Drug & supplement interaction

Indian Snakeroot + Nebivolol

Nebivolol brand names: Bystolic, Nebilet.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Nebivolol falls into 3 drug categories that Indian Snakeroot can interact with; the most serious is rated major. Theoretically, taking Indian snakeroot with beta-blockers might increase the risk of bradycardia and/or hypotension.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Indian Snakeroot and Nebivolol

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Indian Snakeroot interacts with whole categories of medication. Nebivolol falls into 3 of those categories, so it can interact with Indian Snakeroot in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

BETA-BLOCKERS

1 of 3

Why this applies to Nebivolol

Nebivolol falls under BETA-BLOCKERS — the group Indian Snakeroot interacts with.

Theoretically, taking Indian snakeroot with beta-blockers might increase the risk of bradycardia and/or hypotension.
Indian snakeroot contains small amounts of reserpine. Reserpine causes catecholamine-depletion. Concomitant use of Indian snakeroot and beta-blockers might increase the risk or bradycardia and/or hypotension.
Severity Major Likelihood Probable Evidence D

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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing with pairing Indian snakeroot and Nebivolol (Bystolic). Both of these push your blood pressure and heart rate in the same downward direction. Nebivolol is a beta-blocker that relaxes blood vessels and slows the heart, while Indian snakeroot contains reserpine, which depletes the nerve chemicals (like norepinephrine) that normally keep your heart rate and pressure up. Stack them together and those effects can pile on.

So in plain terms, you could end up with too much of a good thing: very low blood pressure, a heart rate that drops too far, dizziness, lightheadedness, or fainting. To be fair, this is a theoretical concern based on how the two work, not hard clinical proof. Still, snakeroot is potent, so please loop in your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Moderate

ANTIHYPERTENSIVE DRUGS

2 of 3

Nebivolol also falls under ANTIHYPERTENSIVE DRUGS.

Theoretically, concomitant use of Indian snakeroot and antihypertensive drugs might increase the risk of hypotension.
Indian snakeroot, which contains reserpine, can reduce both systolic and diastolic blood pressure.
Severity Moderate Likelihood Possible Evidence B

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 simple version: both Indian snakeroot and your Nebivolol push your blood pressure in the same downward direction. Nebivolol (Bystolic) is a beta blocker that relaxes blood vessels and slows your heart. Indian snakeroot contains reserpine, which also lowers blood pressure and slows nerve signals. Stack them together and the effects can add up.

When that happens, you might feel dizzy, lightheaded, tired, or faint, especially when standing up quickly, and your heart rate could drop too low. Reserpine can also worsen low mood in some people. This concern is mostly theoretical and rated moderate, but it's a real possibility worth respecting. Please don't start or stop anything on your own. Check in with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
  2. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
  3. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

3 of 3

Nebivolol also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, Indian snakeroot might inhibit CYP2D6 enzymes and reduce the metabolism of CYP2D6 substrates.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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 thing to keep in mind if you're pairing these two. Your body relies on a liver enzyme called CYP2D6 to clear nebivolol out of your system. Indian snakeroot contains a small amount of yohimbine, which in lab studies appears to slow that enzyme down. If that holds true in people, your nebivolol could build up a bit and hit harder than expected.

For a beta blocker like this, stronger effects can mean a slower heart rate, dizziness, fatigue, or blood pressure dropping too low. And remember, snakeroot itself contains reserpine, which also lowers blood pressure, so the two could add up. The catch is this is only theoretical, based on test-tube work, not real patients. Still, please don't combine them without checking with your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed

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

Indian Snakeroot Also Interacts With Other Medications

Indian Snakeroot has 82 major, 760 moderate known drug interactions in our database — the Nebivolol one above is among them. If you take anything else, check it against the full list below.

Major 82 Moderate 760 No known interaction 1,988 (incl. Nebivolol)
Taking anything else?

Check Another of Your Medications Against Indian Snakeroot

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

From our Q&A

Questions About Indian Snakeroot or Nebivolol

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

This page covers Indian Snakeroot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nebivolol page lists 183 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Tyramine (major) and 1,3-dmaa (moderate).

By severity: 5 major · 151 moderate · 27 minor.

Open the Nebivolol interaction page

One more smart check

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

We hold 70 real supplement products containing Indian Snakeroot, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Snakeroot. Your product may carry other ingredients that interact with Nebivolol too, on top of Indian Snakeroot — 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 Indian Snakeroot and Nebivolol 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 Indian Snakeroot
Top half

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

29 days ago today
Medication Nebivolol
Steady interest

#1,446 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 Indian Snakeroot

What is Indian Snakeroot?

Indian Snakeroot
  • High blood pressure
  • Anxiety and stress
  • Insomnia
  • Agitation
  • Fever (traditional use)

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious side effects like depression and very low blood pressure, it should never be used without medical supervision. It is not a safe or simple home remedy, and many countries restrict its use.

Read the full Indian Snakeroot monograph & all interactions
Medication

About Nebivolol

What Is Nebivolol Used For?

Brand names: Bystolic, Nebilet

Nebivolol tablets are used to treat high blood pressure (hypertension). Lowering blood pressure reduces the risk of serious cardiovascular events, especially stroke and heart attack. It can be used alone or combined with other blood pressure medications.

Managing blood pressure is most effective as part of a broader plan that may include diet changes, exercise, and other treatments your doctor recommends.

See full Nebivolol drug information
Keep checking

Other Drugs & Indian Snakeroot

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

82Major
760Moderate
0Minor
1,987No known interaction
82 Major 760 Moderate 1,987 No interaction
Major

82 interactions

Showing 60 of 82 major interactions — see all 82 on the Indian Snakeroot page.

Moderate

760 interactions

Showing 60 of 760 moderate interactions — see all 760 on the Indian Snakeroot page.

No interaction 1,987 drugs checked — show the list

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

Showing the 60 most looked-up of 1,987 medications checked with no known interaction — see the full Indian Snakeroot list.

See the full Indian Snakeroot interactions page
See every supplement checked against Nebivolol, ranked by severity
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

Keep exploring
Indian Snakeroot monograph › Uses, safety, and every drug interaction in one place Nebivolol supplement interactions › Every supplement checked against Nebivolol, ranked by severity Nebivolol drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Indian Snakeroot and Nebivolol Together: Common Questions

Can you take Indian Snakeroot with Nebivolol?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Indian Snakeroot and Nebivolol?
Nebivolol belongs to more than one drug category, and Indian Snakeroot interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Indian Snakeroot and Nebivolol interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Nebivolol and Indian Snakeroot?

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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.