Drug & supplement interaction

European Barberry + Tiagabine

Tiagabine brand name: Gabitril.

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

Tiagabine falls into 2 drug categories that European Barberry can interact with; the most serious is rated moderate. Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.

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

European Barberry and Tiagabine

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. Tiagabine 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

CNS DEPRESSANTS

1 of 2

Why this applies to Tiagabine

Tiagabine falls under CNS DEPRESSANTS — the group European Barberry interacts with.

Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Animal research suggests that berberine, a constituent of European barberry, might have sedative effects. 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 simple version: tiagabine already tends to make people feel drowsy, dizzy, or mentally foggy because it boosts a calming brain chemical. European barberry contains berberine, and in animal studies berberine seemed to have a mild sedating effect of its own. So the worry is that stacking the two could pile on extra sleepiness or slowed thinking.

I'll be honest with you, this is a theoretical concern based on lab and animal work, not real cases in people, so I don't want to alarm you. Still, if you ever feel unusually groggy, unsteady, or have trouble concentrating, that's worth noticing. Please don't start or stop either one on your own. Just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
  2. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Tiagabine 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

Here's the connection worth knowing about. Your body relies on a liver enzyme called CYP3A4 to break down and clear tiagabine (Gabitril). The berberine in European barberry may slow that enzyme down a bit. If it does, tiagabine could clear more slowly and build up in your system, meaning a stronger than expected effect.

With tiagabine specifically, more drug hanging around can mean more drowsiness, dizziness, trouble concentrating, weakness, or feeling unsteady. I want to be honest though: this is a theoretical concern based on lab-level pharmacology, not real patient cases, so it may never amount to much. Still, since seizure medicines need steady levels, please run barberry by your pharmacist or doctor before combining them.

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 Tiagabine one above is among them. If you take anything else, check it against the full list below.

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

This page covers European Barberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tiagabine page lists 214 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 157 moderate · 48 minor.

From our pharmacist’s overview on the Tiagabine page

“Anyone taking tiagabine (Gabitril) for seizures should treat its supplement interactions with real vigilance. The drug is cleared by the liver enzyme CYP3A4, so grapefruit can push its blood level up while St.”

Reviewed by 2 · Jul 18, 2026

Open the Tiagabine 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 Tiagabine 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 Tiagabine 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%

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

29 days ago today
Medication Tiagabine
Steady interest

#2,688 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 Tiagabine

What Is Tiagabine Used For?

Brand name: Gabitril

Tiagabine is used as add-on (adjunctive) therapy for partial seizures. That means it is taken along with other seizure medicines, not on its own.

It is approved for adults and children 12 years and older. Safety and effectiveness have not been established for any other use.

See full Tiagabine 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 Tiagabine, 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 Tiagabine supplement interactions › Every supplement checked against Tiagabine, ranked by severity Tiagabine 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 Tiagabine Together: Common Questions

Can you take European Barberry with Tiagabine?
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 Tiagabine?
Tiagabine 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 Tiagabine 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 Tiagabine 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.