Drug & supplement interaction

European Mandrake + Pyridostigmine Bromide

Pyridostigmine Bromide brand names: Mestinon, Regonol.

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

European Mandrake has a moderate interaction with Pyridostigmine Bromide. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.

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

European Mandrake and Pyridostigmine Bromide

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

Moderate

ORAL DRUGS

Why this applies to Pyridostigmine Bromide

Pyridostigmine Bromide falls under ORAL DRUGS — the group European Mandrake interacts with.

Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First things first: European mandrake is genuinely toxic, and I'd urge you not to take it at all. Beyond that, there's a more specific clash here. Pyridostigmine works by boosting a nervous system signal (acetylcholine) so your muscles fire better. Mandrake's tropane alkaloids (atropine, scopolamine) do the exact opposite, they block that same signal. So mandrake can directly work against your Mestinon, meaning your myasthenia gravis weakness could come creeping back.

On top of that, mandrake slows your gut down, which could theoretically change how much pyridostigmine your body absorbs. This part is based on pharmacology reasoning, not solid studies, so the exact effect is hard to predict. Either way, please don't combine these, and talk with your doctor or pharmacist before adding anything new.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

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 Mandrake Also Interacts With Other Medications

European Mandrake has 2,041 moderate known drug interactions in our database — the Pyridostigmine Bromide one above is one of them. If you take anything else, check it against the full list below.

Moderate 2,041 No known interaction 789 (incl. Pyridostigmine Bromide)
Taking anything else?

Check Another of Your Medications Against European Mandrake

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

Everything else you take

See Every Supplement That Interacts With Pyridostigmine Bromide

This page covers European Mandrake only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pyridostigmine Bromide page lists 39 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Arenaria Rubra (moderate), Bacopa (moderate), Bael (moderate) and Betel Nut (moderate).

By severity: 1 major · 28 moderate · 10 minor.

From our pharmacist’s overview on the Pyridostigmine Bromide page

“Activated charcoal is the single major-rated risk among the 39 supplements on file for pyridostigmine (Mestinon, Regonol), and it belongs at the top of your attention. Charcoal can soak up the medicine in the gut before it works, and for someone counting on pyridostigmine to keep muscles strong in myasthenia gravis, a blunted dose can…”

Reviewed by 2 · Jul 18, 2026

Open the Pyridostigmine Bromide interaction page

How much people look this up

Where European Mandrake and Pyridostigmine Bromide 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 Mandrake
Top 25%

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

29 days ago today
Medication Pyridostigmine Bromide
Top 25%

#625 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 Mandrake

What is European Mandrake?

European Mandrake
  • Insomnia (traditional)
  • Pain relief (historical)
  • Anxiety or depression (folk use)
  • Gout and aches (traditional)
  • Sedation or anesthesia (historical)

European mandrake is a highly toxic plant from the nightshade family that was used in ancient and medieval times as a sedative and pain reliever. It contains powerful poisons that can cause serious harm or death, and there is no proof it safely treats any condition. We strongly recommend you do not consume mandrake in any form.

Read the full European Mandrake monograph & all interactions
Medication

About Pyridostigmine

What Is Pyridostigmine Used For?

Brand names: Mestinon, Regonol

Pyridostigmine is used for different purposes depending on the product.

Mestinon and pyridostigmine bromide oral solution are used to treat myasthenia gravis. Regonol injection reverses the effects of nondepolarizing muscle relaxants. Pyridostigmine bromide tablets and extended-release tablets are for military medical use only, as pretreatment against the lethal effects of soman nerve agent poisoning in adults.

See full Pyridostigmine drug information
Keep checking

Other Drugs & European Mandrake

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

0Major
2,041Moderate
0Minor
788No known interaction
2,041 Moderate 788 No interaction
Moderate

2,041 interactions

Showing 60 of 2,041 moderate interactions — see all 2,041 on the European Mandrake page.

No interaction 788 drugs checked — show the list

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

Showing the 60 most looked-up of 788 medications checked with no known interaction — see the full European Mandrake list.

See the full European Mandrake interactions page
See every supplement checked against Pyridostigmine Bromide, 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 Mandrake monograph › Uses, safety, and every drug interaction in one place Pyridostigmine Bromide supplement interactions › Every supplement checked against Pyridostigmine Bromide, ranked by severity Pyridostigmine 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 Mandrake and Pyridostigmine Bromide Together: Common Questions

Can you take European Mandrake with Pyridostigmine Bromide?
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 Mandrake and Pyridostigmine Bromide 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 Pyridostigmine Bromide and European Mandrake?

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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.