Drug & supplement interaction

Quassia + Ranitidine Bismuth Citrate

Ranitidine Bismuth Citrate brand name: Tritec.

Minor Interaction
The bottom line Minor

Quassia has a minor interaction with Ranitidine Bismuth Citrate. Theoretically, due to reports that quassia increases stomach acid, quassia might decrease the effectiveness of H2-blockers.

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

Quassia and Ranitidine Bismuth Citrate

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

Minor

H2-BLOCKERS

Why this applies to Ranitidine Bismuth Citrate

Ranitidine Bismuth Citrate falls under H2-BLOCKERS — the group Quassia interacts with.

Theoretically, due to reports that quassia increases stomach acid, quassia might decrease the effectiveness of H2-blockers. The H2 blockers include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).
Severity Minor 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 thinking behind this one. Quassia is a strong bitter, and bitters can nudge your stomach into making more acid. Ranitidine bismuth citrate works in the opposite direction, calming acid down to ease ulcers, heartburn, or reflux. So in theory, sipping concentrated quassia could push back against the very effect you're taking this medicine for, meaning a bit more burning, sour stomach, or indigestion than you'd expect.

That said, this is very soft evidence, just a few anecdotal reports, and it's rated minor. A taste of bitters with a meal likely won't matter much, while regular concentrated doses are more of a question mark. If you notice your symptoms creeping back, check in with your pharmacist or doctor before changing anything.

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

Quassia Also Interacts With Other Medications

Quassia has 162 moderate, 35 minor known drug interactions in our database — the Ranitidine Bismuth Citrate 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 Quassia

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

From our Q&A

Questions About Quassia or Ranitidine Bismuth Citrate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Quassia or Ranitidine Bismuth Citrate, 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 Ranitidine Bismuth Citrate

This page covers Quassia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ranitidine Bismuth Citrate page lists 73 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), African Wild Potato (moderate), Banderol (moderate) and Beer (moderate).

By severity: 2 major · 43 moderate · 28 minor.

Open the Ranitidine Bismuth Citrate interaction page

One more smart check

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

We hold 172 real supplement products containing Quassia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Quassia. Your product may carry other ingredients that interact with Ranitidine Bismuth Citrate too, on top of Quassia — 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 Quassia and Ranitidine Bismuth Citrate 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 Quassia
Top half

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

29 days ago today
Medication Ranitidine Bismuth Citrate
Top half

#1,293 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 Quassia

What is Quassia?

  • Loss of appetite
  • Digestive upset
  • Head lice (topical)
  • Intestinal worms/parasites
  • Bitter tonic

Quassia is a tropical wood known for its very bitter taste, traditionally used as a digestive bitter and as a folk remedy for parasites and head lice. Human evidence for these uses is limited, and high doses may irritate the stomach, so it should be used cautiously and avoided in pregnancy.

Read the full Quassia monograph & all interactions
Medication

About Ranitidine

What Is Ranitidine Used For?

Brand name: Tritec

Ranitidine is used to treat several acid-related stomach and esophageal conditions. These include active duodenal ulcers (ulcers in the small intestine) and benign gastric ulcers (stomach ulcers), GERD (gastroesophageal reflux disease, or chronic acid reflux), erosive esophagitis (irritation and damage to the esophagus from acid), and pathological hypersecretory conditions — rare disorders where the stomach produces too much acid, such as Zollinger-Ellison syndrome and systemic mastocytosis. It is also used as maintenance therapy to keep ulcers and esophagitis from coming back after healing.

Over-the-counter products Acid Reducer and Wal-Zan tablets are specifically labeled to relieve heartburn associated with acid indigestion and sour stomach, and to prevent heartburn brought on by certain foods or beverages.

See full Ranitidine drug information
Keep checking

Other Drugs & Quassia

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

0Major
162Moderate
35Minor
2,632No known interaction
Moderate

162 interactions

Showing 60 of 162 moderate interactions — see all 162 on the Quassia page.

Minor

35 interactions

No interaction 2,632 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 Quassia and Ranitidine Bismuth Citrate Together: Common Questions

Can you take Quassia with Ranitidine Bismuth Citrate?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Quassia and Ranitidine Bismuth Citrate interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Ranitidine Bismuth Citrate and Quassia?

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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.