Drug & supplement interaction

Oregon Grape + Hydrocortisone

Hydrocortisone brand names: Cortef, Hydrocortone, Carmol HC cream, Hydrocortisone Iodoquinol Cream, Vytone Cream, and others.

Moderate Interaction
The bottom line Moderate

Hydrocortisone falls into 2 drug categories that Oregon Grape can interact with; the most serious is rated moderate. Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP3A4.

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

Oregon Grape and Hydrocortisone

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. Hydrocortisone 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

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Hydrocortisone

Hydrocortisone falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Oregon Grape interacts with.

Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP3A4.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, moderately inhibits cytochrome P450 3A4 (CYP3A4).
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: your body uses an enzyme called CYP3A4 to break down hydrocortisone. Oregon grape contains berberine, which may gently slow that same enzyme. If hydrocortisone clears more slowly, a bit more of it can linger in your system, which could nudge up the usual steroid effects, things like fluid retention, higher blood sugar, trouble sleeping, mood changes, or stomach upset.

I want to be honest about how solid this is: it's mostly theoretical, based on lab work and a little early human data, not strong real-world proof. For most people, especially with short-term or topical hydrocortisone, it's unlikely to cause trouble. Still, before pairing them, run it by your pharmacist or doctor so they can check your specific dose.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. 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
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Hydrocortisone also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, Oregon grape might increase serum levels of drugs that are P-glycoprotein (P-gp) substrates.
In vitro research suggests that Oregon grape extracts inhibit P-gp efflux.
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: your body uses a tiny pump called P-glycoprotein to shuttle certain drugs, including hydrocortisone, back out of cells. Oregon grape contains berberine, which in lab dish studies seems to block that pump a little. In theory, that could let slightly more hydrocortisone build up in your system.

Honestly, this is a weak, theoretical concern based only on test-tube research, not on people, so I wouldn't lose sleep over it. If it did matter, you might notice more typical steroid effects like fluid retention, a bump in blood sugar, mood changes, or trouble sleeping. Topical creams are even less likely to cause trouble. Before adding Oregon grape, just run it by your pharmacist or doctor, especially if you take hydrocortisone daily.

References
  1. Fan Y, Zhou Z, Zhang L. Effect of Oregon grape root extracts on P-glycoprotein mediated transport in in vitro cell lines. J Pharm Pharm Sci 2024;26:11927. 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 1,218 moderate known drug interactions in our database — the Hydrocortisone 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 Hydrocortisone

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 Hydrocortisone, 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 Hydrocortisone

This page covers Oregon Grape only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrocortisone page lists 205 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lily-of-the-valley (major), St. John's Wort (major) and Acacia Rigidula (moderate).

By severity: 4 major · 164 moderate · 37 minor.

Open the Hydrocortisone 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 Hydrocortisone 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 Hydrocortisone 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%

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

29 days ago today
Medication Hydrocortisone
Steady interest

#1,593 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 Hydrocortisone

What Is Hydrocortisone Used For?

Brand names: Cortef, Hydrocortone, Carmol HC cream, Hydrocortisone Iodoquinol Cream, Vytone Cream, Massengil Medicated Towelettes, Dioderm, Efcortelan Cream, Mildison, Alphaderm, Calmurid HC, Efcortelan Ointment, Texacort, Alkindi Sprinkle

Hydrocortisone comes in many products, and each one is approved for different uses. Which one you get depends on the condition being treated.

Cortef tablets are used for adrenal insufficiency, congenital adrenal hyperplasia, rheumatic disorders (such as rheumatoid arthritis and gouty arthritis) and collagen diseases such as lupus. Hydrocortisone sodium succinate and Solu-Cortef injections are used when oral therapy is not feasible, for severe allergic states, skin diseases, and adrenal insufficiency. Alkindi (oral granules) is used as replacement therapy in children with adrenocortical insufficiency. Cortenema, Hydrocortisone Rectal Suspension and Cortifoam are used for ulcerative colitis or ulcerative proctitis. Topical hydrocortisone butyrate and valerate products, including Evesse lotion, are used for itchy, inflamed skin conditions and atopic dermatitis.

See full Hydrocortisone 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
1,218Moderate
0Minor
1,611No known interaction
Moderate

1,218 interactions

Showing 60 of 1,218 moderate interactions — see all 1,218 on the Oregon Grape page.

No interaction 1,611 drugs checked — show the list

We also checked Oregon Grape against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,611 medications checked with no known interaction — see the full Oregon Grape 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 Oregon Grape and Hydrocortisone Together: Common Questions

Can you take Oregon Grape with Hydrocortisone?
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 Hydrocortisone?
Hydrocortisone 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 Hydrocortisone 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.