Interaction Details

Sofosbuvir is classified as belonging to the following category: P-Glycoprotein Substrates

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.

Interaction Rating


Likelihood of Occurrence


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.


  • 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.

Goldenseal Overview

Goldenseal Goldenseal is a perennial herb in the buttercup family that is native to the northeastern portion of North America. It has small, yellow flowers and heart-shaped leaves. The root of the goldenseal herb is among the most commonly used dietary supplements in the U.S., often utilized to treat digestive disorders, such as diarrhea and indigestion, as well as respiratory disorders. It is also thought to have antibacterial, antiparasitic, antifungal, and laxative effects.
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Sofosbuvir Overview

  • Sofosbuvir is used along with ribavirin (Copegus, Rebetol, Ribasphere, others) and sometimes another medication (peginterferon alfa [Pegasys]) to treat certain types of chronic hepatitis C (an ongoing viral infection that damages the liver) in adults. Sofosbuvir is also used along with ribavirin to treat certain types of chronic hepatitis C (an ongoing viral infection that damages the liver) in children 3 years of age and older. Sofosbuvir is in a class of antiviral medications called nucleotide polymerase inhibitors. It works by decreasing the amount of hepatitis C virus (HCV) in the body. Sofosbuvir may not prevent the spread of hepatitis C to other people.

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Goldenseal - More Interactions

Goldenseal interacts with 1207 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.

Major The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur.
Moderate Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur.
Minor Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction.
Unknown No interactions have been reported or no interaction data is currently available.

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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

Drug descriptions are provided by MedlinePlus.

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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!

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