Drug & supplement interaction

Rhubarb + Methimazole

Methimazole brand name: Tapazole.

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

Rhubarb has a moderate interaction with Methimazole. Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

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

Rhubarb and Methimazole

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Methimazole

Methimazole falls under HEPATOTOXIC DRUGS — the group Rhubarb interacts with.

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.
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 concern with pairing rhubarb root with methimazole. This isn't about rhubarb changing how the drug works or how strong it is. Instead, both can be a little hard on the liver. Methimazole occasionally irritates the liver on its own, and rhubarb root (because of compounds called anthraquinones) has been tied to a small number of liver injury reports. Stacking two things that stress the liver could, in theory, add up.

I'll be honest: this is mostly theoretical, based on pharmacology and animal data, not strong human studies. Eating rhubarb stalks as food isn't the worry; concentrated root supplements are. Watch for yellowing skin or eyes, dark urine, belly pain, or fatigue, and check with your doctor before using rhubarb supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019;233:190-6. PubMed
  2. Zhao D, Feng SX, Zhang HJ, et al. Pharmacokinetics, tissue distribution and excretion of five rhubarb anthraquinones in rats after oral administration of effective fraction of anthraquinones from rheum officinale. Xenobiotica. 2021;51(8):916-925. 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

Rhubarb Also Interacts With Other Medications

Rhubarb has 657 moderate known drug interactions in our database — the Methimazole one above is one of them. If you take anything else, check it against the full list below.

Moderate 657 No known interaction 2,173 (incl. Methimazole)
Taking anything else?

Check Another of Your Medications Against Rhubarb

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

From our Q&A

Questions About Rhubarb or Methimazole

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

This page covers Rhubarb only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methimazole page lists 64 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Ascophyllum Nodosum (moderate).

By severity: 4 major · 51 moderate · 9 minor.

From our pharmacist’s overview on the Methimazole page

“Methimazole (Tapazole) treats an overactive thyroid, and because the drug can stress the liver on its own, this list calls for real vigilance. Of the 64 supplements on file, 4 are rated major, with 51 moderate and 9 minor.”

Reviewed by 2 · Jul 18, 2026

Open the Methimazole interaction page

One more smart check

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

We hold 133 real supplement products containing Rhubarb, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rhubarb. Your product may carry other ingredients that interact with Methimazole too, on top of Rhubarb — 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 Rhubarb and Methimazole 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 Rhubarb
Top 25%

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

29 days ago today
Medication Methimazole
Top half

#1,280 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 Rhubarb

What is Rhubarb?

Rhubarb
  • Constipation
  • Digestive upset
  • Menopausal symptoms
  • Kidney and liver conditions (traditional)
  • Pancreatitis (hospital/traditional use)

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality evidence, and the root can cause cramping and diarrhea. The leaves are toxic and should never be eaten, and rhubarb supplements are best avoided in pregnancy and breastfeeding.

Read the full Rhubarb monograph & all interactions
Medication

About Methimazole

What Is Methimazole Used For?

Brand name: Tapazole

Methimazole tablets are used in adults and children with hyperthyroidism (an overactive thyroid) due to Graves' disease or toxic multinodular goiter when surgery or radioactive iodine is not the right option. They work to lower thyroid hormone levels and ease symptoms.

Methimazole tablets are also used to bring thyroid hormone levels down before a patient undergoes thyroidectomy (thyroid surgery) or radioactive iodine treatment, making those procedures safer.

See full Methimazole drug information
Keep checking

Other Drugs & Rhubarb

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

0Major
657Moderate
0Minor
2,172No known interaction
657 Moderate 2,172 No interaction
Moderate

657 interactions

Showing 60 of 657 moderate interactions — see all 657 on the Rhubarb page.

No interaction 2,172 drugs checked — show the list

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

Showing the 60 most looked-up of 2,172 medications checked with no known interaction — see the full Rhubarb list.

See the full Rhubarb interactions page
See every supplement checked against Methimazole, 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
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Pharmacist Counseling Corner

Taking Rhubarb and Methimazole Together: Common Questions

Can you take Rhubarb with Methimazole?
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 Rhubarb and Methimazole 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 Methimazole and Rhubarb?

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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.