Drug & supplement interaction

Oregon Grape + Azilsartan

Azilsartan brand name: Edarbi.

Moderate Interaction
The bottom line Moderate

Azilsartan falls into 2 drug categories that Oregon Grape can interact with; the most serious is rated moderate. Theoretically, Oregon grape might increase the risk of hypotension when taken with antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Oregon Grape and Azilsartan

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Oregon Grape interacts with whole categories of medication. Azilsartan falls into 2 of those categories, so it can interact with Oregon Grape in 2 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 2

Why this applies to Azilsartan

Azilsartan falls under ANTIHYPERTENSIVE DRUGS — the group Oregon Grape interacts with.

Theoretically, Oregon grape might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that berberine, a constituent of Oregon grape, can have hypotensive effects. Also, an analysis of clinical evidence suggests that taking berberine in combination with amlodipine (Norvasc) can lower systolic and diastolic blood pressure when compared with taking amlodipine alone.
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 gist: Oregon grape contains berberine, which on its own may nudge blood pressure down a little. Azilsartan (Edarbi) already lowers your blood pressure by relaxing your blood vessels. Stack the two, and in theory their effects could add up, pushing your numbers lower than you want.

If that happened, you might feel dizzy, lightheaded, tired, or woozy when standing up too fast. I'll be honest though, this concern comes mainly from animal and lab studies, so it's more of a theoretical caution than something proven in people taking azilsartan. Azilsartan isn't a prodrug, so this is simply about overlapping effects, not changed metabolism. If you'd like to try Oregon grape, check with your pharmacist or doctor first and keep an eye on your blood pressure.

References
  1. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  2. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  3. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Azilsartan also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP2C9.
Preliminary clinical evidence suggests that berberine, a constituent of Oregon grape, can inhibit cytochrome P450 2C9 (CYP2C9).
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 gist: your blood pressure pill azilsartan (Edarbi) is partly cleared by a liver enzyme called CYP2C9. The berberine in Oregon grape may slow that enzyme down a bit. If it does, a little more azilsartan can linger in your system, which could nudge its blood-pressure-lowering effect a touch higher. In practice, that might show up as dizziness, lightheadedness when you stand, or unusually low readings.

I want to be honest about the strength here: this is mostly theoretical and based on limited evidence, so for many people it may never cause a noticeable problem. Azilsartan isn't a prodrug, so it doesn't get weaker from this. Still, before adding Oregon grape supplements, check with your pharmacist or doctor so they can keep an eye on your numbers.

References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. 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

Oregon Grape Also Interacts With Other Medications

Oregon Grape has 1,217 moderate known drug interactions in our database — the Azilsartan 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 Oregon Grape

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

From our Q&A

Questions About Oregon Grape or Azilsartan

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

This page covers Oregon Grape only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azilsartan page lists 182 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 Adrafinil (moderate).

By severity: 4 major · 145 moderate · 33 minor.

From our pharmacist’s overview on the Azilsartan page

“Edarbi (azilsartan) lowers blood pressure, and its users are often the same shoppers browsing supplements sold for heart health, which makes this list of 182 ingredients one to treat with real care. Start with the four rated major: activated charcoal can soak up an oral dose before it absorbs, tyramine can push pressure up and blunt th…”

Reviewed by 2 · Jul 18, 2026

Open the Azilsartan interaction page

One more smart check

Taking Oregon Grape as Part of a Dietary Supplement Product? Check It for Interactions

We hold 740 real supplement products containing Oregon Grape, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Oregon Grape. Your product may carry other ingredients that interact with Azilsartan too, on top of Oregon Grape — 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 Oregon Grape and Azilsartan 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 Oregon Grape
Top 25%

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

29 days ago today
Medication Azilsartan
Steady interest

#1,556 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 Oregon Grape

What is Oregon Grape?

Oregon Grape
  • Psoriasis (topical)
  • Eczema and other skin conditions
  • Digestive upset
  • Mild skin infections
  • General 'detox' or tonic use

Oregon grape is a shrub whose root contains berberine and related compounds. The strongest (though still modest) evidence is for topical creams that may slightly ease psoriasis; evidence for other uses is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Oregon Grape monograph & all interactions
Medication

About Azilsartan

What Is Azilsartan Used For?

Brand name: Edarbi

Azilsartan medoxomil tablets — sold as both the generic Azilsartan Medoxomil and the brand Edarbi — are approved to treat high blood pressure (hypertension) in adults. Bringing blood pressure down lowers the risk of serious cardiovascular events, especially stroke and heart attack.

The medication can be used on its own or alongside other blood pressure medicines. It is not a cure for high blood pressure, and managing the condition fully often involves lifestyle steps like limiting sodium, exercising, and quitting smoking.

See full Azilsartan drug information
Keep checking

Other Drugs & Oregon Grape

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

0Major
1,217Moderate
0Minor
1,612No known interaction
Moderate

1,217 interactions

Showing 60 of 1,217 moderate interactions — see all 1,217 on the Oregon Grape page.

No interaction 1,612 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 Oregon Grape and Azilsartan Together: Common Questions

Can you take Oregon Grape with Azilsartan?
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 2 interactions listed for Oregon Grape and Azilsartan?
Azilsartan belongs to more than one drug category, and Oregon Grape 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 Oregon Grape and Azilsartan 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

Still Have a Question About Azilsartan and Oregon Grape?

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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.