Drug & supplement interaction

Quassia + Spironolactone

Spironolactone brand names: Aldactone, Spiroton, Carospir.

Moderate Interaction
The bottom line Moderate

Quassia has a moderate interaction with Spironolactone. Overuse of quassia might compound diuretic-induced potassium loss.

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

Quassia and Spironolactone

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

Moderate

DIURETIC DRUGS

Why this applies to Spironolactone

Spironolactone falls under DIURETIC DRUGS — the group Quassia interacts with.

Overuse of quassia might compound diuretic-induced potassium loss. There is some concern that people taking quassia along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients.
Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), and 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

Here's an interesting wrinkle with this pairing. The concern on file is about diuretics that flush out potassium, like furosemide or hydrochlorothiazide. But spironolactone is different. It's a potassium-sparing diuretic, meaning it actually helps your body hold onto potassium rather than lose it. So the usual worry about quassia worsening low potassium doesn't really line up with how spironolactone works.

If anything, the bigger thing to watch with spironolactone is potassium running too high, which can cause muscle weakness or an irregular heartbeat. This particular interaction is theoretical and based on pharmacology, not strong human studies. Still, before adding quassia, it's worth a quick chat with your pharmacist or doctor so they can keep an eye on your potassium levels.

References
  1. Robbers JE, Speedie MK, Tyler VE. Pharmacognosy and Pharmacobiotechnology. Baltimore, MD: Williams & Wilkins, 1996.

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 161 moderate, 36 minor known drug interactions in our database — the Spironolactone 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 Spironolactone

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 Spironolactone, 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 Spironolactone

This page covers Quassia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Spironolactone page lists 206 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), Lithium (major) and Oleander (major).

By severity: 7 major · 174 moderate · 25 minor.

From our pharmacist’s overview on the Spironolactone page

“Potassium is the supplement I check first for anyone on spironolactone (Aldactone, Carospir), because this water pill works by holding potassium in the body, and supplementing more on top of that can push blood levels too high. It is one of 206 supplement and herbal ingredients with documented interactions here, and the list warrants g…”

Reviewed by 2 · Jul 18, 2026

Open the Spironolactone 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 Spironolactone 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 Spironolactone 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 Spironolactone
Top 10%

#278 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 Spironolactone

What Is Spironolactone Used For?

Brand names: Aldactone, Spiroton, Carospir

Spironolactone tablets (including Aldactone) are used to treat moderate-to-severe heart failure, high blood pressure, and fluid retention (edema) caused by liver cirrhosis or nephrotic syndrome. They are also used to diagnose and manage primary hyperaldosteronism — a condition where the adrenal glands produce too much of the hormone aldosterone.

Spironolactone oral suspension shares several of these uses — heart failure, high blood pressure, and edema from liver cirrhosis — but is not the same as Aldactone and is not therapeutically interchangeable with it. Your prescriber will choose the right form for your situation.

See full Spironolactone 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
161Moderate
36Minor
2,632No known interaction
Moderate

161 interactions

Showing 60 of 161 moderate interactions — see all 161 on the Quassia page.

Minor

36 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 Spironolactone Together: Common Questions

Can you take Quassia with Spironolactone?
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 Quassia and Spironolactone 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 Spironolactone 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.