Drug & supplement interaction

Gamboge + Mannitol

Mannitol brand names: Osmitrol, Bronchitol.

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

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

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Gamboge and Mannitol

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

Moderate

DIURETIC DRUGS

Why this applies to Mannitol

Mannitol 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 simple version. Mannitol (Osmitrol, Bronchitol) is a type of diuretic, meaning it pulls extra fluid out of your body. When your body flushes out that fluid, you can also lose minerals along with it, including potassium. Gamboge, taken by mouth, acts as a harsh gut irritant and laxative, and that watery diarrhea can drain potassium too. Stack the two together and the worry is that your potassium could drop too low.

Low potassium can cause muscle cramps, weakness, fatigue, and in more serious cases an irregular heartbeat. I'll be honest: this concern is theoretical, based on how each one works rather than reported cases. Even so, I really don't recommend taking gamboge at all, since the resin is toxic even in modest amounts. Please run this by your doctor or pharmacist before combining anything.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Mannitol one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Mannitol)
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 Mannitol

This page covers Gamboge only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mannitol page lists 200 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), Lithium (major) and Oleander (major).

By severity: 7 major · 169 moderate · 24 minor.

From our pharmacist’s overview on the Mannitol page

“American hellebore tops my worry list for anyone on mannitol (Osmitrol, Bronchitol), an osmotic diuretic used to draw fluid off the brain or, when inhaled, to clear mucus in cystic fibrosis. The plant's alkaloids drop blood pressure and slow the heart, a dangerous match for a drug that already shifts fluid and pressure quickly.”

Reviewed by 2 · Jul 18, 2026

Open the Mannitol interaction page

How much people look this up

Where Gamboge and Mannitol 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

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

29 days ago today
Medication Mannitol
Top 25%

#386 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
121 Moderate 2,708 No 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

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Gamboge list.

See the full Gamboge interactions page
See every supplement checked against Mannitol, 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
Gamboge monograph › Uses, safety, and every drug interaction in one place Mannitol supplement interactions › Every supplement checked against Mannitol, 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 Gamboge and Mannitol Together: Common Questions

Can you take Gamboge with Mannitol?
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 Mannitol 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 Mannitol and Gamboge?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.