Drug & supplement interaction

Soy + Hydralazine, Hydrochlorothiazide, Reserpine

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

Moderate Interaction
The bottom line Moderate

Hydralazine, Hydrochlorothiazide, Reserpine falls into 2 drug categories that Soy can interact with; the most serious is rated moderate. Theoretically soy protein may have additive effects with antihypertensive drugs and increase the risk of hypotension.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceA
What do Severity, Likelihood & Evidence mean?
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Interaction report

Soy and Hydralazine, Hydrochlorothiazide, Reserpine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Soy interacts with whole categories of medication. Hydralazine, Hydrochlorothiazide, Reserpine falls into 2 of those categories, so it can interact with Soy in 2 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 2

Why this applies to Hydralazine, Hydrochlorothiazide, Reserpine

Hydralazine, Hydrochlorothiazide, Reserpine falls under ANTIHYPERTENSIVE DRUGS — the group Soy interacts with.

Theoretically soy protein may have additive effects with antihypertensive drugs and increase the risk of hypotension.
Although some contradictory research exists, most clinical evidence suggests that consuming soy protein modestly reduces systolic and diastolic blood pressure in individuals with prehypertension or hypertension.
Severity Moderate Likelihood Possible Evidence A

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

This combination pill teams up three blood pressure lowering medicines: hydralazine relaxes your blood vessels, hydrochlorothiazide is a water pill, and reserpine calms certain nerve signals. Here's the thing with soy: studies suggest soy protein can modestly nudge blood pressure down on its own. So when you add soy on top of these medicines, the small effects can stack up.

For most people eating tofu, edamame, or soy milk as part of meals, this is gentle and usually not a problem. With concentrated soy supplements, your pressure could dip a bit lower than expected, leaving you lightheaded, dizzy when you stand, or unusually tired. If you're starting soy supplements or noticing these signs, check with your pharmacist or doctor before changing anything.

References
  1. He J, Gu D, Wu X, et al. Effect of soybean protein on blood pressure: A randomized, controlled trial. Ann Intern Med 2005;143:1-9. PubMed
  2. Sacks FM, Lichtenstein A, Van Horn L, et al. Soy protein, isoflavones, and cardiovascular health. An American Heart Association Science Advisory for Professionals from the Nutrition Committee. Circulation 2006;113:1034-44. PubMed
  3. Altorf-van der Kuil, W., Engberink, M. F., Brink, E. J., van Baak, M. A., Bakker, S. J., Navis, G., van, 't, V, and Geleijnse, J. M. Dietary protein and blood pressure: a systematic review. PLoS.One. 2010;5(8):e12102. PubMed
Moderate

DIURETIC DRUGS

2 of 2

Hydralazine, Hydrochlorothiazide, Reserpine also falls under DIURETIC DRUGS.

Theoretically, soy might have additive effects when used with diuretic drugs.
Animal research suggests that genistein, a soy isoflavone, increases diuresis within 6 hours of subcutaneous administration in rats. The effects seem to be similar to those of furosemide. This effect 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

This combo pill packs a water pill (hydrochlorothiazide) along with two blood pressure lowering medicines (hydralazine and reserpine). The concern with soy here is pretty mild and mostly theoretical. In animal studies, the soy isoflavone genistein acted a little like a diuretic, helping the body shed extra fluid. That same effect has never been shown in people.

If it did add up, you could in theory pass more urine or feel a bit dizzy or lightheaded, especially when standing. Honestly, this isn't something I'd lose sleep over from soy in foods like tofu or edamame. Concentrated soy isoflavone capsules are a different story, so just give your pharmacist a heads up before starting those.

References
  1. Gimenez, I., Martinez, R. M., Lou, M., Mayoral, J. A., Garay, R. P., and Alda, J. O. Salidiuretic action by genistein in the isolated, perfused rat kidney. Hypertension 1998;31(2):706-711. 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

Soy Also Interacts With Other Medications

Soy has 9 major, 342 moderate, 259 minor known drug interactions in our database — the Hydralazine, Hydrochlorothiazide, Reserpine 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 Soy

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

Everything else you take

See Every Supplement That Interacts With Hydralazine, Hydrochlorothiazide, Reserpine

This page covers Soy 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

One more smart check

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

We hold 821 real supplement products containing Soy, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Soy. Your product may carry other ingredients that interact with Hydralazine, Hydrochlorothiazide, Reserpine too, on top of Soy — 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 Soy 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 Soy
Top 25%

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

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

#2,108 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 Soy

What is Soy?

  • Menopause symptoms (hot flashes)
  • Heart and cholesterol health
  • Bone health
  • Plant-based protein source
  • General nutrition

Soy is a nutritious bean that is a staple food and a popular source of plant protein and isoflavones. Eating soy foods as part of a balanced diet is generally considered safe for most people, and there is moderate evidence it may modestly help cholesterol and some menopause symptoms, though results vary. Talk with your pharmacist or doctor before using concentrated soy isoflavone supplements, especially if you have a history of hormone-sensitive conditions.

Read the full Soy monograph & all interactions
Keep checking

Other Drugs & Soy

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

9Major
342Moderate
259Minor
2,219No known interaction
Major

9 interactions

Moderate

342 interactions

Showing 60 of 342 moderate interactions — see all 342 on the Soy page.

Minor

259 interactions

Showing 60 of 259 minor interactions — see all 259 on the Soy page.

No interaction 2,219 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 Soy and Hydralazine, Hydrochlorothiazide, Reserpine Together: Common Questions

Can you take Soy 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.
Why are there 2 interactions listed for Soy and Hydralazine, Hydrochlorothiazide, Reserpine?
Hydralazine, Hydrochlorothiazide, Reserpine belongs to more than one drug category, and Soy 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 Soy 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.