Drug & supplement interaction

European Barberry + Mavacamten

Mavacamten brand name: Camzyos.

Moderate Interaction
The bottom line Moderate

European Barberry has a moderate interaction with Mavacamten. Theoretically, European barberry might increase the levels and clinical effects of CYP3A4 substrates.

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

European Barberry and Mavacamten

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Mavacamten

Mavacamten falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group European Barberry interacts with.

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

Here's the gist: your body relies on a liver enzyme called CYP3A4 to clear Mavacamten (Camzyos) from your system. Berberine, the main active compound in European barberry, is thought to slow that same enzyme down. If it does, Mavacamten could clear more slowly and build up higher than expected in your blood.

Why that matters: Mavacamten works by relaxing the heart muscle, and too much of it can lower your heart's pumping strength (your ejection fraction). That can lead to symptoms like shortness of breath, swelling, dizziness, or fainting. To be honest, this warning is theoretical and based on early lab signals, not real patient reports, so don't panic. But because Mavacamten is dosed so carefully, please check with your pharmacist or cardiologist before adding barberry or berberine.

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 1,211 moderate known drug interactions in our database — the Mavacamten 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 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 Mavacamten

This page covers European Barberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mavacamten page lists 143 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 100 moderate · 40 minor.

From our pharmacist’s overview on the Mavacamten page

“Grapefruit is the first thing I would set aside for anyone taking mavacamten (Camzyos), the medicine for obstructive hypertrophic cardiomyopathy. It blocks CYP3A4, the liver enzyme that clears mavacamten, and too much of this drug can weaken the heart's pumping strength, the very problem careful dosing exists to prevent.”

Reviewed by 2 · Jul 18, 2026

Open the Mavacamten 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 Mavacamten 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 Mavacamten 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
Top 25%

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

29 days ago today
Medication Mavacamten
Steady interest

#2,547 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
Medication

About Mavacamten

What Is Mavacamten Used For?

Brand name: Camzyos

Camzyos is used in adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM). This is a condition where the heart muscle is thickened and can block blood flow out of the heart.

It is meant for people with New York Heart Association (NYHA) class II-III symptoms. The goal is to improve how well you can be active and to ease your symptoms.

See full Mavacamten drug information Mavacamten NDC codes and packages
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
1,211Moderate
0Minor
1,618No known interaction
Moderate

1,211 interactions

Showing 60 of 1,211 moderate interactions — see all 1,211 on the European Barberry page.

No interaction 1,618 drugs checked — show the list

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

Showing the 60 most looked-up of 1,618 medications checked with no known interaction — see the full European Barberry 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 Mavacamten Together: Common Questions

Can you take European Barberry with Mavacamten?
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 European Barberry and Mavacamten 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

Still Have a Question About Mavacamten and European Barberry?

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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.