Drug & supplement interaction

Horsetail + Stavudine

Stavudine brand name: Zerit.

Moderate Interaction
The bottom line Moderate

Horsetail has a moderate interaction with Stavudine. Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.

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

Horsetail and Stavudine

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

Moderate

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Why this applies to Stavudine

Stavudine falls under NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs) — the group Horsetail interacts with.

Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown. It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.
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 concern with pairing horsetail and stavudine (Zerit). Stavudine is one of your HIV medications, and it works best when its levels in your blood stay steady enough to keep the virus suppressed. The worry is that horsetail might lower how well stavudine works, which could let your viral load creep back up. If that happens, you usually won't feel it, which is exactly why it matters.

I'll be honest with you: this is based on weak, anecdotal evidence. In two reported cases, people taking horsetail with their HIV regimen had detectable virus, which cleared after stopping the supplement. Nobody knows the exact reason, and stavudine wasn't one of the drugs studied. Still, with HIV treatment I lean cautious. Please check with your pharmacist or doctor before adding horsetail, and don't change your stavudine.

References
  1. Cordova E, Morganti L, Rodriguez C. Possible Drug-Herb Interaction between Herbal Supplement Containing Horsetail (Equisetum arvense) and Antiretroviral Drugs. J Int Assoc Provid AIDS Care. 2017;16(1):11-13.

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

Horsetail Also Interacts With Other Medications

Horsetail has 187 moderate known drug interactions in our database — the Stavudine 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 Horsetail

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

From our Q&A

Questions About Horsetail or Stavudine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Horsetail or Stavudine, 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 Stavudine

This page covers Horsetail only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Stavudine page lists 18 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 · 8 moderate · 9 minor.

From our pharmacist’s overview on the Stavudine page

“Stavudine (Zerit) fights HIV, and with antiretrovirals the cost of an interaction runs high, since anything that lowers drug levels can let the virus rebound and build resistance. That makes this list one to respect, even though 17 of its 18 entries share a single theme: charcoal, fibers, gums, and mucilage-rich herbs that can blunt ho…”

Reviewed by 2 · Jul 18, 2026

Open the Stavudine interaction page

One more smart check

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

We hold 2,089 real supplement products containing Horsetail, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Horsetail. Your product may carry other ingredients that interact with Stavudine too, on top of Horsetail — 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 Horsetail and Stavudine 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 Horsetail
Top 10%

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

29 days ago today
Medication Stavudine
Steady interest

#1,627 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 Horsetail

What is Horsetail?

Horsetail
  • Fluid retention (mild diuretic)
  • Urinary and bladder concerns
  • Hair, skin, and nail support
  • Wound healing
  • Bone health

Horsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. It can cause thiamine (vitamin B1) loss with long-term use, and some related species are toxic, so choose products carefully and talk to your pharmacist or doctor before using it.

Read the full Horsetail monograph & all interactions
Medication

About Stavudine

What Is Stavudine Used For?

Brand name: Zerit

  • Stavudine is used along with other medications to treat human immunodeficiency virus (HIV) infection. Stavudine is in a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). It works by decreasing the amount of HIV in the blood. Although stavudine does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other life-style changes may decrease the risk of transmitting (spreading) the HIV virus to other people.

See full Stavudine drug information
Keep checking

Other Drugs & Horsetail

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

0Major
187Moderate
0Minor
2,642No known interaction
Moderate

187 interactions

Showing 60 of 187 moderate interactions — see all 187 on the Horsetail page.

No interaction 2,642 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 Horsetail and Stavudine Together: Common Questions

Can you take Horsetail with Stavudine?
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 Horsetail and Stavudine 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 Stavudine and Horsetail?

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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.