Drug & supplement interaction

Gamboge + Atenolol, Chlortalidone

Atenolol, Chlortalidone brand names: AtenixCo, Totaretic, Tenoret 50.

Moderate Interaction
The bottom line Moderate

Gamboge has a moderate interaction with Atenolol, Chlortalidone. Overuse of gamboge might compound diuretic-induced potassium loss.

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

Gamboge and Atenolol, Chlortalidone

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

Moderate

DIURETIC DRUGS

Why this applies to Atenolol, Chlortalidone

Atenolol, Chlortalidone falls under DIURETIC DRUGS — the group Gamboge interacts with.

Overuse of gamboge might compound diuretic-induced potassium loss. There is some concern that people taking gamboge along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients.
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 gist with this combo. The chlortalidone half of your tablet is a thiazide-type water pill, and one thing it does is flush out potassium along with extra fluid. Gamboge is a harsh laxative, and harsh laxatives can pull potassium out of your body too. Stack them together and you could end up with low potassium (hypokalemia), which can show up as muscle cramps, weakness, tiredness, or an irregular heartbeat. That last part matters more here because atenolol is a beta-blocker working on your heart rhythm.

I'll be honest, this is a theoretical concern based on how these things work, not hard proof from studies. The bigger issue is that gamboge itself is toxic and really shouldn't be taken orally at all. Please don't change your blood pressure medicine, but do run any gamboge use past your pharmacist or doctor first.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 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

Gamboge Also Interacts With Other Medications

Gamboge has 121 moderate known drug interactions in our database — the Atenolol, Chlortalidone 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 Gamboge

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

Everything else you take

See Every Supplement That Interacts With Atenolol, Chlortalidone

This page covers Gamboge only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atenolol, Chlortalidone page lists 229 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), Dolomite (major) and Indian Snakeroot (major).

By severity: 9 major · 197 moderate · 23 minor.

Open the Atenolol, Chlortalidone interaction page

How much people look this up

Where Gamboge and Atenolol, Chlortalidone 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 Gamboge
Steady interest

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

29 days ago today
Medication Atenolol, Chlortalidone
Top half

#987 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 Gamboge

What is Gamboge?

  • Laxative (purgative)
  • Expelling intestinal worms
  • Traditional wound care
  • Use as a yellow dye/pigment

Gamboge is a bright yellow tree resin used historically as a strong laxative and as an artists' pigment, but it is toxic in even modest amounts and is not a safe dietary supplement. Modern interest centers on its compound gambogic acid in laboratory cancer research, which does not make the raw resin safe to take. We recommend avoiding oral use of gamboge.

Read the full Gamboge monograph & all interactions
Keep checking

Other Drugs & Gamboge

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

0Major
121Moderate
0Minor
2,708No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Gamboge page.

No interaction 2,708 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 Gamboge and Atenolol, Chlortalidone Together: Common Questions

Can you take Gamboge with Atenolol, Chlortalidone?
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 Gamboge and Atenolol, Chlortalidone 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.