Drug & supplement interaction

Indian Snakeroot + Timolol

Timolol brand names: Blocadren, Timol, Timoptic.

Major Interaction
The bottom line Major

Timolol 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 Timolol

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. Timolol 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 Timolol

Timolol 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 simple version: both Indian snakeroot and timolol push your heart and blood pressure in the same direction, downward. Timolol (a beta-blocker) already slows your heart rate and relaxes blood vessels. Indian snakeroot contains reserpine, which depletes the nerve chemicals (like norepinephrine) that normally keep your heart rate and blood pressure up. Stack them together and you can overshoot.

That could mean a heart rate that drops too low, lightheadedness, fainting, or feeling unusually tired or down in mood. This concern is theoretical, based on how these substances work, not on strong human studies, but the potential effect is serious enough that I wouldn't combine them on your own. Please check with your doctor or pharmacist first.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Moderate

ANTIHYPERTENSIVE DRUGS

2 of 3

Timolol 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 timolol push your blood pressure in the same direction, downward. Timolol is a beta blocker that already relaxes blood vessels and slows your heart rate. Indian snakeroot contains reserpine, which lowers those same nerve signals that keep your blood pressure up. Stack the two together and the effects can add up.

What that might feel like is dizziness, lightheadedness when you stand, unusual tiredness, or a heart rate that runs too slow. This concern is largely theoretical, but reserpine is a potent compound, so I wouldn't treat it lightly. Please don't start or stop anything on your own. Check in with your pharmacist or doctor first so they can keep an eye on your numbers.

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

Timolol 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 situation with these two. Your body relies on a liver enzyme called CYP2D6 to help clear timolol out of your system. Lab research hints that Indian snakeroot (which carries small amounts of yohimbine) may slow that enzyme down. If timolol clears more slowly, more of it can linger, and its blood-pressure-lowering effect could stack up.

For you, that might show up as feeling lightheaded, dizzy, unusually tired, or noticing a slower-than-normal heartbeat. I'll be honest, though: this is only suggested by test-tube studies, not real patients, so it's more of a theoretical concern. Still, on top of snakeroot's own strong blood-pressure-lowering punch, I'd loop in your pharmacist or doctor before combining them.

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 Timolol one above is among them. If you take anything else, check it against the full list below.

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 Timolol

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 Timolol, 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 Timolol

This page covers Indian Snakeroot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Timolol 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.

From our pharmacist’s overview on the Timolol page

“The supplement list for timolol (Blocadren, Timoptic) calls for genuine care, starting with its five major-rated entries. Timolol is a beta-blocker that slows the heart and lowers blood pressure, and even the eye-drop form absorbs enough to matter.”

Reviewed by 2 · Jul 18, 2026

Open the Timolol 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 Timolol 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 Timolol 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 Timolol
Steady interest

#1,641 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 Timolol

What Is Timolol Used For?

Brand names: Blocadren, Timol, Timoptic

Timolol is available in ophthalmic (eye) forms and as an oral tablet, and each form has its own approved uses. Ophthalmic formulations — including Betimol, Istalol, Timolol GFS, Timolol hemihydrate, Timolol Maleate eye drops, and Timolol Maleate Ophthalmic Gel Forming Solution — are used to lower elevated intraocular pressure (pressure inside the eye) in people with ocular hypertension or open-angle glaucoma.

Timolol Maleate tablets are used orally for three separate conditions: treating high blood pressure (alone or combined with other blood pressure medicines), reducing the risk of death and repeat heart attack in people who have survived a heart attack and are clinically stable, and preventing migraine headaches.

See full Timolol 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
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
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 Indian Snakeroot and Timolol Together: Common Questions

Can you take Indian Snakeroot with Timolol?
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 Timolol?
Timolol 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 Timolol 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

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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.