Drug & supplement interaction

Pau D'arco + Metoprolol

Metoprolol brand names: Lopressor, Toprol XL.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Pau D'arco and Metoprolol in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Metoprolol states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Pau D'arco and Metoprolol

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Metoprolol and Pau D'arco in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Pau D'arco safety at a glance

Pau D'arco overall Use caution May cause side effects at higher doses and human safety data is limited.
Pregnancy Possibly Unsafe When used orally in typical doses. Animal studies have found that lapachol, a constituent of pau d'arco, has teratogenic and abortifacient effects; avoid using.... Read the full pregnancy detail
Breastfeeding Avoid Not enough safety information is available, so avoid while breastfeeding.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Metoprolol and Pau D'arco? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Metoprolol

Interactions in our licensed database are recorded against drug classes, not just single drug names. Metoprolol is filed under 6 classifications — including beta-blockers, antihypertensive drugs, cytochrome p450 2d6 (cyp2d6) substrates. Pau D'arco has documented interactions with 1 drug class — the most serious being anticoagulant/antiplatelet drugs (moderate) — and none of Metoprolol’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Pau D'arco Does Interact With Other Medications

Pau D'arco has 122 moderate known drug interactions in our database — Metoprolol isn’t one of them. If you take anything else, check it against the full list below.

Moderate 122 No known interaction 2,708 (incl. Metoprolol)
Taking anything else?

Check Another of Your Medications Against Pau D'arco

Covers the 2,830 medications we’ve checked against Pau D'arco. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Pau D'arco and Metoprolol May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Wheezing Worth acting on Additional detail

    Pau D'arco

    “Occupational exposure to sawdust from the pau d'arco tree and related species may cause asthma and dermatitis. The fresh sawdust can produce erythema and papules which progress to a severe weeping and crusting dermatitis.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in asthma.

    1 source cited
    1. 92184. Algranti E, Mendonça EM, Ali SA, Kokron CM, Raile V. Occupational asthma caused by Ipe (Tabebuia spp) dust. J Investig Allergol Clin Immunol 2005;15(1):81-3.

    Metoprolol

    Listed in the ADVERSE REACTIONS section of the FDA label for Metoprolol. Read the label on DailyMed ›

  • Bleeding or bruising Worth acting on Additional detail

    Pau D'arco

    “Orally, the lapachol constituent of pau d'arco, taken in doses above 1.5 grams daily, may cause anemia and increased risk of bleeding.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in anemia.

    1 source cited
    1. 91939. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.

    Metoprolol

    Listed in the ADVERSE REACTIONS section of the FDA label for Metoprolol. Read the label on DailyMed ›

  • Dizziness Additional detail

    Pau D'arco

    “Orally, the lapachol constituent of pau d'arco, taken in doses above 1.5 grams daily, may cause dizziness.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in vertigo.

    1 source cited
    1. 91939. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.

    Metoprolol

    Listed in the ADVERSE REACTIONS section of the FDA label for Metoprolol. Read the label on DailyMed ›

  • Diarrhea / Vomiting / Nausea Additional detail

    Pau D'arco

    “Orally, the lapachol constituent of pau d'arco, taken in doses above 1.5 grams daily, may cause severe nausea, vomiting, and diarrhea.”

    Pau D'arco · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 91939. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.

    Metoprolol

    Listed in the ADVERSE REACTIONS section of the FDA label for Metoprolol. Read the label on DailyMed ›

  • A skin rash Additional detail

    Pau D'arco

    Recorded for Pau D'arco in the same Natural Medicines adverse-effect record shown under Wheezing above.

    Metoprolol

    Listed in the ADVERSE REACTIONS section of the FDA label for Metoprolol. Read the label on DailyMed ›

Reported for Pau D'arco but not commonly for Metoprolol: anemia.

Effects for Metoprolol come from the ADVERSE REACTIONS section of its FDA label; effects for Pau D'arco come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Pau D'arco in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally in typical doses. Animal studies have found that lapachol, a constituent of pau d'arco, has teratogenic and abortifacient effects; avoid using. There is insufficient reliable information available about the safety of pau d'arco when used topically in pregnancy; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Metoprolol Products Have a Food Rule — Pau D'arco Should Not Break It

At least one FDA label for a product containing Metoprolol says to take it with food. If you take Pau D'arco on an empty stomach out of habit, keep them separate — and take Metoprolol with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Metoprolol products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Administer once daily with food or after a meal.

From the Dosage and Administration section of the FDA label we read for Metoprolol — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Pau D'arco or Metoprolol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Pau D'arco or Metoprolol, 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 Metoprolol

This page covers Pau D'arco only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metoprolol page lists 183 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), Indian Snakeroot (major) and Tyramine (major).

By severity: 5 major · 152 moderate · 26 minor.

From our pharmacist’s overview on the Metoprolol page

“With metoprolol (Lopressor, Toprol XL), a beta-blocker for high blood pressure and heart problems, these interactions deserve genuine care, starting with the five rated major. Most entries pull blood pressure one way or the other: many supplements add to metoprolol's lowering effect and can drop pressure too far, while a few, tyramine…”

Reviewed by 2 · Jul 18, 2026

Open the Metoprolol interaction page

One more smart check

Taking Pau D'arco as Part of a Dietary Supplement Product? Check It for Interactions

We hold 707 real supplement products containing Pau D'arco, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pau D'arco. Even though Pau D'arco itself has no known interaction with Metoprolol, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Pau D'arco and Metoprolol 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 Pau D'arco
Top 25%

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

29 days ago today
Medication Metoprolol
Top 10

#7 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Pau D'arco reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Pau D'arco and Metoprolol records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Pau D'arco

What is Pau D'arco?

