purely a test-tube finding and hasn't actually been seen in people, so I wouldn't lose sleep over it. Since propranolol for infant hemangioma is carefully dosed, it's still worth a quick chat with your pediatrician or pharmacist before adding any ivy-containing cough product.

References
  1. Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7). PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 2

Propranolol Hydrochloride also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2D6.
In vitro research shows that English ivy inhibits CYP2D6 enzymes. So far, this interaction has not been reported in humans.
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 basic idea with English ivy and propranolol. Your child's body uses a liver enzyme called CYP2D6 to help clear propranolol. In lab dish studies, English ivy appears to slow that same enzyme down. If that were to happen in a real person, propranolol could build up a bit and act stronger than expected.

With infants on propranolol for hemangioma, the things to watch for are a slower heart rate, low blood sugar (poor feeding, sleepiness, shakiness), or low blood pressure. I want to stress this is theoretical, seen only in test tubes and never reported in actual patients, so don't panic. Still, since this is a baby on a carefully dosed medicine, please check with your pediatrician or pharmacist before giving any English ivy cough product.

References
  1. Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7). PubMed

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

English Ivy Also Interacts With Other Medications

English Ivy has 279 moderate known drug interactions in our database — the Propranolol Hydrochloride 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 English Ivy

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

Everything else you take

See Every Supplement That Interacts With Propranolol Hydrochloride

This page covers English Ivy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Propranolol Hydrochloride page lists 236 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), Indian Snakeroot (major) and Tyramine (major).

Open the Propranolol Hydrochloride interaction page

One more smart check

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

We hold 118 real supplement products containing English Ivy, each one broken down to its full ingredient list — and combination products often carry several ingredients besides English Ivy. Your product may carry other ingredients that interact with Propranolol Hydrochloride too, on top of English Ivy — 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 English Ivy and Propranolol Hydrochloride 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 English Ivy
Top half

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

29 days ago today
Medication Propranolol Hydrochloride
Top half

#1,390 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 English Ivy

What is English Ivy?

English Ivy
  • Cough and chest congestion
  • Bronchitis
  • Asthma symptoms
  • Sore throat
  • Skin irritation

English ivy leaf extract is most commonly used in cough and cold syrups to help loosen mucus and ease coughing, and it is a popular ingredient in many European herbal products. Some research suggests it may help with certain coughs, but the evidence is still limited and mixed. The raw plant is poisonous if eaten and can irritate skin, so only use properly prepared commercial products and check with your pharmacist first.

Read the full English Ivy monograph & all interactions
Medication

About Propranolol (Infantile Hemangioma)

What Is Propranolol (Infantile Hemangioma) Used For?

Brand name: Hemangeol

This intravenous (IV) form of propranolol is used in hospital settings to treat serious, life-threatening heart rhythm problems. It works on several types of abnormal rhythms, including those that happen during anesthesia or are caused by drug toxicity.

Specific uses include fast heart rhythms coming from the upper chambers of the heart (supraventricular tachycardia), dangerous rhythms caused by too much digitalis in the body, and certain fast rhythms triggered by excess stress hormones (catecholamines) during surgery.

See full Propranolol (Infantile Hemangioma) drug information
Keep checking

Other Drugs & English Ivy

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

0Major
279Moderate
0Minor
2,550No known interaction
Moderate

279 interactions

Showing 60 of 279 moderate interactions — see all 279 on the English Ivy page.

No interaction 2,550 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 English Ivy and Propranolol Hydrochloride Together: Common Questions

Can you take English Ivy with Propranolol Hydrochloride?
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 English Ivy and Propranolol Hydrochloride?
Propranolol Hydrochloride belongs to more than one drug category, and English Ivy 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 English Ivy and Propranolol Hydrochloride 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.