Goldenseal + Naltrexone Hydrochloride, Oxycodone Hydrochloride
Naltrexone Hydrochloride, Oxycodone Hydrochloride brand name: Troxyca ER.
Naltrexone Hydrochloride, Oxycodone Hydrochloride falls into 2 drug categories that Goldenseal can interact with; the most serious is rated moderate. Theoretically, goldenseal might increase the sedative effects of CNS depressants.
Read the full interaction reportGoldenseal and Naltrexone Hydrochloride, Oxycodone Hydrochloride
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. Naltrexone Hydrochloride, Oxycodone Hydrochloride 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).
CNS DEPRESSANTS
1 of 2Why this applies to Naltrexone Hydrochloride, Oxycodone Hydrochloride
Naltrexone Hydrochloride, Oxycodone Hydrochloride falls under CNS DEPRESSANTS — the group Goldenseal interacts with.
Goldenseal contains berberine. Animal research shows that berberine can have sedative effects. However, this effect has not been reported in humans.
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.
Troxyca ER pairs oxycodone, a strong opioid, with naltrexone, which is built into the capsule to discourage misuse. The oxycodone part already causes drowsiness, slowed breathing, and foggy thinking. The concern here is simple: goldenseal contains berberine, and in animal studies berberine showed mild sedative effects. So in theory, layering it on top of an opioid could add to that sleepiness.
I want to be honest about how thin this evidence is. This is a theoretical concern based on lab and animal work, and the sedation has not actually been reported in people. Still, since oxycodone is potent, it makes sense to be cautious. Please check with your pharmacist or doctor before combining the two, and watch for extra drowsiness or feeling unusually out of it.
- Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
- Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
- Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
- Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 2Naltrexone Hydrochloride, Oxycodone Hydrochloride also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.
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..
This medicine pairs oxycodone, an opioid pain reliever, with naltrexone (which is meant to stay sealed inside the capsule unless someone tampers with it). Your body partly uses an enzyme called CYP2D6 to process oxycodone. Goldenseal can block that enzyme, so the oxycodone may not be broken down as quickly and can build up a bit more than expected.
In real life, that could mean stronger opioid effects: more drowsiness, dizziness, constipation, nausea, or slowed breathing. The research here is fair but not rock-solid, and food-level amounts aren't the concern. Concentrated goldenseal supplements are. Please don't stop or change anything on your own. Check with your pharmacist or doctor before combining the two.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Sevior, D. K., Hokkanen, J., Tolonen, A., Abass, K., Tursas, L., Pelkonen, O., and Ahokas, J. T. Rapid screening of commercially available herbal products for the inhibition of major human hepatic cytochrome P450 enzymes using the N-in-one cocktail. Xeno PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Goldenseal Also Interacts With Other Medications
Goldenseal has 1,235 moderate, 1 minor known drug interactions in our database — the Naltrexone Hydrochloride, Oxycodone Hydrochloride one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Goldenseal
We haven’t checked that one against Goldenseal yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Goldenseal. Pick one to open its full report.
See Every Supplement That Interacts With Naltrexone Hydrochloride, Oxycodone Hydrochloride
This page covers Goldenseal only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naltrexone Hydrochloride, Oxycodone Hydrochloride page lists 145 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).
By severity: 8 major · 114 moderate · 23 minor.
From our pharmacist’s overview on the Naltrexone Hydrochloride, Oxycodone Hydrochloride page
“Alcohol tops this list. Beer and wine both carry major, well-documented interactions with Troxyca ER (naltrexone and oxycodone hydrochloride), an extended-release opioid, because adding a second sedative to an opioid can slow breathing, not just deepen drowsiness.”
Reviewed by 2 · Jul 18, 2026
Open the Naltrexone Hydrochloride, Oxycodone Hydrochloride interaction page
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 Naltrexone Hydrochloride, Oxycodone Hydrochloride 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:
Where Goldenseal and Naltrexone Hydrochloride, Oxycodone Hydrochloride 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.
#151 of 1,452 supplements looked up here in the last 7 days
#656 of 2,830 medications looked up here in the last 7 days
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.
About Goldenseal
What is 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.
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.
No drugs match “”.
1,235 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Guaifenesin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Acetaminophen ›
Showing 60 of 1,235 moderate interactions — see all 1,235 on the Goldenseal page.
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.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Amoxicillin ›
- Bupropion ›
- Bendamustine ›
- Acyclovir ›
- Methotrexate ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cephalexin ›
- Cyclopentolate ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Ezetimibe ›
- Amoxicillin, Clavulanate Potassium ›
- Levothyroxine Sodium ›
- Daptomycin ›
- Dexmethylphenidate ›
- Mitomycin ›
- Hexobarbitone ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Cefaclor ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hydroxychloroquine ›
- Dirithromycin ›
- Triptorelin ›
- Pizotifen ›
- Bentoquatam ›
- Ribavirin Aerosol ›
- Dextrothyroxine ›
- Procainamide ›
- Tocainide ›
- Rocuronium ›
- Ropinirole ›
- Mitomycin C ›
- Lomustine ›
- Salbutamol Sulfate ›
- Digitoxin ›
- Chenodiol ›
- Gestodene ›
- Halothane ›
- Caspofungin ›
- Flutemetamol F-18 ›
- Desflurane ›
Showing the 60 most looked-up of 1,593 medications checked with no known interaction — see the full Goldenseal list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Taking Goldenseal and Naltrexone Hydrochloride, Oxycodone Hydrochloride Together: Common Questions
Can you take Goldenseal with Naltrexone Hydrochloride, Oxycodone Hydrochloride?
Why are there 2 interactions listed for Goldenseal and Naltrexone Hydrochloride, Oxycodone Hydrochloride?
How serious is the Goldenseal and Naltrexone Hydrochloride, Oxycodone Hydrochloride interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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