Drug & supplement interaction

Hawthorn + Colesevelam

Colesevelam brand names: WelChol, Lodalis.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Hawthorn and Colesevelam in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Colesevelam states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Hawthorn and Colesevelam

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Colesevelam and Hawthorn in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Hawthorn safety at a glance

Hawthorn overall Use caution Generally well tolerated in studies, but heart conditions need medical supervision.
Pregnancy Avoid Not enough safety information; avoid use during pregnancy.
Breastfeeding Avoid Not enough safety information; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Colesevelam and Hawthorn? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Colesevelam

Interactions in our licensed database are recorded against drug classes, not just single drug names. Colesevelam is filed under a single classification — oral drugs. Hawthorn has documented interactions with 6 drug classes — the most serious being nitrates (major), phosphodiesterase-5 inhibitors (major) and anticoagulant/antiplatelet drugs (moderate) — and none of Colesevelam’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Hawthorn Does Interact With Other Medications

Hawthorn has 14 major, 177 moderate known drug interactions in our database — Colesevelam isn’t one of them. If you take anything else, check it against the full list below.

Major 14 Moderate 177 No known interaction 2,639 (incl. Colesevelam)
Taking anything else?

Check Another of Your Medications Against Hawthorn

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

What to actually watch for

No Interaction Found — But Data Suggests Hawthorn and Colesevelam May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • A slow heartbeat Worth acting on Additional detail

    Hawthorn

    “Orally, tachycardia (with facial pains) of uncertain relationship to hawthorn was reported in a multicenter clinical trial. Palpitations were reported in three patients in a large surveillance trial of 3,664 patients with cardiac failure and in 11 patients with congestive heart failure (CHF) in a literature review of 5,577 patients.”

    Hawthorn · Natural Medicines adverse-effect record, reported in angina.

    6 sources cited
    1. 54640. Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
    2. 19244. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
    3. 54692. Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
    4. 19247. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
    5. 19222. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
    6. 8281. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam. Read the label on DailyMed ›

  • A higher chance of infection Worth acting on Additional detail

    Hawthorn

    “Flu-like syndrome and other non-specific infections have been reported following the use of the hawthorn extract WS 1442. Hawthorn has also been reported to cause nosebleeds.”

    Hawthorn · Natural Medicines adverse-effect record, reported in influenza.

    4 sources cited
    1. 8281. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
    2. 17203. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63. PubMed
    3. 19222. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
    4. 10144. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam. Read the label on DailyMed ›

  • An allergic reaction Worth acting on Additional detail

    Hawthorn

    “Orally, hawthorn seems to be well tolerated when used appropriately. Topically, no adverse effects have been reported, although a thorough evaluation of safety outcomes has not been conducted.

    Serious Adverse Effects (Rare):

    Orally: Multiorgan hypersensitivity reactions resulting in acute renal failure have been reported rarely.”

    Hawthorn · Natural Medicines adverse-effect record, reported in kidney failure.

    “A case of multiorgan hypersensitivity reaction and acute renal failure following the consumption of C. orientalis has been reported.”

    Hawthorn · Natural Medicines adverse-effect record, reported in kidney failure.

    1 source cited
    1. 54654. Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042. PubMed

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam. Read the label on DailyMed ›

  • Muscle pain / Back pain reported in 8.1% of FDA reports for Colesevelam Additional detail

    Hawthorn

    “In clinical trials, arthritis, back pain, weakness, and other non-specific musculoskeletal effects have been reported following the use of various hawthorn preparations (e.g. WS 1442, CKBM-A01). Additionally, in a case report, myalgia has been reported following use of hawthorn root extract.”

    Hawthorn · Natural Medicines adverse-effect record, reported in back pain.

    4 sources cited
    1. 8281. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
    2. 19243. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
    3. 19222. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
    4. 113113. Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6. PubMed

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Bloating or gas / Stomach upset / Vomiting Additional detail

    Hawthorn

    “Orally, rare abdominal discomfort of uncertain relationship to hawthorn has been reported in a large clinical trial, surveillance study, case reports, and a literature review. Digestive intolerance, diarrhea, flatulence, gastroenteritis, increased bowel movements, obstipation, mild and rare nausea, vomiting, nutritional and metabolic problems, and other non-specific gastrointestinal effects, have also been reported.”

    Hawthorn · Natural Medicines adverse-effect record, reported in congestive heart failure (chf).

