Licorice + Ambrisentan
Ambrisentan brand names: Letairis, Volibris.
Ambrisentan falls into 3 drug categories that Licorice can interact with; the most serious is rated moderate. Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full interaction reportLicorice and Ambrisentan
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Licorice interacts with whole categories of medication. Ambrisentan falls into 3 of those categories, so it can interact with Licorice in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
ANTIHYPERTENSIVE DRUGS
1 of 3Why this applies to Ambrisentan
Ambrisentan falls under ANTIHYPERTENSIVE DRUGS — the group Licorice interacts with.
In human research, licorice increases blood pressure in a dose-dependent manner.
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.
Here's the simple version: Ambrisentan (Letairis) works to relax and lower the pressure in the blood vessels going to your lungs. Licorice, when it contains glycyrrhizin, does the opposite kind of thing in the body. It makes you hold onto sodium and water and lose potassium, which can nudge your blood pressure up. So the worry is that real licorice could work against what ambrisentan is trying to do for your PAH.
This is mostly a theoretical concern, and it depends on dose. Regular licorice candy or supplements taken often or in large amounts matter most, while deglycyrrhizinated (DGL) products are far less likely to cause this. Before adding any licorice, please check with your pharmacist or doctor.
- Sigurjonsdottir HA, Ragnarsson J, Franzson L, Sigurdsson G. Is blood pressure commonly raised by moderate consumption of liquorice? J Hum Hypertens 1995;9:345-8.
- Sigurjonsdottir HA, Franzson L, Manhem K, et al. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens 2001;15:549-52. PubMed
- Koster, M. and David, G. K. Reversible severe hypertension due to licorice ingestion. N Engl J Med 1968;278(25):1381-1383. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Ambrisentan also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
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.
Here's the deal with combining licorice and your ambrisentan (Letairis). Ambrisentan is handled in part by a liver enzyme called CYP3A4, and licorice can nudge that enzyme in either direction depending on the type. Some licorice (with glycyrrhizin) may speed the enzyme up a bit, which could lower ambrisentan levels and possibly make it less effective for controlling your pulmonary hypertension. Other licorice (containing glabridin) may slow the enzyme, which could raise levels and increase side effects like swelling, fluid retention, flushing, or a stuffy nose.
Honestly, this is mostly theoretical and based on weaker studies, so I wouldn't panic. But ambrisentan is too important to risk. There's also a separate concern: licorice can raise blood pressure and cause fluid buildup, which works against what you're treating. Please check with your pharmacist or doctor before using any licorice supplement.
- Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Tu, J. H., He, Y. J., Chen, Y., Fan, L., Zhang, W., Tan, Z. R., Huang, Y. F., Guo, D., Hu, D. L., Wang, D., and Hong-Hao Zhou. Effect of glycyrrhizin on the activity of CYP3A enzyme in humans. Eur J Clin Pharmacol 2010;66(8):805-810. PubMed
- Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190. PubMed
P-GLYCOPROTEIN SUBSTRATES
3 of 3Ambrisentan also falls under P-GLYCOPROTEIN SUBSTRATES.
In vitro research shows that licorice can increase P-glycoprotein activity.
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.
Here's the gist for ambrisentan (Letairis). Your body uses a sort of cellular pump called P-glycoprotein to move drugs around, and lab studies suggest licorice may rev up that pump. If it does, your gut might shuttle a bit less ambrisentan into your bloodstream, which could leave you with a slightly weaker effect from the medicine that keeps your lung blood pressure in check.
I want to be honest about the strength of this: it comes from test-tube and animal work, not real patients, so it's mostly theoretical. The bigger concern with licorice is that it can raise blood pressure and lower potassium, which is not ideal when you're managing pulmonary hypertension. Please check with your pharmacist or doctor before adding it, and ask about DGL versions.
- Wang H, Dong L, Qu F, et al. Effects of glycyrrhizin on the pharmacokinetics of nobiletin in rats and its potential mechanism. Pharm Biol. 2020 Dec;58(1):352-356. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Licorice Also Interacts With Other Medications
Licorice has 976 moderate, 63 minor known drug interactions in our database — the Ambrisentan one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Licorice
We haven’t checked that one against Licorice yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Licorice. Pick one to open its full report.
Questions About Licorice or Ambrisentan
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Licorice or Ambrisentan, 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:
- Concerns With Taking Licorice With Metoprolol ›
- Can Licorice Or Alfalfa Affect Birth Control Pills? ›
- Is It Safe to Take Herbs With Lisinopril? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Ambrisentan
This page covers Licorice only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ambrisentan page lists 256 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), Beer (major) and Grapefruit (major).
By severity: 9 major · 210 moderate · 37 minor.
Taking Licorice as Part of a Dietary Supplement Product? Check It for Interactions
We hold 4,721 real supplement products containing Licorice, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Licorice. Your product may carry other ingredients that interact with Ambrisentan too, on top of Licorice — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Licorice and Ambrisentan 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.
#37 of 1,452 supplements looked up here in the last 7 days
#1,554 of 2,830 medications looked up here in the last 7 days
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.
About Licorice
What is Licorice?
