Drug & supplement interaction

Foxglove + Psyllium , Senna (OTC drug)

Psyllium , Senna (OTC drug) brand name: Perdiem.

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

Foxglove has a moderate interaction with Psyllium , Senna (OTC drug). Theoretically, overuse of stimulant laxatives increases the risk of cardiac glycoside toxicity.

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

Foxglove and Psyllium , Senna (OTC drug)

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

Moderate

STIMULANT LAXATIVES

Why this applies to Psyllium , Senna (OTC drug)

Psyllium , Senna (OTC drug) falls under STIMULANT LAXATIVES — the group Foxglove interacts with.

Theoretically, overuse of stimulant laxatives increases the risk of cardiac glycoside toxicity.
Foxglove contains varied cardiac glycosides, including digoxin. Hypokalemia, which may be caused by overuse of stimulant laxative, increases the risk of cardiac glycoside toxicity.
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 with your Perdiem, which contains senna, a stimulant laxative. Foxglove carries the same kind of heart compounds found in digoxin. The worry isn't a direct chemical clash, it's about your body's potassium. When senna is overused (taken too often or in large amounts over time), it can flush out potassium and leave your levels low. Low potassium makes the heart more sensitive to these foxglove glycosides, which can tip you toward dangerous heart rhythm problems.

To be honest, this is a theoretical, pharmacology-based concern, not something heavily documented. And really, foxglove shouldn't be used as a supplement at all because it's genuinely toxic. Used as directed for occasional constipation, senna is unlikely to cause this. If you take it regularly, please check in with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.

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

Foxglove Also Interacts With Other Medications

Foxglove has 3 major, 129 moderate known drug interactions in our database — the Psyllium , Senna (OTC drug) one above is one of them. If you take anything else, check it against the full list below.

Major 3 Moderate 129 No known interaction 2,698 (incl. Psyllium , Senna (OTC drug))
Taking anything else?

Check Another of Your Medications Against Foxglove

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

Everything else you take

See Every Supplement That Interacts With Psyllium , Senna (OTC drug)

This page covers Foxglove only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Psyllium , Senna (OTC drug) page lists 46 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Jalap (major), Oleander (major), Alder Buckthorn (moderate) and Aloe (moderate).

By severity: 3 major · 34 moderate · 9 minor.

From our pharmacist’s overview on the Psyllium , Senna (OTC drug) page

“Perdiem pairs psyllium fiber with senna, a stimulant laxative, and that senna half is why this list of 46 interacting supplements calls for genuine care. Twenty-nine entries are stimulant laxative herbs themselves; layering them on senna compounds fluid and potassium loss, and the strongest of them, jalap, is rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Psyllium , Senna (OTC drug) interaction page

One more smart check

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

We hold 1 real supplement products containing Foxglove, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Foxglove. Your product may carry other ingredients that interact with Psyllium , Senna (OTC drug) too, on top of Foxglove — 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 Foxglove and Psyllium , Senna (OTC drug) 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 Foxglove
Steady interest

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

29 days ago today
Medication Psyllium , Senna (OTC drug)
Top 10%

#192 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 Foxglove

What is Foxglove?

  • Heart failure (historical/medical use)
  • Irregular heartbeat (historical/medical use)
  • Fluid retention or 'dropsy' (historical use)
  • Ornamental garden plant

Foxglove is a beautiful but highly poisonous plant that contains powerful heart-affecting compounds called cardiac glycosides. It should never be used as a home remedy or supplement because even small amounts can cause life-threatening heart problems. The purified prescription drugs derived from it (like digoxin) are used only under close medical supervision.

Read the full Foxglove monograph & all interactions
Keep checking

Other Drugs & Foxglove

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

3Major
129Moderate
0Minor
2,697No known interaction
3 Major 129 Moderate 2,697 No interaction
Major

3 interactions

Moderate

129 interactions

Showing 60 of 129 moderate interactions — see all 129 on the Foxglove page.

No interaction 2,697 drugs checked — show the list

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

Showing the 60 most looked-up of 2,697 medications checked with no known interaction — see the full Foxglove list.

See the full Foxglove interactions page
See every supplement checked against Psyllium , Senna (OTC drug), 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
Foxglove monograph › Uses, safety, and every drug interaction in one place Psyllium , Senna (OTC drug) supplement interactions › Every supplement checked against Psyllium , Senna (OTC drug), 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Foxglove and Psyllium , Senna (OTC drug) Together: Common Questions

Can you take Foxglove with Psyllium , Senna (OTC drug)?
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 Foxglove and Psyllium , Senna (OTC drug) 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 Psyllium , Senna (OTC drug) and Foxglove?

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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.