Drug & supplement interaction

Phellodendron + Mometasone, formoterol

Mometasone, formoterol brand name: Zenhale.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Mometasone, formoterol falls into 3 drug categories that Phellodendron can interact with; the most serious is rated moderate. Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2D6.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Phellodendron and Mometasone, formoterol

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Phellodendron interacts with whole categories of medication. Mometasone, formoterol falls into 3 of those categories, so it can interact with Phellodendron in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 3

Why this applies to Mometasone, formoterol

Mometasone, formoterol falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Phellodendron interacts with.

Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2D6.
Phellodendron contains berberine. In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6. Theoretically, phellodendron might also inhibit CYP2D6.
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 quick version: Zenhale is an inhaler that combines mometasone (a steroid that calms airway swelling) and formoterol (a long-acting bronchodilator that opens the lungs). The concern on file is that phellodendron contains berberine, which may block the CYP2D6 enzyme. In theory, slowing that enzyme could let a little more of the medicine linger in your system, nudging up the chance of formoterol side effects like a fast or pounding heart, jitteriness, shakiness, or trouble sleeping.

I want to be honest with you though: this is a theoretical caution based on lab work, not real-world reports with this inhaler, and most of the inhaled dose acts right in your lungs. It's worth a quick mention to your pharmacist or doctor before adding phellodendron, but please don't stop your inhaler on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  2. 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
  3. 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

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

Mometasone, formoterol 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

Zenhale combines two medicines you breathe in: mometasone (a steroid) and formoterol (a long-acting bronchodilator that opens your airways). The concern here is theoretical. Phellodendron contains berberine, which lab and early human research suggests can slow down a liver enzyme called CYP2C9. If that enzyme is partly responsible for clearing your inhaler's medicine, levels could in theory creep up a bit.

In real life, this is a soft, unproven worry. Because you inhale Zenhale, only small amounts reach your bloodstream. Still, if levels rose, you might notice more formoterol-type effects like a fast or pounding heartbeat, jitteriness, or shakiness. I wouldn't lose sleep over it, but please run it by your pharmacist or doctor before adding phellodendron, especially if you already feel jittery.

Contact Dr. Brian directly if you have additional questions on this interaction
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 3

Mometasone, formoterol 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

Zenhale combines two active medicines: mometasone (an inhaled steroid) and formoterol (a long-acting bronchodilator that opens your airways). Both are partly cleared by a liver enzyme called CYP3A4. The berberine in phellodendron may slow that enzyme down, so in theory more of these medicines could linger in your body. With the steroid side, that could mean a slightly higher chance of side effects over time. With formoterol, you might notice things like a faster heartbeat, jitteriness, tremor, or a headache.

I'll be honest with you though, this is a theoretical concern based on lab and early research, not strong real-world data, and inhaled doses reach the bloodstream in small amounts. Still, it's worth a quick chat with your pharmacist or doctor before adding phellodendron.

Contact Dr. Brian directly if you have additional questions on this interaction
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

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 Mometasone, formoterol one above is among them. If you take anything else, check it against the full list below.

Moderate 1,159 No known interaction 1,671 (incl. Mometasone, formoterol)
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.

Everything else you take

See Every Supplement That Interacts With Mometasone, formoterol

This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mometasone, formoterol page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 2 major · 120 moderate · 33 minor.

From our pharmacist’s overview on the Mometasone, formoterol page

“Mometasone and formoterol (Zenhale) is an inhaled asthma controller, a steroid paired with a long-acting airway opener, and its supplement list calls for real vigilance rather than a shrug. Nearly everything on it acts on the liver enzymes that break these medicines down, chiefly one called CYP3A4.”

Reviewed by 2 · Jul 18, 2026

Open the Mometasone, formoterol 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 Mometasone, formoterol 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 Mometasone, formoterol 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 Mometasone, formoterol
Steady interest

#2,205 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
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
1,159 Moderate 1,670 No 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

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

Showing the 60 most looked-up of 1,670 medications checked with no known interaction — see the full Phellodendron list.

See the full Phellodendron interactions page
See every supplement checked against Mometasone, formoterol, ranked by severity
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
Phellodendron monograph › Uses, safety, and every drug interaction in one place Mometasone, formoterol supplement interactions › Every supplement checked against Mometasone, formoterol, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Phellodendron and Mometasone, formoterol Together: Common Questions

Can you take Phellodendron with Mometasone, formoterol?
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 3 interactions listed for Phellodendron and Mometasone, formoterol?
Mometasone, formoterol 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 Mometasone, formoterol 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.