Drug & supplement interaction

European Buckthorn + Ketoconazole

Ketoconazole brand name: Nizoral.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between European Buckthorn and Ketoconazole 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 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 Buckthorn and Ketoconazole

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 Ketoconazole and European Buckthorn 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 Buckthorn safety at a glance

European Buckthorn overall Use caution It is a harsh stimulant laxative and raw berries can be toxic, so use only with professional guidance.
Pregnancy Likely Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally; avoid using. 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 Ketoconazole and European Buckthorn? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ketoconazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ketoconazole is filed under 8 classifications — including antifungals, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 2c9 (cyp2c9) inhibitors. European Buckthorn has documented interactions with 4 drug classes — the most serious being digoxin (lanoxin) (major), diuretic drugs (moderate) and stimulant laxatives (moderate) — and none of Ketoconazole’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 Buckthorn Does Interact With Other Medications

European Buckthorn has 1 major, 98 moderate known drug interactions in our database — Ketoconazole isn’t one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 98 No known interaction 2,731 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against European Buckthorn

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

What to actually watch for

No Interaction Found — But Data Suggests European Buckthorn and Ketoconazole May Share Several of the Same Side Effects

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.

  • Stomach pain / Diarrhea Additional detail

    European Buckthorn

    “Orally, European buckthorn seems to be well tolerated, short term. It can cause abdominal pain, cramps, or watery diarrhea (12). Chronic use or abuse of the berry can lead to potassium depletion, albuminuria, and hematuria. Potassium depletion can lead to disturbed heart function and muscle weakness (2).”

    European Buckthorn · Natural Medicines adverse-effect record, reported in albuminuria.

    3 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    3. 6138. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed

    “Orally, European buckthorn can cause abdominal pain, cramps, or watery diarrhea (12). Chronic use can cause pseudomelanosis coli (pigment spots in intestinal mucosa) which is harmless, usually reverses with discontinuation (2), and is not associated with an increased risk of developing colorectal adenoma or carcinoma.”

    European Buckthorn · Natural Medicines adverse-effect record, reported in colorectal adenoma.

    3 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    3. 6138. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed

    Ketoconazole

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

Reported for European Buckthorn but not commonly for Ketoconazole: low potassium and muscle weakness.

Effects for Ketoconazole come from the ADVERSE REACTIONS section of its FDA label; effects for European Buckthorn come from the Natural Medicines adverse-effect record, quoted above. 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 Buckthorn in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally; avoid using.

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

From our Q&A

Questions About European Buckthorn or Ketoconazole

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 Buckthorn or Ketoconazole, 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 Ketoconazole

This page covers European Buckthorn only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 135 moderate · 41 minor.

From our pharmacist’s overview on the Ketoconazole page

“Ketoconazole (Nizoral) is already hard on the liver, so treat its 182 interacting supplements with genuine care, starting with the six rated major. Most of the list runs through CYP3A4, the liver enzyme ketoconazole strongly blocks, so it can raise levels of over a hundred herbal ingredients, while grapefruit pushes ketoconazole itself…”

Reviewed by 2 · Jul 18, 2026

Open the Ketoconazole interaction page

One more smart check

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

We hold 20 real supplement products containing European Buckthorn, each one broken down to its full ingredient list — and combination products often carry several ingredients besides European Buckthorn. Even though European Buckthorn itself has no known interaction with Ketoconazole, 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 Buckthorn and Ketoconazole 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 Buckthorn
Top half

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

29 days ago today
Medication Ketoconazole
Steady interest

#2,170 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 Buckthorn reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The European Buckthorn and Ketoconazole records this page draws on were last updated July 10, 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 Buckthorn

What is European Buckthorn?

  • Constipation
  • Occasional laxative use
  • Digestive complaints
  • Traditional 'detox' remedies

European Buckthorn is a shrub whose bark and berries contain compounds that act as a strong, irritant-type laxative. Because it can cause cramping, fluid and electrolyte loss, and the berries can be toxic if eaten raw, it is rarely recommended today and safer constipation options are usually preferred. Talk to a pharmacist or doctor before using it.

Rhamnus cathartica · Rhamnaceae · Bark and berries (fruit) · Dried bark, tinctures, teas, and liquid extracts (rarely sold as a modern standardized supplement)

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

European Buckthorn: dosing

There is no well-established, standardized dose for European Buckthorn supplements, and the strength of homemade preparations can vary widely. This is one reason it is hard to use safely.If a product is used at all, it should be a properly labeled commercial preparation, taken exactly as directed and only for short-term use.

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

Read the full European Buckthorn monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole 2% shampoo and foam are used to treat tinea versicolor (also called pityriasis versicolor) — a fungal infection caused by Pityrosporum orbiculare (also known as Malassezia furfur), a yeast that naturally lives on the skin.

This infection creates light or dark patches, most often on the trunk, neck, arms, and upper thighs. Even after the fungus is cleared, those skin patches may take months to return to their normal color — that's normal, and depends on your skin type and sun exposure. Tinea versicolor can also come back, since the fungus lives on healthy skin even when there's no active infection.

Most-Reported Side Effects for Ketoconazole

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Pruritus 984 reports
Fatigue 975 reports
Nausea 873 reports
Rash 858 reports
Diarrhea 814 reports
See full Ketoconazole drug information
Keep checking

Other Drugs & European Buckthorn

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

1Major
98Moderate
0Minor
2,730No known interaction
1 Major 98 Moderate 2,730 No interaction
Major

1 interaction

Moderate

98 interactions

Showing 60 of 98 moderate interactions — see all 98 on the European Buckthorn page.

No interaction 2,730 drugs checked — show the list

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

Showing the 60 most looked-up of 2,730 medications checked with no known interaction — see the full European Buckthorn list.

See the full European Buckthorn interactions page
See every supplement checked against Ketoconazole, ranked by severity
Evidence & sources

European Buckthorn References

The 7 references that drive our European Buckthorn 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. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Tyler VE. Herbs of Choice. Binghamton, NY: Pharmaceutical Products Press, 1994.
  3. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  4. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.
  5. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  6. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  7. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. 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 Buckthorn and Ketoconazole Together: Common Questions

Is it safe to take European Buckthorn with Ketoconazole?
We do not list a known interaction between European Buckthorn and Ketoconazole. 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 Buckthorn and Ketoconazole have any of the same side effects?
Yes — our sources link each of them separately to 2 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.
How was the European Buckthorn and Ketoconazole combination checked?
Interactions in our licensed database are recorded against drug classes. Ketoconazole is filed under 8 classifications, and European Buckthorn has documented interactions with 4 drug classes — none of Ketoconazole'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 Buckthorn interact with any other medications?
Yes. European Buckthorn has 99 documented drug interactions in our database — Ketoconazole 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 Ketoconazole interact with any supplements?
Yes. Ketoconazole has documented interactions with 182 supplements in our database — European Buckthorn is not one of them. The Ketoconazole 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 Buckthorn monograph Uses, safety profile, and every drug interaction in one place Ketoconazole drug information The full plain-English guide to this medication Ketoconazole supplement interactions Every supplement checked against Ketoconazole, 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 7 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ketoconazole and European Buckthorn?

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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.