    6 sources cited
    1. 19241. Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75. PubMed
    2. 19243. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
    3. 113112. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298. PubMed
    4. 8281. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
    5. 10144. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed
    6. 19247. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam. Read the label on DailyMed ›

  • A skin rash Additional detail

    Hawthorn

    “Orally, erythematous rash has been reported in patients with CHF in a literature review of 5,577 patients. Non-specific rashes and itching as well as toxiderma from the fruits of hawthorn have also been reported.”

    Hawthorn · Natural Medicines adverse-effect record, reported in congestive heart failure (chf).

    4 sources cited
    1. 19247. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
    2. 19222. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
    3. 19243. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
    4. 54670. Rogov VD. [Toxiderma due to the fruits of the hawthorn]. Vestn Dermatol Venerol 1984;7(7):46-47.

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam. Read the label on DailyMed ›

  • Headache Additional detail

    Hawthorn

    “Orally, headache and dizziness/vertigo were reported in 2 patients in a large surveillance trial of 3,664 patients with cardiac failure, in 15 patients with CHF as reported in a literature review of 5,577 patients, in a varying number of clinical trial participants, and in case reports. Incidences of fainting, fever, and infrequent, mild and transient sleepiness have also been reported.”

    Hawthorn · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 54692. Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
    2. 19247. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
    3. 8281. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
    4. 19222. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
    5. 19244. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
    6. 113112. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298. PubMed

    Colesevelam

    Listed in the ADVERSE REACTIONS section of the FDA label for Colesevelam. Read the label on DailyMed ›

Showing the 10 most notable of 11 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Hawthorn but not commonly for Colesevelam: diarrhea, heart failure, an irregular heartbeat and kidney problems.

Effects for Colesevelam come from the ADVERSE REACTIONS section of its FDA label; effects for Hawthorn come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 2,014 voluntary FDA FAERS reports for Colesevelam that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Colesevelam Products Have a Food Rule — Hawthorn Should Not Break It

At least one FDA label for a product containing Colesevelam says to take it with food. If you take Hawthorn on an empty stomach out of habit, keep them separate — and take Colesevelam with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Colesevelam products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Colesevelam hydrochloride should be taken as follows ( 2.2 , 2.4 ): Tablets Take 6 tablets once daily or 3 tablets twice daily with a meal and liquid.

From the Dosage and Administration section of the FDA label we read for Colesevelam — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Colesevelam Is Prescribed For, and What Hawthorn Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Colesevelam is a prescription medicine with approved uses on its FDA label. Hawthorn is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Colesevelam is prescribed for: Colesevelam is used alongside diet and exercise to reduce high LDL cholesterol (the "bad" cholesterol) in adults with primary hyperlipidemia (high cholesterol). It is also approved to lower LDL cholesterol in boys and girls aged 10–17 who have heterozygous familial hypercholesterolemia (HeFH) — an inherited condition that causes very high cholesterol — when diet and lifestyle changes alone haven't worked. Colesevelam tablets and oral suspension (Welchol and colesevelam hydrochloride products) are also used to improve blood sugar control in adults with type 2 diabetes, as an add-on to diet and exercise. Colesevelam is not for type 1 diabetes or diabetic ketoacidosis.

Hawthorn has been studied for:

  • Hyperlipidemia studied, not established Hawthorn has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Hawthorn for hyperlipidemia

    Although there has been interest in using oral hawthorn for hyperlipidemia, there is insufficient reliable information about the clinical effects of arrhythmia for this condition.

  • Angina studied, not established Hawthorn has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Hawthorn for angina

    It is unclear if oral hawthorn is beneficial in patients with angina.

  • Atherosclerosis studied, not established Hawthorn has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Hawthorn for atherosclerosis

    Although there has been interest in using oral hawthorn for atherosclerosis, there is insufficient reliable information about the clinical effects of arrhythmia for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Colesevelam on your own; if you are taking Hawthorn for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Hawthorn or Colesevelam

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hawthorn or Colesevelam, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Colesevelam

This page covers Hawthorn only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Colesevelam page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Colesevelam page

“Colesevelam (WelChol, Lodalis) lowers cholesterol by binding bile acids in your gut, and every one of the 17 supplements on this list can interfere with how oral medicines are absorbed in that same territory. I would treat this list with genuine care, and the place to start is activated charcoal, the only major-rated entry.”

Reviewed by 2 · Jul 18, 2026

Open the Colesevelam interaction page

One more smart check

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

We hold 2,624 real supplement products containing Hawthorn, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hawthorn. Even though Hawthorn itself has no known interaction with Colesevelam, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Hawthorn and Colesevelam 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 Hawthorn
Top 10%

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

29 days ago today
Medication Colesevelam
Steady interest

#1,818 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Hawthorn reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Hawthorn and Colesevelam records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Hawthorn

What is Hawthorn?

