Drug & supplement interaction

Fever Bark + Hydrochlorothiazide, Lisinopril

Hydrochlorothiazide, Lisinopril brand names: Zestoretic, Prinzide.

Moderate Interaction
The bottom line Moderate

Fever Bark has a moderate interaction with Hydrochlorothiazide, Lisinopril. Theoretically, fever bark might alter the effects of antihypertensive drugs.

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

Fever Bark and Hydrochlorothiazide, Lisinopril

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Hydrochlorothiazide, Lisinopril

Hydrochlorothiazide, Lisinopril falls under ANTIHYPERTENSIVE DRUGS — the group Fever Bark interacts with.

Theoretically, fever bark might alter the effects of antihypertensive drugs.
Yohimbine, a constituent of fever bark, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Conversely, reserpine can reduce both systolic and diastolic blood pressure. Theoretically, concomitant use of fever bark and antihypertensive drugs can interfere with blood pressure control.
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

Your Zestoretic combines lisinopril (an ACE inhibitor) with hydrochlorothiazide (a water pill) to keep your blood pressure in a healthy range. The concern with fever bark is that it's a mixed bag chemically. It contains yohimbine-like compounds that can raise blood pressure, plus reserpine-like ones that can lower it. So it could tug your numbers in either direction and make them harder to predict.

If your pressure climbs, your medication may seem less effective. If it drops too low, you might feel dizzy, lightheaded, or faint, especially when standing up quickly. Keep in mind this is a theoretical interaction based on how these plant chemicals behave, not solid human studies. Still, I'd skip fever bark and check with your pharmacist or doctor first.

References
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  3. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
  4. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.

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

Fever Bark Also Interacts With Other Medications

Fever Bark has 40 major, 673 moderate, 87 minor known drug interactions in our database — the Hydrochlorothiazide, Lisinopril one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Fever Bark

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

Everything else you take

See Every Supplement That Interacts With Hydrochlorothiazide, Lisinopril

This page covers Fever Bark only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Lisinopril page lists 236 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 199 moderate · 27 minor.

From our pharmacist’s overview on the Hydrochlorothiazide, Lisinopril page

“I would not add a supplement casually alongside hydrochlorothiazide and lisinopril (Zestoretic, Prinzide). This combination lowers blood pressure with a water pill plus an ACE inhibitor, and most interacting ingredients either drag pressure down too far or push back against the drug, while smaller groups strain the kidneys, drain potas…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Lisinopril interaction page

How much people look this up

Where Fever Bark and Hydrochlorothiazide, Lisinopril 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 Fever Bark
Steady interest

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

29 days ago today
Medication Hydrochlorothiazide, Lisinopril
Top half

#719 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 Fever Bark

What is Fever Bark?

Fever Bark
  • Fever
  • Diarrhea
  • Malaria (traditional)
  • Digestive complaints
  • Bitter tonic

Fever bark is the bark of the Australian tree Alstonia constricta, used in traditional medicine for fever, diarrhea, and infections. There is very little reliable human research to support these uses, and the bark contains potent alkaloids that may cause serious side effects. It is best avoided unless used under direct medical supervision.

Read the full Fever Bark monograph & all interactions
Medication

About Lisinopril and Hydrochlorothiazide

What Is Lisinopril and Hydrochlorothiazide Used For?

Brand names: Zestoretic, Prinzide

Lisinopril and hydrochlorothiazide tablets — sold as the brand Zestoretic and as the generic combination — are used to treat high blood pressure (hypertension). Lowering blood pressure reduces the risk of serious cardiovascular events such as stroke and heart attack.

This is a fixed-dose combination product and is not intended as a first-line (initial) treatment for high blood pressure. It is typically prescribed for patients whose blood pressure is not adequately controlled on a single medication alone.

See full Lisinopril and Hydrochlorothiazide drug information
Keep checking

Other Drugs & Fever Bark

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

40Major
673Moderate
87Minor
2,029No known interaction
Major

40 interactions

Moderate

673 interactions

Showing 60 of 673 moderate interactions — see all 673 on the Fever Bark page.

Minor

87 interactions

Showing 60 of 87 minor interactions — see all 87 on the Fever Bark page.

No interaction 2,029 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Fever Bark and Hydrochlorothiazide, Lisinopril Together: Common Questions

Can you take Fever Bark with Hydrochlorothiazide, Lisinopril?
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 Fever Bark and Hydrochlorothiazide, Lisinopril 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

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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.