Drug & supplement interaction

Goldenseal + Hydrochlorothiazide, Valsartan

Hydrochlorothiazide, Valsartan brand name: Diovan HCT.

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

Hydrochlorothiazide, Valsartan falls into 2 drug categories that Goldenseal can interact with; the most serious is rated moderate. Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Goldenseal and Hydrochlorothiazide, Valsartan

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Goldenseal interacts with whole categories of medication. Hydrochlorothiazide, Valsartan falls into 2 of those categories, so it can interact with Goldenseal in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Hydrochlorothiazide, Valsartan

Hydrochlorothiazide, Valsartan falls under ANTIHYPERTENSIVE DRUGS — the group Goldenseal interacts with.

Theoretically, goldenseal might increase the risk of hypotension when taken with antihypertensive drugs.
Goldenseal contains berberine. Animal research shows that berberine can have hypotensive effects. Also, an analysis of clinical research shows that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. However, this effect has not been reported with goldenseal.
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

Your Diovan HCT combines two blood pressure medicines: valsartan, which relaxes blood vessels, and hydrochlorothiazide, a water pill. Goldenseal contains a compound called berberine that, at least in animal studies and one human study with a different drug, may also nudge blood pressure down a bit. So the concern here is simple addition: goldenseal could theoretically add to the blood pressure lowering you already get from your medication.

If your pressure drops too low, you might feel dizzy, lightheaded, tired, or off-balance, especially when standing up quickly. I want to be honest though: this is a theoretical interaction based on how berberine behaves, and it has not actually been reported with goldenseal itself. Still, it is worth mentioning to your pharmacist or doctor before adding goldenseal, particularly so you can keep an eye on your readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  2. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  3. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Hydrochlorothiazide, Valsartan also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.
In vitro research shows that goldenseal root extract can modestly inhibit CYP2C9. This effect may be due to its alkaloid constituents, hydrastine and berberine. However, this effect has not been reported in humans.
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 situation with your Diovan HCT (valsartan plus hydrochlorothiazide). Valsartan is partly handled by a liver enzyme called CYP2C9, and in test-tube studies goldenseal can mildly slow that enzyme down. In theory, that could let a little more valsartan build up in your blood than usual. Practically speaking, that might mean a bit more blood-pressure lowering, so things like dizziness, lightheadedness when you stand up, or feeling unusually tired.

The important part: this has only been seen in lab studies, not in real people, so it's more of a theoretical concern than a proven problem. Still, since both pieces of this combo affect blood pressure, it's worth a quick chat with your pharmacist or doctor before adding goldenseal.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. 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 Hydrochlorothiazide, Valsartan one above is among them. If you take anything else, check it against the full list below.

Moderate 1,235 Minor 1 No known interaction 1,594 (incl. Hydrochlorothiazide, Valsartan)
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 Hydrochlorothiazide, Valsartan

This page covers Goldenseal only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Valsartan page lists 273 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 · 226 moderate · 37 minor.

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

“Diovan HCT pairs valsartan with the water pill hydrochlorothiazide to bring blood pressure down, and the 273 supplements listed here deserve genuine care, ten of them rated major. Most of the moderate entries either drop blood pressure further than intended or blunt the medication, and a second large group compounds the diuretic action…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Valsartan 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 Hydrochlorothiazide, Valsartan 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 Hydrochlorothiazide, Valsartan 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 25%

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

29 days ago today
Medication Hydrochlorothiazide, Valsartan
Top 25%

#483 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
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
1,235 Moderate 1 Minor 1,593 No 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

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

Showing the 60 most looked-up of 1,593 medications checked with no known interaction — see the full Goldenseal list.

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

Can you take Goldenseal with Hydrochlorothiazide, Valsartan?
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.
Why are there 2 interactions listed for Goldenseal and Hydrochlorothiazide, Valsartan?
Hydrochlorothiazide, Valsartan belongs to more than one drug category, and Goldenseal interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Goldenseal and Hydrochlorothiazide, Valsartan 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.