Pau D'arco
  • Infections (bacterial, fungal, yeast)
  • Inflammation
  • Immune support
  • Digestive complaints
  • Skin conditions

Pau d'arco is a South American tree bark traditionally used for infections and inflammation, and it contains compounds like lapachol that show activity in lab studies. However, strong human evidence is lacking, and safety concerns exist at higher doses, so it should be used cautiously and discussed with a pharmacist or doctor first.

Handroanthus impetiginosus · Bignoniaceae · Inner bark · Tea (decoction), capsules, tablets, liquid extracts, tinctures

An interaction check asks whether these two react with each other — it does not ask whether Pau D'arco is a good idea for someone in your situation. Here is what our Pau D'arco record says about it on its own.

Pau D'arco: dosing

There is no well-established, standardized dose for pau d'arco. Products vary widely in strength and form, and the amount of active compounds can differ from one product to another.Because larger doses raise the risk of toxic effects, it is best to use the smallest reasonable amount, follow the directions on the product label, and not exceed them.

From our Pau D'arco monograph — the full record covers uses, side effects and every documented interaction.

Read the full Pau D'arco monograph & all interactions
Medication

About Metoprolol

What Is Metoprolol Used For?

Brand names: Lopressor, Toprol XL

Metoprolol is used to treat several heart and blood pressure conditions. Metoprolol succinate extended-release tablets (including Toprol-XL) are approved for high blood pressure, angina pectoris (chest pain from the heart), and heart failure. Metoprolol tartrate tablets (including Lopressor) are approved for high blood pressure, angina, and — when used alongside intravenous metoprolol — to reduce the risk of cardiovascular death after a definite or suspected heart attack.

Metoprolol tartrate injection (intravenous form) is used in hemodynamically stable patients with a definite or suspected acute heart attack to reduce cardiovascular death, and is followed by oral metoprolol therapy. Lowering blood pressure with metoprolol reduces the risk of strokes and heart attacks.

Most-Reported Side Effects for Metoprolol

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 23,416 reports
Dyspnea 20,183 reports
Diarrhea 19,912 reports
Nausea 19,659 reports
Dizziness 16,726 reports
See full Metoprolol drug information
Keep checking

Other Drugs & Pau D'arco

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

0Major
122Moderate
0Minor
2,707No known interaction
122 Moderate 2,707 No interaction
Moderate

122 interactions

Showing 60 of 122 moderate interactions — see all 122 on the Pau D'arco page.

No interaction 2,707 drugs checked — show the list

We also checked Pau D'arco against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,707 medications checked with no known interaction — see the full Pau D'arco list.

See the full Pau D'arco interactions page
See every supplement checked against Metoprolol, ranked by severity
Evidence & sources

Pau D'arco References

The 6 references that drive our Pau D'arco monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gómez Castellanos JR, Prieto JM, Heinrich M. Red Lapacho (Tabebuia impetiginosa)--a global ethnopharmacological commodity? J Ethnopharmacol 2009;121:1-13. PubMed
  2. Guerra, Mde O., Mazoni, A. S., Brandao, M. A., and Peters, V. M. Toxicology of Lapachol in rats: embryolethality. Braz.J Biol. 2001;61(1):171-174. PubMed
  3. Felicio, A. C., Chang, C. V., Brandao, M. A., Peters, V. M., and Guerra, Mde O. Fetal growth in rats treated with lapachol. Contraception 2002;66(4):289-293. PubMed
  4. Son, D. J., Lim, Y., Park, Y. H., Chang, S. K., Yun, Y. P., Hong, J. T., Takeoka, G. R., Lee, K. G., Lee, S. E., Kim, M. R., Kim, J. H., and Park, B. S. Inhibitory effects of Tabebuia impetiginosa inner bark extract on platelet aggregation and vascular s
  5. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4(4):27-8.
  6. Algranti E, Mendonça EM, Ali SA, Kokron CM, Raile V. Occupational asthma caused by Ipe (Tabebuia spp) dust. J Investig Allergol Clin Immunol 2005;15(1):81-3.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Pau D'arco and Metoprolol Together: Common Questions

Is it safe to take Pau D'arco with Metoprolol?
We do not list a known interaction between Pau D'arco and Metoprolol. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Pau D'arco and Metoprolol have any of the same side effects?
Yes — our sources link each of them separately to 7 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Pau D'arco and Metoprolol at the same time of day?
At least one FDA label for a product containing Metoprolol says to take it with food. If you take Pau D'arco on an empty stomach out of habit, keep them separate and take Metoprolol with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Metoprolol products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Pau D'arco and Metoprolol combination checked?
Interactions in our licensed database are recorded against drug classes. Metoprolol is filed under 6 classifications, and Pau D'arco has documented interactions with 1 drug class — none of Metoprolol's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Pau D'arco interact with any other medications?
Yes. Pau D'arco has 122 documented drug interactions in our database — Metoprolol is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Metoprolol interact with any supplements?
Yes. Metoprolol has documented interactions with 183 supplements in our database — Pau D'arco is not one of them. The Metoprolol interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Pau D'arco monograph Uses, safety profile, and every drug interaction in one place Metoprolol drug information The full plain-English guide to this medication Metoprolol supplement interactions Every supplement checked against Metoprolol, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 6 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Metoprolol and Pau D'arco?

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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.