Drug & supplement interaction

Pleurisy Root + Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine brand names: Ser-Ap-Es, Unipres, Uniserp.

Moderate Interaction
The bottom line Moderate

Pleurisy Root has a moderate interaction with Hydralazine, Hydrochlorothiazide, Reserpine. Theoretically, concomitant use of potassium-depleting diuretics and pleurisy root can increase the risk of cardiac glycoside toxicity due to potassium depletion.

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

Pleurisy Root and Hydralazine, Hydrochlorothiazide, Reserpine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DIURETIC DRUGS

Why this applies to Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine falls under DIURETIC DRUGS — the group Pleurisy Root interacts with.

Theoretically, concomitant use of potassium-depleting diuretics and pleurisy root can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
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

The reason this combination raises a flag has nothing to do with how your blood pressure pill is broken down. It comes down to the hydrochlorothiazide part of your medicine, which is a water pill that can lower your body's potassium over time. Pleurisy root naturally contains heart-active compounds similar to the cardiac glycosides found in digoxin. When potassium runs low, those heart compounds can become more irritating to the heart, which in theory could raise the chance of an irregular or pounding heartbeat.

I want to be honest that this concern is theoretical, based on how these substances behave rather than real-world reports. Still, since pleurisy root can be toxic on its own, I'd skip it and check with your pharmacist or doctor before trying any herbal remedy.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Pleurisy Root Also Interacts With Other Medications

Pleurisy Root has 1 major, 115 moderate known drug interactions in our database — the Hydralazine, Hydrochlorothiazide, Reserpine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Pleurisy Root

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

Everything else you take

See Every Supplement That Interacts With Hydralazine, Hydrochlorothiazide, Reserpine

This page covers Pleurisy Root only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydralazine, Hydrochlorothiazide, Reserpine page lists 231 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), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 196 moderate · 25 minor.

From our pharmacist’s overview on the Hydralazine, Hydrochlorothiazide, Reserpine page

“Ser-Ap-Es combines three blood pressure drugs, hydralazine, hydrochlorothiazide, and reserpine, so this list deserves real attention before you add a supplement. Most of the 231 ingredients on file either push blood pressure down further than intended or pile onto the diuretic and drag potassium and fluid levels with it.”

Reviewed by 2 · Jul 18, 2026

Open the Hydralazine, Hydrochlorothiazide, Reserpine interaction page

How much people look this up

Where Pleurisy Root and Hydralazine, Hydrochlorothiazide, Reserpine 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 Pleurisy Root
Top half

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

29 days ago today
Medication Hydralazine, Hydrochlorothiazide, Reserpine
Steady interest

#1,738 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 Pleurisy Root

What is Pleurisy Root?

  • Respiratory congestion
  • Pleurisy and chest discomfort
  • Coughs and bronchitis
  • Promoting sweating during fevers
  • Loosening mucus

Pleurisy root is the dried root of Asclepias tuberosa (butterfly weed), a plant used in traditional North American and herbal medicine mainly for respiratory complaints. There is very little modern scientific evidence that it works for any condition, and it contains compounds that can be toxic, so caution is strongly advised. Pregnant and breastfeeding people should avoid it, and anyone considering it should check with a pharmacist or doctor first.

Read the full Pleurisy Root monograph & all interactions
Keep checking

Other Drugs & Pleurisy Root

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

1Major
115Moderate
0Minor
2,713No known interaction
Major

1 interaction

Moderate

115 interactions

Showing 60 of 115 moderate interactions — see all 115 on the Pleurisy Root page.

No interaction 2,713 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 Pleurisy Root and Hydralazine, Hydrochlorothiazide, Reserpine Together: Common Questions

Can you take Pleurisy Root with Hydralazine, Hydrochlorothiazide, Reserpine?
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.
How serious is the Pleurisy Root and Hydralazine, Hydrochlorothiazide, Reserpine 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.