Drug & supplement interaction

Quercetin + Irbesartan, Hydrochlorothiazide

Irbesartan, Hydrochlorothiazide brand name: CoAprovel.

Moderate Interaction
The bottom line Moderate

Irbesartan, Hydrochlorothiazide falls into 4 drug categories that Quercetin can interact with; the most serious is rated moderate. Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceB
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Quercetin and Irbesartan, Hydrochlorothiazide

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

Why Are There 4 Interactions?

Quercetin interacts with whole categories of medication. Irbesartan, Hydrochlorothiazide falls into 4 of those categories, so it can interact with Quercetin 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 Irbesartan, Hydrochlorothiazide

Irbesartan, Hydrochlorothiazide falls under ANTIHYPERTENSIVE DRUGS — the group Quercetin interacts with.

Theoretically, taking quercetin with antihypertensive drugs might increase the risk of hypotension.

Quercetin can modestly decrease blood pressure in people with mild hypertension. Theoretically, it might have additive blood pressure lowering effects when used with antihypertensive drugs.
Severity Moderate Likelihood Possible Evidence B

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 simple version: CoAprovel already lowers your blood pressure two ways. Irbesartan relaxes your blood vessels, and hydrochlorothiazide (a water pill) helps your body shed extra fluid and salt. Quercetin, in concentrated supplement doses, may nudge blood pressure down a little on its own. Stack the two together and the effects can add up, which could push your pressure lower than intended.

If that happens, you might feel dizzy, lightheaded, or tired, especially when you stand up quickly. This is mostly theoretical and based on weak human evidence, and everyday food amounts of quercetin (apples, onions, tea) are very unlikely to matter. Before starting a high-dose supplement, just check with your pharmacist or doctor so they can keep an eye on your numbers.

References
  1. Edwards RL, Lyon T, Litwin SE, et al. Quercetin reduces blood pressure in hypertensive subjects. J Nutr 2007;137:2405-11.
  2. Larson A, Witman MA, Guo Y, et al. Acute, quercetin-induced reductions in blood pressure in hypertensive individuals are not secondary to lower plasma angiotensin-converting enzyme activity or endothelin-1: nitric oxide. Nutr Res. 2012;32(8):557-64. PubMed
Moderate

ORGANIC ANION TRANSPORTER 3 (OAT3) SUBSTRATES

2 of 4

Irbesartan, Hydrochlorothiazide also falls under ORGANIC ANION TRANSPORTER 3 (OAT3) SUBSTRATES.

Theoretically, concomitant use might increase the effects and adverse effects of OAT3 substrates.

In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT3, with half-maximal inhibitory concentration (IC50) values as low as 0.75 mcM. So far, this interaction has not been reported in humans.
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 for your CoAprovel, which pairs irbesartan (a blood pressure pill) with the water pill hydrochlorothiazide. Your kidneys use a little transporter called OAT3 to help clear these out of your body. In test-tube studies, quercetin blocks that transporter pretty strongly. If it works the same way in people, your body might clear these drugs a bit slower, leaving more of them around. That could nudge their effects up, things like lower blood pressure, lightheadedness, dizziness when standing, more frequent urination, or shifts in potassium and sodium.

The key point: this is theoretical, based only on lab work and never reported in real patients. Food amounts of quercetin are very unlikely to matter. Before starting a high-dose supplement, just run it by your pharmacist or doctor.

References
  1. Li C, Wang X, Bi Y, et al. Potent Inhibitors of Organic Anion Transporters 1 and 3 From Natural Compounds and Their Protective Effect on Aristolochic Acid Nephropathy. Toxicol Sci. 2020;175(2):279-291. PubMed
  2. Ni Y, Duan Z, Zhou D, et al. Identification of Structural Features for the Inhibition of OAT3-Mediated Uptake of Enalaprilat by Selected Drugs and Flavonoids. Front Pharmacol. 2020;11:802. PubMed
Moderate

ORGANIC ANION TRANSPORTER 1 (OAT1) SUBSTRATES

3 of 4

Irbesartan, Hydrochlorothiazide also falls under ORGANIC ANION TRANSPORTER 1 (OAT1) SUBSTRATES.

Theoretically, concomitant use might increase the effects and adverse effects of OAT1 substrates.

In vitro research shows that quercetin is a strong non-competitive inhibitor of OAT1, with half-maximal inhibitory concentration (IC50) values less than 10 mcM. So far, this interaction has not been reported in humans.
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 short version: your blood pressure pill combines irbesartan with hydrochlorothiazide (a water pill). The kidneys use a transporter called OAT1 to help clear certain drugs, and in lab dish studies quercetin can block that transporter. In theory, blocking it could let a bit more of the drug linger in your body, which might nudge its effects a little stronger.

