Drug & supplement interaction

European Barberry + Sodium Oxybate

Sodium Oxybate brand name: Xyrem.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between European Barberry and Sodium Oxybate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Sodium Oxybate states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

European Barberry and Sodium Oxybate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Sodium Oxybate and European Barberry in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

European Barberry safety at a glance

European Barberry overall Use caution May be fine short-term for some people, but quality evidence on safe long-term use is limited.
Pregnancy Likely Unsafe When used orally. Berberine is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Berberine and other harmful constituents can be transferred to the infant through breast milk. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Sodium Oxybate and European Barberry? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Sodium Oxybate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Sodium Oxybate is filed under 3 classifications — sodium-containing drugs, seizure threshold lowering drugs, oral drugs. European Barberry has documented interactions with 8 drug classes — the most serious being anticholinergic drugs (moderate), anticoagulant/antiplatelet drugs (moderate) and antidiabetes drugs (moderate) — and none of Sodium Oxybate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

European Barberry Does Interact With Other Medications

European Barberry has 1,210 moderate known drug interactions in our database — Sodium Oxybate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 1,210 No known interaction 1,620 (incl. Sodium Oxybate)
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.

What to actually watch for

No Interaction Found — But Data Suggests European Barberry and Sodium Oxybate May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Reduced appetite Additional detail

    European Barberry

    “Orally, a case of hepatitis-associated aplastic anemia is reported in an adult male after consuming European barberry 15 drops and nannari root 15 drops twice a day for 2 weeks. The patient presented with lethargy, loss of appetite, and jaundice that progressed to high-grade fevers, chills, rigors, severe pancytopenia, and abnormal liver function tests. Liver biopsy was suggestive of drug-induced liver injury.”

    European Barberry · Natural Medicines adverse-effect record, reported in anemia.

    1 source cited
    1. 110021. Philips CA, Theruvath AH, Ravindran R. Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use. BMJ Case Rep 2022;15(3):e247867. PubMed

    Sodium Oxybate

    Listed in the ADVERSE REACTIONS section of the FDA label for Sodium Oxybate. Read the label on DailyMed ›

Reported for European Barberry but not commonly for Sodium Oxybate: liver problems, a low platelet count, a higher chance of infection and yellowing of the skin or eyes.

Effects for Sodium Oxybate come from the ADVERSE REACTIONS section of its FDA label; effects for European Barberry come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 65,315 voluntary FDA FAERS reports for Sodium Oxybate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

European Barberry in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. Berberine is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine.

Lactation Likely Unsafe

When used orally. Berberine and other harmful constituents can be transferred to the infant through breast milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Sodium Oxybate Products Have a Food Rule — European Barberry Should Not Break It

At least one FDA label for a product containing Sodium Oxybate says to take it with food. If you take European Barberry on an empty stomach out of habit, keep them separate — and take Sodium Oxybate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Sodium Oxybate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

• Allow 2 hours after eating before dosing ( 2.3 ).

From the Dosage and Administration section of the FDA label we read for Sodium Oxybate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About European Barberry or Sodium Oxybate

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 Sodium Oxybate, 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 Sodium Oxybate

This page covers European Barberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sodium Oxybate page lists 25 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Biofeedback (moderate), Coffee Charcoal (moderate), Dendrobium (moderate) and European Mandrake (moderate).

By severity: 1 major · 15 moderate · 9 minor.

From our pharmacist’s overview on the Sodium Oxybate page

“Activated charcoal is the single major-rated interaction with sodium oxybate (Xyrem), and it earns that rating because the drug only works if each dose is fully absorbed; charcoal can bind it in the gut and weaken the nighttime control it provides for narcolepsy. Treat this list with genuine care, since 17 of the 25 ingredients on file…”

Reviewed by 2 · Jul 18, 2026

Open the Sodium Oxybate 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. Even though European Barberry itself has no known interaction with Sodium Oxybate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where European Barberry and Sodium Oxybate 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

#1,029 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sodium Oxybate
Top 10%

#212 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every European Barberry reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The European Barberry and Sodium Oxybate records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Berberis vulgaris · Berberidaceae · Root, root bark, stem bark, leaf, and fruit (berries) · Capsules, tablets, dried herb, tea, tincture/liquid extract, topical preparations

An interaction check asks whether these two react with each other — it does not ask whether European Barberry is a good idea for someone in your situation. Here is what our European Barberry record says about it on its own.

European Barberry: dosing

There is no well-established standard dose for European barberry as a whole herb. Products vary widely in strength and in how much berberine they contain, which makes a single recommended amount difficult to give.If you choose to use a barberry or berberine product, follow the directions on the product label and do not exceed them. They can help you decide if it is appropriate and what amount, if any, is reasonable for you.

