Drug & supplement interaction

European Barberry + Rabeprazole Sodium

Rabeprazole Sodium brand names: Aciphex, Aciphex Sprinkle.

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

European Barberry has a moderate interaction with Rabeprazole Sodium. 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 Rabeprazole Sodium

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Rabeprazole Sodium

Rabeprazole Sodium 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 uses an enzyme called CYP3A4 to help clear rabeprazole (Aciphex). Berberine, the main active compound in European barberry, may gently slow that enzyme down. If it does, a bit more rabeprazole could linger in your system, which in theory might mean slightly stronger effects or a touch more of its usual side effects like headache, diarrhea, or nausea.

I want to be honest about how weak this is. It comes from very early lab thinking, not from real cases in people taking barberry and rabeprazole together. Rabeprazole is also a pretty forgiving medicine, so a small shift usually isn't a big deal. Still, if you plan to use a concentrated berberine or barberry supplement, run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Rabeprazole Sodium one above is one of them. If you take anything else, check it against the full list below.

Moderate 1,211 No known interaction 1,619 (incl. Rabeprazole Sodium)
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.

From our Q&A

Questions About European Barberry or Rabeprazole Sodium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers European Barberry or Rabeprazole Sodium, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Rabeprazole Sodium

This page covers European Barberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rabeprazole Sodium page lists 169 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 · 116 moderate · 50 minor.

From our pharmacist’s overview on the Rabeprazole Sodium page

“Three entries on this rabeprazole (Aciphex) list call for real vigilance before you read further: grapefruit, St. John's wort, and activated charcoal, all rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Rabeprazole Sodium 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 Rabeprazole Sodium 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 Rabeprazole Sodium 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%

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

29 days ago today
Medication Rabeprazole Sodium
Steady interest

#2,354 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 Rabeprazole

What Is Rabeprazole Used For?

Brand names: Aciphex, Aciphex Sprinkle

Rabeprazole delayed-release tablets (sold as AcipHex and as Rabeprazole Sodium) lower stomach acid. In adults, they are used for several conditions. These include healing erosive or ulcerative GERD, keeping it healed, and treating heartburn and other GERD symptoms.

They are also used to heal duodenal ulcers (ulcers in the first part of the small intestine). With the antibiotics amoxicillin and clarithromycin, they treat H. pylori infection in people with duodenal ulcer disease. They are also used long-term for conditions that cause too much stomach acid, including Zollinger-Ellison syndrome. Adolescents 12 and older can take them for up to 8 weeks for symptomatic GERD.

See full Rabeprazole drug information
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
1,211 Moderate 1,618 No 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.

See the full European Barberry interactions page
See every supplement checked against Rabeprazole Sodium, 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
European Barberry monograph › Uses, safety, and every drug interaction in one place Rabeprazole Sodium supplement interactions › Every supplement checked against Rabeprazole Sodium, ranked by severity Rabeprazole drug information › The full plain-English guide to this medication 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 European Barberry and Rabeprazole Sodium Together: Common Questions

Can you take European Barberry with Rabeprazole Sodium?
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 Rabeprazole Sodium 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 Rabeprazole Sodium 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.