Drug & supplement interaction

European Barberry + Levamlodipine

Levamlodipine brand name: Conjupri.

Moderate Interaction
The bottom line Moderate

Levamlodipine falls into 2 drug categories that European Barberry can interact with; the most serious is rated moderate. Theoretically, taking European barberry with antihypertensive drugs might increase the risk of hypotension.

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

European Barberry and Levamlodipine

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

Why Are There 2 Interactions?

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

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Levamlodipine

Levamlodipine falls under ANTIHYPERTENSIVE DRUGS — the group European Barberry interacts with.

Theoretically, taking European barberry with antihypertensive drugs might increase the risk of hypotension.
Animal and human research suggests that European barberry extracts can have hypotensive effects.
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

Levamlodipine (Conjupri) is a calcium channel blocker that lowers blood pressure by relaxing your blood vessels. European barberry, mostly through its berberine content, has shown its own mild blood-pressure-lowering effect in some animal and human studies. So if you pair the two, the worry is simple math: two things pushing your pressure down at once could push it a little too low.

Keep in mind this concern is theoretical and based mostly on pharmacology, not strong human trials. Still, watch for signs of low blood pressure like dizziness, lightheadedness when you stand up, headache, or unusual tiredness. Levamlodipine isn't a prodrug, so this is an additive effect, not a change in how the drug is broken down. Before adding barberry, check with your pharmacist or doctor.

References
  1. Fatehi M, Saleh TM, Fatehi-Hassanabad Z, et al. A pharmacological study on Berberis vulgaris fruit extract. J Ethnopharmacol 2005;102:46-52. PubMed
  2. Fatehi-Hassanabad, Z., Jafarzadeh, M., Tarhini, A., and Fatehi, M. The antihypertensive and vasodilator effects of aqueous extract from Berberis vulgaris fruit on hypertensive rats. Phytother Res 2005;19(3):222-225.
  3. Lazavi F, Mirmiran P, Sohrab G, Nikpayam O, Angoorani P, Hedayati M. The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: A randomized clinical trial. Complement Ther Clin Pract. 2018;31:170-174. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Levamlodipine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, European barberry might increase the levels and clinical effects of CYP3A4 substrates.
There is very preliminary evidence suggesting that berberine, a constituent of European barberry, might inhibit the CYP3A4 enzyme. Theoretically, European barberry might have a similar effect.
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

Levamlodipine (Conjupri) is a calcium channel blocker that lowers your blood pressure, and your body clears it using an enzyme called CYP3A4. The thinking here is that berberine, found in European barberry, may slow that enzyme down a bit. If that happens, more levamlodipine could linger in your system, which can nudge its effects up.

In practice, that might mean more of the usual side effects: lightheadedness, flushing, headache, swollen ankles, or feeling a little dizzy when you stand. I want to be honest though, this is only a theoretical concern based on lab clues, not proven in people, and food amounts of barberry are unlikely to matter. Before adding a concentrated berberine supplement, please run it by your pharmacist or doctor.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. 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

European Barberry Also Interacts With Other Medications

European Barberry has 1,209 moderate known drug interactions in our database — the Levamlodipine 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 European Barberry

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

Everything else you take

See Every Supplement That Interacts With Levamlodipine

This page covers European Barberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levamlodipine page lists 232 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), Coleus (major) and Grapefruit (major).

By severity: 7 major · 183 moderate · 42 minor.

Open the Levamlodipine interaction page

One more smart check

Taking European Barberry as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing European Barberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides European Barberry. Your product may carry other ingredients that interact with Levamlodipine too, on top of European Barberry — 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 European Barberry and Levamlodipine 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 European Barberry
Steady interest

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

29 days ago today
Medication Levamlodipine
Top half

#1,140 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 European Barberry

What is European Barberry?

European Barberry
  • Digestive upset
  • Antimicrobial support
  • Blood sugar support
  • Cholesterol and metabolic support
  • Skin conditions

European barberry is a shrub whose root, bark, and berries contain berberine, a bitter plant alkaloid that has been studied mostly in isolated form. Some early research on berberine is promising for blood sugar and cholesterol, but high-quality evidence for the whole barberry herb is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full European Barberry monograph & all interactions
Keep checking

Other Drugs & European Barberry

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

0Major
1,209Moderate
0Minor
1,620No known interaction
Moderate

1,209 interactions

Showing 60 of 1,209 moderate interactions — see all 1,209 on the European Barberry page.

No interaction 1,620 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 European Barberry and Levamlodipine Together: Common Questions

Can you take European Barberry with Levamlodipine?
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 European Barberry and Levamlodipine?
Levamlodipine belongs to more than one drug category, and European Barberry 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 European Barberry and Levamlodipine 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.