From our European Barberry monograph — the full record covers uses, side effects and every documented interaction.

Read the full European Barberry monograph & all interactions
Medication

About Sodium Oxybate

What Is Sodium Oxybate Used For?

Brand name: Xyrem

Sodium oxybate treats two major symptoms of narcolepsy: cataplexy (sudden muscle weakness triggered by emotion) and excessive daytime sleepiness (EDS). It is available in several products, each approved for these uses.

Xyrem (oral solution) and the generic sodium oxybate oral solution are approved for cataplexy or EDS in patients with narcolepsy. Lumryz (extended-release oral suspension) is specifically approved for cataplexy or EDS in patients 7 years of age and older with narcolepsy. The generic sodium oxybate oral solution label does not include the pediatric indication due to marketing exclusivity held by Xyrem.

Most-Reported Side Effects for Sodium Oxybate

From FAERS, the FDA’s public side-effect reporting system (65,536 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 4,928 reports
Anxiety 3,979 reports
Somnolence 3,965 reports
Insomnia 3,371 reports
Feeling abnormal 3,223 reports
See full Sodium Oxybate 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
1,210Moderate
0Minor
1,619No known interaction
1,210 Moderate 1,619 No interaction
Moderate

1,210 interactions

Showing 60 of 1,210 moderate interactions — see all 1,210 on the European Barberry page.

No interaction 1,619 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 1,619 medications checked with no known interaction — see the full European Barberry list.

See the full European Barberry interactions page
See every supplement checked against Sodium Oxybate, ranked by severity
Evidence & sources

European Barberry References

The 15 references that drive our European Barberry monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. PubMed
  2. 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
  3. Shamsa F, Ahmadiani A, Khosrokhavar R. Antihistaminic and anticholinergic activity of barberry fruit (Berberis vulgaris) in the guinea-pig ileum. J Ethnopharmacol 1999;64:161-6. PubMed
  4. Fatehi M, Saleh TM, Fatehi-Hassanabad Z, et al. A pharmacological study on Berberis vulgaris fruit extract. J Ethnopharmacol 2005;102:46-52. PubMed
  5. Kostalova, D., Bukovsky, M., Koscova, H., and Kardosova, A. [Anticomplement activity of Mahonia aquifolium bisbenzylisoquinoline alkaloids and berberine extract]. Ceska.Slov.Farm 2001;50(6):286-289.
  6. 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.
  7. Singh, J. and Kakkar, P. Antihyperglycemic and antioxidant effect of Berberis aristata root extract and its role in regulating carbohydrate metabolism in diabetic rats. J Ethnopharmacol. 5-4-2009;123(1):22-26. PubMed
  8. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  9. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  10. Xuan, B., Wang, W., and Li, D. X. Inhibitory effect of tetrahydroberberine on platelet aggregation and thrombosis. Zhongguo Yao Li Xue.Bao. 1994;15(2):133-135.
  11. Gao, C. R., Zhang, J. Q., and Huang, Q. L. [Experimental study on berberin raised insulin sensitivity in insulin resistance rat models]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 1997;17(3):162-164. DOI
  12. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  13. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.
  14. 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
  15. Philips CA, Theruvath AH, Ravindran R. Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use. BMJ Case Rep 2022;15(3):e247867. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking European Barberry and Sodium Oxybate Together: Common Questions

Is it safe to take European Barberry with Sodium Oxybate?
We do not list a known interaction between European Barberry and Sodium Oxybate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do European Barberry and Sodium Oxybate have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take European Barberry and Sodium Oxybate at the same time of day?
At least one FDA label for a product containing Sodium Oxybate says to take it with food. If you take European Barberry on an empty stomach out of habit, keep them separate and take Sodium Oxybate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Sodium Oxybate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the European Barberry and Sodium Oxybate combination checked?
Interactions in our licensed database are recorded against drug classes. Sodium Oxybate is filed under 3 classifications, and European Barberry has documented interactions with 8 drug classes — none of Sodium Oxybate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does European Barberry interact with any other medications?
Yes. European Barberry has 1,210 documented drug interactions in our database — Sodium Oxybate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Sodium Oxybate interact with any supplements?
Yes. Sodium Oxybate has documented interactions with 25 supplements in our database — European Barberry is not one of them. The Sodium Oxybate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

European Barberry monograph Uses, safety profile, and every drug interaction in one place Sodium Oxybate drug information The full plain-English guide to this medication Sodium Oxybate supplement interactions Every supplement checked against Sodium Oxybate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Sodium Oxybate 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.