Hawthorn
  • Heart failure symptoms
  • High blood pressure
  • Chest pain (angina)
  • Irregular heartbeat
  • Digestive upset
  • Anxiety

Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the evidence is mixed and it should never replace prescribed heart medicines. Always talk to your pharmacist or doctor before using hawthorn, especially if you have a heart condition.

Crataegus monogyna · Rosaceae · Leaves, flowers, and berries (fruit) · Capsules, tablets, standardized extracts, liquid tinctures, teas

An interaction check asks whether these two react with each other — it does not ask whether Hawthorn is a good idea for someone in your situation. Here is what our Hawthorn record says about it on its own.

Hawthorn: dosing

There is no single standard dose of hawthorn that fits everyone. This is especially important if you take heart or blood pressure medicines or have any chronic health condition. Do not assume that more is better.

From our Hawthorn monograph — the full record covers uses, side effects and every documented interaction.

Read the full Hawthorn monograph & all interactions
Medication

About Colesevelam

What Is Colesevelam Used For?

Brand names: WelChol, Lodalis

Colesevelam is used alongside diet and exercise to reduce high LDL cholesterol (the "bad" cholesterol) in adults with primary hyperlipidemia (high cholesterol). It is also approved to lower LDL cholesterol in boys and girls aged 10–17 who have heterozygous familial hypercholesterolemia (HeFH) — an inherited condition that causes very high cholesterol — when diet and lifestyle changes alone haven't worked.

Colesevelam tablets and oral suspension (Welchol and colesevelam hydrochloride products) are also used to improve blood sugar control in adults with type 2 diabetes, as an add-on to diet and exercise. Colesevelam is not for type 1 diabetes or diabetic ketoacidosis.

Most-Reported Side Effects for Colesevelam

From FAERS, the FDA’s public side-effect reporting system (2,014 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Diarrhea 241 reports
Dyspnea 172 reports
Cough 169 reports
Muscle spasms 163 reports
Nasopharyngitis 150 reports
See full Colesevelam drug information
Keep checking

Other Drugs & Hawthorn

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

14Major
177Moderate
0Minor
2,638No known interaction
14 Major 177 Moderate 2,638 No interaction
Major

14 interactions

Moderate

177 interactions

Showing 60 of 177 moderate interactions — see all 177 on the Hawthorn page.

No interaction 2,638 drugs checked — show the list

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

Showing the 60 most looked-up of 2,638 medications checked with no known interaction — see the full Hawthorn list.

See the full Hawthorn interactions page
See every supplement checked against Colesevelam, ranked by severity
Evidence & sources

Hawthorn References

The 25 references that drive our Hawthorn monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
  2. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed
  3. Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
  4. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63. PubMed
  5. Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
  6. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
  7. Werner NS, Duschek S, and Schandry R. D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo controlled double blind study. Phytomedicine. 2009;16:1077-82. PubMed
  8. Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75. PubMed
  9. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
  10. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
  11. Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen.Pract 2006;56:437-43.
  12. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
  13. Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J.Clin.Pharmacol. 2003;43:637-42. DOI
  14. Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
  15. Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Hawthorn and Colesevelam Together: Common Questions

Is it safe to take Hawthorn with Colesevelam?
We do not list a known interaction between Hawthorn and Colesevelam. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Hawthorn and Colesevelam have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Hawthorn and Colesevelam at the same time of day?
At least one FDA label for a product containing Colesevelam says to take it with food. If you take Hawthorn on an empty stomach out of habit, keep them separate and take Colesevelam with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Colesevelam products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Hawthorn and Colesevelam used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Hawthorn in each. That is a conversation for your prescriber, especially if Colesevelam is being adjusted to a target.
How was the Hawthorn and Colesevelam combination checked?
Interactions in our licensed database are recorded against drug classes. Colesevelam is filed under 1 classification, and Hawthorn has documented interactions with 6 drug classes — none of Colesevelam's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Hawthorn interact with any other medications?
Yes. Hawthorn has 191 documented drug interactions in our database — Colesevelam is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Colesevelam interact with any supplements?
Yes. Colesevelam has documented interactions with 17 supplements in our database — Hawthorn is not one of them. The Colesevelam interaction page linked on this page lists every one, ranked by severity.

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Hawthorn monograph Uses, safety profile, and every drug interaction in one place Colesevelam drug information The full plain-English guide to this medication Colesevelam supplement interactions Every supplement checked against Colesevelam, 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 References The 25 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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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.