- Sore throat and cough
- Heartburn and stomach upset
- Mouth ulcers and digestive complaints
- Inflammation
- Traditional tonic/adrenal support
Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, which can raise blood pressure and lower potassium when taken in large amounts or for a long time, so deglycyrrhizinated (DGL) products are often preferred. Talk to your pharmacist or doctor before using it, especially if you have high blood pressure, heart, or kidney problems.
About Ambrisentan
What Is Ambrisentan Used For?
Brand names: Letairis, Volibris
Ambrisentan tablets and Letairis tablets are both used to treat pulmonary arterial hypertension (PAH, WHO Group 1) — a condition where the blood pressure in the arteries leading to the lungs is dangerously high. Both are approved to help adults exercise better and slow the worsening of PAH.
Both ambrisentan tablets and Letairis are also approved to be used together with tadalafil (another PAH medicine) to further reduce the risk of disease progression, lower the chance of hospitalization for worsening PAH, and improve exercise ability. Most of the clinical evidence was in patients with mild-to-moderate symptoms and PAH caused by unknown or inherited causes, or PAH linked to connective tissue diseases.
Other Drugs & Licorice
Browse every other medication we’ve checked against Licorice — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
976 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Hydrocortisone ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ivermectin ›
- Lofepramine ›
- Medroxyprogesterone ›
Showing 60 of 976 moderate interactions — see all 976 on the Licorice page.
63 interactions
- Theophylline ›
- Acetaminophen ›
- Methotrexate ›
- Nortriptyline ›
- Bendamustine ›
- Riluzole ›
- Asenapine ›
- Clozapine ›
- Propafenone ›
- Ropinirole ›
- Tizanidine ›
- Anagrelide ›
- Bendamustine Hydrochloride ›
- Chlordiazepoxide ›
- Fezolinetant ›
- Fluvoxamine ›
- Grepafloxacin ›
- Methotrexate Sodium ›
- Mexiletine ›
- Olanzapine ›
- Paracetamol ›
- Pentazocine ›
- Pirfenidone ›
- Rasagiline ›
- Ropivacaine ›
- Tacrine ›
- Triclabendazole ›
- Acetaminophen, Butalbital ›
- Acetaminophen, Pseudoephedrine ›
- Guaifenesin, Theophylline ›
- Acetaminophen, Dichloralantipyrine, Isometheptene ›
- Acetaminophen, Oxycodone ›
- Acetaminophen, Propoxyphene ›
- Acetaminophen, Chlorzoxazone ›
- Acetaminophen, Diphenhydramine, Pseudoephedrine ›
- Acetaminophen, Chlorzoxazone, Codeine ›
- Acetaminophen, Codeine ›
- Acetaminophen, Codeine, Methocarbamol ›
- Acetaminophen, Diphenhydramine ›
- Acetaminophen, Phenyltoloxamine ›
- Ephedrine, Hydroxyzine, Theophylline ›
- Acetaminophen, Aspirin ›
- Acetaminophen, Brompheniramine, Phenylpropanolamine ›
- Acetaminophen, Butalbital, Codeine ›
- Acetaminophen, Butalbital, Codeine Phosphate ›
- Acetaminophen, Codeine, Doxylamine ›
- Acetaminophen, Dexbrompheniramine, Pseudoephedrine ›
- Acetaminophen, Dichloralphenazone, Isometheptene ›
- Acetaminophen, Dichlorophenazone, Isometheptane ›
- Acetaminophen, Doxylamine, Pseudoephedrine ›
- Acetaminophen, Meperidine ›
- Acetaminophen, Methocarbamol ›
- Acetaminophen, Pentazocine ›
- Acetaminophen, Phenylpropanolamine ›
- Acetaminophen, Phenylpropanolamine, Phenyltoloxamine ›
- Acetaminophen, Phenyltoloxamine, Salicylamide ›
- Acetaminophen, Pseudoephedrine, Triprolidine ›
- Aspirin, Pentazocine ›
- Chlordiazepoxide, Clidinium Bromide ›
- Codeine, Paracetamol ›
Showing 60 of 63 minor interactions — see all 63 on the Licorice page.
No interaction 1,790 drugs checked — show the list
We also checked Licorice against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Methamphetamine ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Lisdexamfetamine ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Lamotrigine ›
- Amphetamine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Dextroamphetamine ›
- Methylene Blue ›
- Duloxetine ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Factor 7a ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Venlafaxine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Phentermine, Topiramate ›
- Dirithromycin ›
- Bentoquatam ›
- Codeine Sulfate ›
- Procainamide ›
- Tenecteplase ›
- Amoxicillin, Clavulanate Potassium ›
- Hydroxychloroquine ›
- Azelaic Acid ›
- Dextrothyroxine ›
- Triptorelin ›
- Lomustine ›
Showing the 60 most looked-up of 1,790 medications checked with no known interaction — see the full Licorice list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Ambrisentan Is Linked to Lower Levels of One Nutrient
Natural Medicines records Ambrisentan as a medicine that can lower these. This is not an interaction with Licorice — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Ambrisentan nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Licorice and Ambrisentan Together: Common Questions
Can you take Licorice with Ambrisentan?
Why are there 3 interactions listed for Licorice and Ambrisentan?
How serious is the Licorice and Ambrisentan interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Ambrisentan and Licorice?
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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.