What that could feel like: slightly lower blood pressure than usual, with possible dizziness, lightheadedness when you stand, or more frequent urination. But honestly, this is only seen in test-tube research and hasn't been reported in real people. Everyday food amounts of quercetin are very unlikely to matter. Before starting a high-dose supplement, just check with your pharmacist or doctor.

References
  1. Ni Y, Duan Z, Zhou D, et al. Identification of Structural Features for the Inhibition of OAT3-Mediated Uptake of Enalaprilat by Selected Drugs and Flavonoids. Front Pharmacol. 2020;11:802. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

4 of 4

Irbesartan, Hydrochlorothiazide also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, concomitant use might increase the levels and adverse effects of CYP2C9 substrates.

A small clinical study in healthy volunteers shows that taking quercetin 500 mg twice daily for 10 days prior to taking diclofenac, a CYP2C9 substrate, increases diclofenac plasma levels by 75% and prolongs the half-life by 32.5%. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar), a substrate of CYP2C9. Furthermore, laboratory research shows that quercetin inhibits CYP2C9.
Severity Moderate Likelihood Possible Evidence B

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 situation with CoAprovel (which combines irbesartan and hydrochlorothiazide) and quercetin. The irbesartan part is partly handled by a liver enzyme called CYP2C9. Quercetin in high supplement doses appears to slow that enzyme down, so in theory irbesartan could hang around longer and have a slightly stronger effect. Irbesartan is not a prodrug, so more drug in your system means more blood-pressure lowering, not less.

What that could feel like is dizziness, lightheadedness, or feeling washed out, especially when you stand up quickly. Honestly though, this is mostly theoretical and based on small or animal studies, and food amounts of quercetin are unlikely to matter. If you're considering a high-dose supplement, just run it past your pharmacist or doctor first.

References
  1. Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000;294:88-95. DOI
  2. DiCenzo R, Frerichs V, Larppanichpoonphol P, et al. Effect of quercetin on the plasma and intracellular concentrations of saquinavir in healthy adults. Pharmacotherapy 2006;26:1255-61. PubMed
  3. Bedada SK, Neerati P. Evaluation of the effect of quercetin treatment on CYP2C9 enzyme activity of diclofenac in healthy human volunteers. Phytother Res. 2018 Feb;32(2):305-311. doi: 10.1002/ptr.5978. PubMed
  4. Zhao Q, Wei J, Zhang H. Effects of quercetin on the pharmacokinetics of losartan and its metabolite EXP3174 in rats. Xenobiotica 2019;49(5):563-8. 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

Quercetin Also Interacts With Other Medications

Quercetin has 1,168 moderate known drug interactions in our database — the Irbesartan, Hydrochlorothiazide 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 Quercetin

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

Everything else you take

See Every Supplement That Interacts With Irbesartan, Hydrochlorothiazide

This page covers Quercetin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Irbesartan, Hydrochlorothiazide page lists 273 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 · 226 moderate · 37 minor.

Open the Irbesartan, Hydrochlorothiazide interaction page

One more smart check

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

We hold 4,589 real supplement products containing Quercetin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Quercetin. Your product may carry other ingredients that interact with Irbesartan, Hydrochlorothiazide too, on top of Quercetin — 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 Quercetin and Irbesartan, Hydrochlorothiazide 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 Quercetin
Top 5%

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

29 days ago today
Medication Irbesartan, Hydrochlorothiazide
Top 10%

#206 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 Quercetin

What is Quercetin?

Quercetin
  • Seasonal allergies
  • Antioxidant support
  • Heart and blood pressure health
  • Anti-inflammatory support
  • Immune support
  • Exercise recovery

Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood pressure, and inflammation, strong human evidence is limited for most uses. It is generally well tolerated in food amounts, but talk to your pharmacist or doctor before taking high-dose supplements.

Read the full Quercetin monograph & all interactions
Keep checking

Other Drugs & Quercetin

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

0Major
1,168Moderate
0Minor
1,661No known interaction
Moderate

1,168 interactions

Showing 60 of 1,168 moderate interactions — see all 1,168 on the Quercetin page.

No interaction 1,661 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 Quercetin and Irbesartan, Hydrochlorothiazide Together: Common Questions

Can you take Quercetin with Irbesartan, Hydrochlorothiazide?
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 Quercetin and Irbesartan, Hydrochlorothiazide?
Irbesartan, Hydrochlorothiazide belongs to more than one drug category, and Quercetin 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 Quercetin and Irbesartan, Hydrochlorothiazide 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 Irbesartan, Hydrochlorothiazide and Quercetin?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.