Drug & supplement interaction

Goldenseal + Betamethasone Dipropionate

Betamethasone Dipropionate brand name: Sernivo.

Moderate Interaction
The bottom line Moderate

Goldenseal has a moderate interaction with Betamethasone Dipropionate. Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.

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

Goldenseal and Betamethasone Dipropionate

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

Why this applies to Betamethasone Dipropionate

Betamethasone Dipropionate falls under P-GLYCOPROTEIN SUBSTRATES — the group Goldenseal interacts with.

Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.
Severity Moderate Likelihood Probable Evidence B

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

Here's some reassuring context for you. The interaction on file involves goldenseal possibly nudging a transporter called P-glycoprotein, which can shift blood levels of certain pills up or down. But the betamethasone you're asking about (Sernivo) is a topical cream or spray that you rub on your skin. Almost all of it stays right where you put it, so very little reaches your bloodstream in the first place.

Because of that, any effect goldenseal has on this transporter is unlikely to matter for your skin steroid. The evidence here is also weak and mixed to begin with. I wouldn't lose sleep over it, but it's always smart to let your pharmacist or doctor know what supplements you take, especially if you ever use betamethasone in a pill or injection form.

References
  1. Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35:240-5. PubMed

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

Goldenseal Also Interacts With Other Medications

Goldenseal has 1,235 moderate, 1 minor known drug interactions in our database — the Betamethasone Dipropionate 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 Goldenseal

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

Everything else you take

See Every Supplement That Interacts With Betamethasone Dipropionate

This page covers Goldenseal only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Betamethasone Dipropionate page lists 107 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Lily-of-the-valley (major), St. John's Wort (major), Active Hexose Correlated Compound (ahcc) (moderate), Alder Buckthorn (moderate) and Alfalfa (moderate).

By severity: 2 major · 95 moderate · 10 minor.

From our pharmacist’s overview on the Betamethasone Dipropionate page

“Betamethasone dipropionate (Sernivo) is a potent corticosteroid applied to the skin, and enough can absorb through it, especially over large areas or with long courses, that these interactions deserve genuine vigilance. Two of the 107 ingredients on file rate major: lily-of-the-valley, whose cardiac glycosides become more toxic when pr…”

Reviewed by 2 · Jul 18, 2026

Open the Betamethasone Dipropionate interaction page

One more smart check

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

We hold 1,726 real supplement products containing Goldenseal, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Goldenseal. Your product may carry other ingredients that interact with Betamethasone Dipropionate too, on top of Goldenseal — 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 Goldenseal and Betamethasone Dipropionate 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 Goldenseal
Top 10%

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

29 days ago today
Medication Betamethasone Dipropionate
Top 25%

#412 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 Goldenseal

What is Goldenseal?

Goldenseal
  • Digestive upset and diarrhea
  • Colds and respiratory infections
  • Sore throat and mouth sores
  • Skin and eye irritation (topical/traditional)
  • Antimicrobial support

Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lacking, and it should be avoided during pregnancy and breastfeeding. Talk to a pharmacist or doctor before using it.

Read the full Goldenseal monograph & all interactions
Medication

About Betamethasone Topical

What Is Betamethasone Topical Used For?

Brand name: Sernivo

Betamethasone topical is used to relieve the redness, swelling, and itching of corticosteroid-responsive dermatoses (skin conditions that respond to steroid treatment). Sernivo Spray is specifically approved for plaque psoriasis of the body. Diprolene (topical cream, ointment, or gel) is indicated for inflammatory and itchy skin conditions in patients 13 years of age and older.

This medication is for use on the skin only. It is not approved for use on the face, groin, or underarms, and it is not for use in the eyes, mouth, or vagina.

See full Betamethasone Topical drug information
Keep checking

Other Drugs & Goldenseal

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

0Major
1,235Moderate
1Minor
1,593No known interaction
Moderate

1,235 interactions

Showing 60 of 1,235 moderate interactions — see all 1,235 on the Goldenseal page.

Minor

1 interaction

No interaction 1,593 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 Goldenseal and Betamethasone Dipropionate Together: Common Questions

Can you take Goldenseal with Betamethasone Dipropionate?
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 Goldenseal and Betamethasone Dipropionate 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 Betamethasone Dipropionate and Goldenseal?

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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.