Drug & supplement interaction

Phellodendron + Losartan Potassium

Losartan Potassium brand name: Cozaar.

Moderate Interaction
The bottom line Moderate

Losartan Potassium falls into 4 drug categories that Phellodendron can interact with; the most serious is rated moderate. Theoretically, phellodendron might have additive effects with antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Phellodendron and Losartan Potassium

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Phellodendron interacts with whole categories of medication. Losartan Potassium falls into 4 of those categories, so it can interact with Phellodendron in 4 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 4

Why this applies to Losartan Potassium

Losartan Potassium falls under ANTIHYPERTENSIVE DRUGS — the group Phellodendron interacts with.

Theoretically, phellodendron might have additive effects with antihypertensive drugs.
Phellodendron contains berberine. Animal research suggests that berberine can have hypotensive effects. Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. Theoretically, phellodendron might also reduce blood pressure.
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: losartan (Cozaar) lowers your blood pressure, and Phellodendron contains berberine, which may gently nudge blood pressure down too. Put them together and those effects could add up. This isn't about one blocking the other in your liver. It's simply two things pushing in the same direction.

If your pressure drops too far, you might feel dizzy, lightheaded, or tired, especially when you stand up quickly. I'll be honest though, this concern is theoretical, based mostly on animal studies and one trial using berberine with a different blood pressure drug. It's worth a heads-up, not alarm. If you'd like to try Phellodendron, check with your pharmacist or doctor first and keep an eye on your blood pressure readings.

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 4

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

Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2C9.
Phellodendron contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, phellodendron might also inhibit CYP2C9.
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 a wrinkle worth knowing about losartan. Your body actually relies on an enzyme called CYP2C9 to turn losartan into its more powerful active form, so losartan behaves a bit like a prodrug. Phellodendron contains berberine, which lab and early human research suggests can slow down that very enzyme.

So in theory, taking phellodendron alongside losartan could mean less of the active form is made, which might make the medicine work a little less well at controlling your blood pressure. This is only a theoretical concern based on how the chemistry lines up, not something proven in real patients, so don't panic. Still, if you're considering this supplement, check in with your pharmacist or doctor first and keep an eye on your blood pressure readings.

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
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Losartan Potassium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP3A4.
Phellodendron contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, phellodendron might also inhibit 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 something interesting about losartan (Cozaar): it actually works in a bit of a backwards way compared to most pills. Losartan itself is fairly weak, and your liver uses an enzyme called CYP3A4 (along with CYP2C9) to convert it into a more powerful active form that does most of the blood pressure lowering. So losartan acts a little like a prodrug.

The berberine in phellodendron may gently slow down that CYP3A4 enzyme. In theory, that could mean less of the active form gets made, so your losartan might not lower your blood pressure as well as expected. Keep in mind this is based on lab and early research, not strong human studies, so it's a maybe, not a sure thing. If you take both, check your blood pressure at home and talk with your pharmacist or doctor before making any changes.

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

LOSARTAN (Cozaar)

4 of 4
Theoretically, phellodendron might reduce the therapeutic effects of losartan by decreasing its conversion to its active form.
Phellodendron contains berberine. Preliminary clinical research suggests that berberine can inhibit cytochrome P450 2C9 (CYP2C9) activity and reduce metabolism of losartan. Theoretically, phellodendron might also inhibit the metabolism of losartan.
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 a wrinkle that makes losartan unusual: it's actually a prodrug. Your body uses a liver enzyme called CYP2C9 to turn losartan into its active form (E-3174), which does most of the work of lowering your blood pressure. The berberine in Phellodendron can slow that same enzyme down.

So the concern goes the opposite way you might expect. If less losartan gets converted, you may get less blood pressure lowering, meaning your numbers could creep up. Keep in mind this is a theoretical interaction based on how these compounds behave, not strong human studies. Still, if you take losartan, check with your pharmacist or doctor before adding Phellodendron, and keep an eye on your home blood pressure readings.

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

Phellodendron Also Interacts With Other Medications

Phellodendron has 1,159 moderate known drug interactions in our database — the Losartan Potassium 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 Phellodendron

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

From our Q&A

Questions About Phellodendron or Losartan Potassium

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

This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Losartan Potassium page lists 253 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), Grapefruit (major) and St. John's Wort (major).

By severity: 6 major · 205 moderate · 42 minor.

From our pharmacist’s overview on the Losartan Potassium page

“Losartan potassium (Cozaar) treats high blood pressure, and this is a list to respect, because six of its 253 supplement interactions carry a major rating. Most entries do one of two things.”

Reviewed by 2 · Jul 18, 2026

Open the Losartan Potassium interaction page

One more smart check

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

We hold 393 real supplement products containing Phellodendron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phellodendron. Your product may carry other ingredients that interact with Losartan Potassium too, on top of Phellodendron — 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 Phellodendron and Losartan Potassium 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 Phellodendron
Top 25%

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

29 days ago today
Medication Losartan Potassium
Top 10

#6 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 Phellodendron

What is Phellodendron?

Phellodendron
  • Digestive complaints and diarrhea
  • Inflammation and joint discomfort
  • Stress and weight management (in combination products)
  • Skin conditions (topical, traditional)
  • Antimicrobial support

Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evidence for most uses is limited, and it is often sold in combination with other herbs, making its individual effects hard to judge. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Phellodendron monograph & all interactions
Medication

About Losartan

What Is Losartan Used For?

Brand name: Cozaar

Losartan tablets — available as branded Cozaar and several generic products — are used to treat high blood pressure (hypertension) in adults and children 6 years and older. Lowering blood pressure reduces the risk of strokes and heart attacks. Losartan tablets are also used to reduce the risk of stroke in people with high blood pressure who also have left ventricular hypertrophy (an enlarged left side of the heart). Note: evidence suggests this stroke-risk benefit may not apply to Black patients.

Losartan tablets are additionally approved to protect the kidneys in people with type 2 diabetes, high blood pressure, and signs of kidney damage (diabetic nephropathy). Arbli, the oral suspension form, shares these same approved uses.

See full Losartan drug information
Keep checking

Other Drugs & Phellodendron

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

0Major
1,159Moderate
0Minor
1,670No known interaction
Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Phellodendron page.

No interaction 1,670 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 Phellodendron and Losartan Potassium Together: Common Questions

Can you take Phellodendron with Losartan Potassium?
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 4 interactions listed for Phellodendron and Losartan Potassium?
Losartan Potassium belongs to more than one drug category, and Phellodendron 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 Phellodendron and Losartan Potassium 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 Losartan Potassium and Phellodendron?

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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.