Drug & supplement interaction

Licorice + Trandolapril, Verapamil

Trandolapril, Verapamil brand name: Tarka.

Moderate Interaction
The bottom line Moderate

Trandolapril, Verapamil falls into 5 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 report
SeverityModerate
LikelihoodPossible
Interactions5
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Licorice and Trandolapril, Verapamil

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

Licorice interacts with whole categories of medication. Trandolapril, Verapamil falls into 5 of those categories, so it can interact with Licorice in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 5

Why this applies to Trandolapril, Verapamil

Trandolapril, Verapamil falls under ANTIHYPERTENSIVE DRUGS — the group Licorice interacts with.

Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.
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

Tarka is a combo pill that lowers blood pressure two ways: trandolapril relaxes your vessels and verapamil eases the heart and arteries. Here's the catch with licorice. Regular licorice (the kind with glycyrrhizin) makes your body hold onto salt and water and lose potassium, which tends to push blood pressure up. That works against what your Tarka is trying to do, so your numbers could creep higher and the medicine may seem less effective.

This is mostly a concern with concentrated supplements or eating a lot of real licorice candy regularly, not the occasional piece. Deglycyrrhizinated (DGL) licorice doesn't carry this risk. If you use licorice often, check in with your pharmacist or doctor before changing anything.

References
  1. 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.
  2. 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
  3. Koster, M. and David, G. K. Reversible severe hypertension due to licorice ingestion. N Engl J Med 1968;278(25):1381-1383. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 5

Trandolapril, Verapamil also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
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.
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 something to keep on your radar with Tarka. The verapamil part of this combo is processed by a liver enzyme called CYP3A4, and licorice can nudge that enzyme in either direction depending on the type. If licorice speeds the enzyme up, your verapamil may clear faster and work less well. If it slows the enzyme down, verapamil can build up, which could mean a slower heart rate, dizziness, swelling in the ankles, or constipation.

Honestly, this is mostly theoretical right now, based on limited and mixed studies. But there's a separate, real concern: regular licorice (the glycyrrhizin kind) can raise blood pressure and drop potassium, which works against your blood pressure medicine. Please run any licorice supplement past your pharmacist or doctor first.

References
  1. 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
  2. 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
  3. 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
  4. 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
Moderate

P-GLYCOPROTEIN SUBSTRATES

3 of 5

Trandolapril, Verapamil also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein 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

Tarka combines two medicines: verapamil (for blood pressure and heart rate) and trandolapril (an ACE inhibitor that relaxes blood vessels). The concern here is that licorice may rev up a transporter called P-glycoprotein, which can act like a pump pushing some drugs back out of your gut. In theory, that could mean a little less of these medicines gets absorbed, so they might not work quite as well. Keep in mind this is based only on lab research, so it's a weak, theoretical signal, not something proven in real patients.

There's a bigger, more practical worry though. Regular (glycyrrhizin-containing) licorice can raise blood pressure and lower potassium, which works directly against what Tarka is doing. Please check with your pharmacist or doctor before using licorice, and DGL versions are usually the safer pick.

References
  1. 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
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

4 of 5

Trandolapril, Verapamil also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
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 honest picture with Tarka (which combines trandolapril and verapamil) and licorice. In the lab, licorice extract can slow down an enzyme called CYP2C8, and the worry is that this might let certain drugs build up. But this is only a test-tube finding and hasn't been seen in real people, so I wouldn't lose sleep over the enzyme part itself.

The bigger, more practical concern is licorice itself. Regular licorice (the kind with glycyrrhizin) can raise blood pressure and lower potassium, which works directly against what Tarka is trying to do for your blood pressure. Verapamil already affects the heart, so swings in potassium aren't something to take lightly. DGL licorice usually avoids this. Please check with your pharmacist before using licorice supplements regularly.

References
  1. 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
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

5 of 5

Trandolapril, Verapamil also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.
Severity Minor 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 Tarka (the trandolapril and verapamil combo) and licorice. There's a lab-only finding that licorice may speed up an enzyme called CYP1A2, which in theory could clear certain drugs a bit faster. For Tarka, this connection is very weak and based only on test-tube work, so I wouldn't lose sleep over it.

The bigger, more practical concern is something different: real licorice (the glycyrrhizin kind) can raise blood pressure and lower potassium. That works directly against what your blood pressure medicine is trying to do, and verapamil already affects your heart rhythm. Occasional candy-sized amounts are usually fine. If you're using licorice supplements or DGL regularly, please check with your pharmacist or doctor first.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. 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

Licorice Also Interacts With Other Medications

Licorice has 976 moderate, 63 minor known drug interactions in our database — the Trandolapril, Verapamil 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 Licorice

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

From our Q&A

Questions About Licorice or Trandolapril, Verapamil

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 Trandolapril, Verapamil, 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 Trandolapril, Verapamil

This page covers Licorice only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Trandolapril, Verapamil page lists 304 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), Asarabacca (major) and Beer (major).

By severity: 11 major · 250 moderate · 43 minor.

From our pharmacist’s overview on the Trandolapril, Verapamil page

“This is one of the supplement lists I would want a patient to read closely, not skim. Tarka combines trandolapril and verapamil to lower blood pressure, and most of these interactions pull on that same lever, either dropping pressure further than intended or working against the medicine altogether.”

Reviewed by 2 · Jul 18, 2026

Open the Trandolapril, Verapamil interaction page

One more smart check

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 Trandolapril, Verapamil 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:

How much people look this up

Where Licorice and Trandolapril, Verapamil 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 Licorice
Top 5%

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

29 days ago today
Medication Trandolapril, Verapamil
Top 25%

#517 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 Licorice

What is Licorice?

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.

Read the full Licorice monograph & all interactions
Keep checking

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.

0Major
976Moderate
63Minor
1,790No known interaction
Moderate

976 interactions

Showing 60 of 976 moderate interactions — see all 976 on the Licorice page.

Minor

63 interactions

Showing 60 of 63 minor interactions — see all 63 on the Licorice page.

No interaction 1,790 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

Keep exploring
Pharmacist Counseling Corner

Taking Licorice and Trandolapril, Verapamil Together: Common Questions

Can you take Licorice with Trandolapril, Verapamil?
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.
Why are there 5 interactions listed for Licorice and Trandolapril, Verapamil?
Trandolapril, Verapamil belongs to more than one drug category, and Licorice 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 Licorice and Trandolapril, Verapamil 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

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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.