Drug & supplement interaction

Hawthorn + Ranolazine

Ranolazine brand names: Ranexa, Aspruzyo.

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 Ranolazine 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 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 Ranolazine

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 Ranolazine 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 Ranolazine and Hawthorn? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ranolazine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ranolazine is filed under 5 classifications — including cytochrome p450 2d6 (cyp2d6) inhibitors, qt interval-prolonging drugs, p-glycoprotein substrates. 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 Ranolazine’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 — Ranolazine 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. Ranolazine)
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 Ranolazine 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.

  • Chest pain / A slow heartbeat Worth acting on reported in 11.8% of FDA reports for Ranolazine 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

    Ranolazine

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

  • Fainting Worth acting on 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

    Ranolazine

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

  • A fast or pounding heartbeat Additional detail

    Hawthorn

    Recorded for Hawthorn in the same Natural Medicines adverse-effect record shown under Chest pain / A slow heartbeat above.

    Ranolazine

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

  • Stomach upset / Vomiting / Nausea 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

    Ranolazine

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

  • Dizziness / Headache reported in 4.1% of FDA reports for Ranolazine Additional detail

    Hawthorn

    Recorded for Hawthorn in the same Natural Medicines adverse-effect record shown under Fainting above.

    Ranolazine

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

Reported for Hawthorn but not commonly for Ranolazine: diarrhea, heart failure, an irregular heartbeat and an allergic reaction.

Effects for Ranolazine 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 10,189 voluntary FDA FAERS reports for Ranolazine 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.

Overlapping uses

What Ranolazine 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. Ranolazine 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.

Ranolazine is prescribed for: Ranolazine treats chronic angina — the recurring chest pain or pressure that happens when the heart isn't getting enough blood and oxygen. It is used when other angina medicines aren't enough on their own. Both the extended-release tablet (sold as Ranexa and generic ranolazine) and the oral powder form (sold as Aspruzyo Sprinkle) are approved for this use. Ranolazine can be combined with other heart medicines such as beta-blockers, nitrates, calcium channel blockers, anti-platelet drugs, statins, ACE inhibitors, and angiotensin receptor blockers.

Hawthorn has been studied for:

  • 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.

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 Ranolazine 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 Ranolazine

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 Ranolazine, 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 Ranolazine

This page covers Hawthorn only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ranolazine page lists 153 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 109 moderate · 36 minor.

From our pharmacist’s overview on the Ranolazine page

“Ranolazine (Ranexa, Aspruzyo), a medicine for chronic chest pain, depends heavily on one liver enzyme, CYP3A4, and that is where most of its supplement trouble sits. Grapefruit can push ranolazine levels up, St.”

Reviewed by 2 · Jul 18, 2026

Open the Ranolazine 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 Ranolazine, 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 Ranolazine 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 Ranolazine
Top 25%

#629 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 Ranolazine 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 Ranolazine

What Is Ranolazine Used For?

Brand names: Ranexa, Aspruzyo

Ranolazine treats chronic angina — the recurring chest pain or pressure that happens when the heart isn't getting enough blood and oxygen. It is used when other angina medicines aren't enough on their own.

Both the extended-release tablet (sold as Ranexa and generic ranolazine) and the oral powder form (sold as Aspruzyo Sprinkle) are approved for this use. Ranolazine can be combined with other heart medicines such as beta-blockers, nitrates, calcium channel blockers, anti-platelet drugs, statins, ACE inhibitors, and angiotensin receptor blockers.

Most-Reported Side Effects for Ranolazine

From FAERS, the FDA’s public side-effect reporting system (10,376 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Myocardial infarction 646 reports
Chest pain 614 reports
Angina pectoris 595 reports
Stent placement 582 reports
Dyspnea 439 reports
See full Ranolazine 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 Ranolazine, 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 Ranolazine Together: Common Questions

Is it safe to take Hawthorn with Ranolazine?
We do not list a known interaction between Hawthorn and Ranolazine. 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 Ranolazine have any of the same side effects?
Yes — our sources link each of them separately to 9 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.
Are Hawthorn and Ranolazine 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 Ranolazine is being adjusted to a target.
How was the Hawthorn and Ranolazine combination checked?
Interactions in our licensed database are recorded against drug classes. Ranolazine is filed under 5 classifications, and Hawthorn has documented interactions with 6 drug classes — none of Ranolazine'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 — Ranolazine 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 Ranolazine interact with any supplements?
Yes. Ranolazine has documented interactions with 153 supplements in our database — Hawthorn is not one of them. The Ranolazine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Hawthorn monograph Uses, safety profile, and every drug interaction in one place Ranolazine drug information The full plain-English guide to this medication Ranolazine supplement interactions Every supplement checked against Ranolazine, 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

Still Have a Question About Ranolazine and Hawthorn?

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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.