Drug & supplement interaction

Squill + Acetazolamide

Acetazolamide brand names: Diamox, Ak-Zol.

Moderate Interaction
The bottom line Moderate

Squill has a moderate interaction with Acetazolamide. Squill contains cardiac glycosides. Theoretically, concomitant use with potassium-depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion.

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

Squill and Acetazolamide

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

Moderate

DIURETIC DRUGS

Why this applies to Acetazolamide

Acetazolamide falls under DIURETIC DRUGS — the group Squill interacts with.

Squill contains cardiac glycosides. Theoretically, concomitant use with potassium-depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), 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 the concern with pairing Squill and acetazolamide (Diamox). Squill contains natural compounds called cardiac glycosides that act on your heart in a way very similar to the drug digoxin. Acetazolamide is a diuretic (a 'water pill'), and like many diuretics it can lower your body's potassium levels over time.

The worry is that when potassium drops too low, the heart becomes more sensitive to those squill glycosides, which raises the risk of dangerous heart rhythm changes. To be clear, this is a theoretical interaction based on how these things work, not on hard human studies, so we don't want to overstate it. Still, squill itself can be quite toxic. Please don't start squill without first checking with your pharmacist or doctor.

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

Squill Also Interacts With Other Medications

Squill has 1 major, 154 moderate known drug interactions in our database — the Acetazolamide 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 Squill

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

From our Q&A

Questions About Squill or Acetazolamide

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

This page covers Squill only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetazolamide page lists 284 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), American Mistletoe (major) and Asarabacca (major).

By severity: 15 major · 242 moderate · 27 minor.

From our pharmacist’s overview on the Acetazolamide page

“Acetazolamide, taken for glaucoma, altitude sickness, and certain seizure types, works partly as a diuretic and can make people drowsy, and most of the supplements that interact with it press on one of those two points. The biggest group adds to its blood-pressure and fluid effects, a second deepens sedation (alcohol and kava sit at th…”

Reviewed by 2 · Jul 18, 2026

Open the Acetazolamide interaction page

One more smart check

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

We hold 2 real supplement products containing Squill, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Squill. Your product may carry other ingredients that interact with Acetazolamide too, on top of Squill — 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 Squill and Acetazolamide 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 Squill
Top half

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

29 days ago today
Medication Acetazolamide
Top half

#1,080 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 Squill

What is Squill?

Squill
  • Cough and chest congestion
  • Fluid retention (diuretic)
  • Heart conditions (traditional 'cardiac tonic')
  • Hair loss (topical use)
  • Rodenticide (red squill, non-medicinal)

Squill is a bulb plant that contains potent cardiac glycosides, which can affect the heart much like the drug digoxin. While it has a long history of use as a cough remedy and heart tonic, it can be dangerously toxic and there is little solid evidence for its modern use, so we do not recommend taking it without close medical supervision.

Read the full Squill monograph & all interactions
Medication

About Acetazolamide

What Is Acetazolamide Used For?

Brand names: Diamox, Ak-Zol

Acetazolamide is used as an add-on treatment for several conditions. Across tablets and the intravenous injection, it treats glaucoma (including open-angle and secondary glaucoma, and before surgery for acute angle-closure glaucoma), certain types of epilepsy (centrencephalic seizures, including petit mal), edema (fluid buildup) due to congestive heart failure, and drug-induced edema.

Acetazolamide extended-release capsules are specifically indicated for the prevention or reduction of acute mountain sickness symptoms — such as headache, nausea, and dizziness — in climbers attempting rapid ascent. Acetazolamide tablets and the intravenous injection are also indicated for acute mountain sickness.

See full Acetazolamide drug information
Keep checking

Other Drugs & Squill

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

1Major
154Moderate
0Minor
2,674No known interaction
Major

1 interaction

Moderate

154 interactions

Showing 60 of 154 moderate interactions — see all 154 on the Squill page.

No interaction 2,674 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 Squill and Acetazolamide Together: Common Questions

Can you take Squill with Acetazolamide?
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 Squill and Acetazolamide 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 Acetazolamide and Squill?

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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.