Drug & supplement interaction

Goldenseal + Mefenamic Acid

Mefenamic Acid brand name: Ponstel.

Moderate Interaction
The bottom line Moderate

Goldenseal has a moderate interaction with Mefenamic Acid. Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.

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

Goldenseal and Mefenamic Acid

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

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

Why this applies to Mefenamic Acid

Mefenamic Acid falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Goldenseal interacts with.

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 basic idea with goldenseal and mefenamic acid (Ponstel). Your liver uses an enzyme called CYP2C9 to break this pain reliever down and clear it out. Goldenseal contains compounds (berberine and hydrastine) that may slow that enzyme a bit. If the enzyme works slower, mefenamic acid could hang around longer and build up, which could mean more of the usual NSAID side effects, things like stomach upset, heartburn, nausea, or, with bigger or longer exposure, stomach irritation or bleeding.

The honest part: this is only seen in lab dishes, not in real people, so it's theoretical. I wouldn't panic over it. Still, since both can be hard on the stomach, it's worth a quick chat with your pharmacist or doctor before combining them.

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 Mefenamic Acid 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 Mefenamic Acid

This page covers Goldenseal only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mefenamic Acid page lists 118 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 86 moderate · 27 minor.

From our pharmacist’s overview on the Mefenamic Acid page

“Mefenamic acid (Ponstel), an NSAID mostly used for menstrual cramps and short-term pain, has a supplement list that earns genuine caution, and the five major-rated entries are where to start. Beer and wine are two of them, because alcohol plus any NSAID raises the risk of stomach and intestinal bleeding.”

Reviewed by 2 · Jul 18, 2026

Open the Mefenamic Acid 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 Mefenamic Acid 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 Mefenamic Acid 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%

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

29 days ago today
Medication Mefenamic Acid
Top half

#926 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 Mefenamic Acid

What Is Mefenamic Acid Used For?

Brand name: Ponstel

Mefenamic acid capsules are approved to manage mild to moderate pain in adults and adolescents 14 years of age and older, but only for short-term use — no longer than 7 days.

They are also approved to treat primary dysmenorrhea (painful menstrual periods), started at the onset of bleeding and associated symptoms.

See full Mefenamic Acid 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 Mefenamic Acid Together: Common Questions

Can you take Goldenseal with Mefenamic Acid?
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 Mefenamic Acid 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 Mefenamic Acid 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.