Licorice - Florinef Acetate (Fludrocortisone) Interaction
Herbal: Licorice
Also Known As: Glycyrrhiza echinate, Alcacuz, Bois Doux, Can Cao, Deglycyrrhized Licorice, Gan Cao, Gan Zao, Glabra, Glycyrrhizic Acid, Glycyrrhizinic Acid, Kanzo, Lakritze, Liquiritiae Radix, Liquirizia, Mulathi, Mulethi, Orozuz, Subholz, Yashtimadhu, Yashti-Madhu
Drug: Fludrocortisone
Brand names:
Florinef Acetate
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 18, 2025
Interaction Details
Fludrocortisone is classified as belonging to the following category: P-Glycoprotein Substrates
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
Interaction Rating
Likelihood of Occurrence
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
References
- 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.
Interaction Details
Fludrocortisone is classified as belonging to the following category: Corticosteroids
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.
Interaction Rating
Likelihood of Occurrence
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
References
- Armanini D, Lewicka S, Pratesi C, et al. Further studies on the mechanism of the mineralocorticoid action of licorice in humans. J Endocrinol Invest 1996;19:624-9.
- Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 2003;88:2384-92.
- Chen MF, Shimada F, Kato H, Yano S, Kanaoka M. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41.
- Teelucksingh S, Mackie AD, Burt D, McIntyre MA, Brett L, Edwards CR. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Lancet 1990;335(8697):1060-3.
- Fugh-Berman, A. Herb-drug interactions. Lancet 2000;355(9198):134-138.
- Chen, M. F., Shimada, F., Kato, H., Yano, S., and Kanaoka, M. Effect of oral administration of glycyrrhizin on the pharmacokinetics of prednisolone. Endocrinol Jpn 1991;38(2):167-174.
- Benge E, Shah P, Yamaguchi L, Josef V. Trick or Treat? Licorice-Induced Hypokalemia: A Case Report. Cureus 2020;12(11):e11656.
Licorice Overview
Licorice, also known as glycyrrhiza, is a plant native to parts of Europe, Asia, and the Mediterranean region. The root of the plant has been used for centuries in traditional medicine and is often consumed in the form of candy, tea, and supplements.
Licorice has a number of purported health benefits, including the ability to soothe sore throats, reduce inflammation, and improve digestive problems. It may also have antiviral and antibacterial properties.
Licorice naturally contains glycyrrhizin, or glycyrrhizic acid, which can have toxic effects if consumed in large amounts. However, licorice can be processed to remove glycyrrhizin, resulting in DGL (deglycyrrhizinated licorice). Many dietary supplements that contain deglycyrrhizinated licorice are often simply named 'DGL'.
Licorice - More Interactions
Licorice interacts with 1011 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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