Drug & supplement interaction

Swamp Milkweed + Captopril, Hydrochlorothiazide

Captopril, Hydrochlorothiazide brand names: Capozide, Acezide.

Moderate Interaction
The bottom line Moderate

Swamp Milkweed has a moderate interaction with Captopril, Hydrochlorothiazide. Theoretically, potassium depleting diuretics might increase the risk of toxicity with swamp milkweed.

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

Swamp Milkweed and Captopril, Hydrochlorothiazide

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

Moderate

DIURETIC DRUGS

Why this applies to Captopril, Hydrochlorothiazide

Captopril, Hydrochlorothiazide falls under DIURETIC DRUGS — the group Swamp Milkweed interacts with.

Theoretically, potassium depleting diuretics might increase the risk of toxicity with swamp milkweed.
Swamp milkweed contains cardioactive steroids known as cardenolides that may have digitalis-like activity. Potassium depletion can increase the risk of cardenolide toxicity.
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 this combo. Your blood pressure pill contains hydrochlorothiazide, a 'water pill' that can lower your body's potassium over time. Swamp Milkweed contains natural compounds that act a little like digitalis (a heart drug), and they can affect your heart rhythm. When potassium runs low, the heart becomes more sensitive to those compounds, which in theory could raise the risk of irregular or dangerous heartbeats.

I want to be honest: this is a theoretical worry based on how these substances work, not proven cases. But Swamp Milkweed is genuinely toxic and isn't a tested supplement, so I wouldn't take it at all. Please check with your pharmacist or doctor before using it, and they can also keep an eye on your potassium level.

References
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 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

Swamp Milkweed Also Interacts With Other Medications

Swamp Milkweed has 3 major, 152 moderate known drug interactions in our database — the Captopril, Hydrochlorothiazide 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 Swamp Milkweed

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

Everything else you take

See Every Supplement That Interacts With Captopril, Hydrochlorothiazide

This page covers Swamp Milkweed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Captopril, Hydrochlorothiazide page lists 236 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 · 199 moderate · 27 minor.

From our pharmacist’s overview on the Captopril, Hydrochlorothiazide page

“Someone taking Capozide (captopril with hydrochlorothiazide) for blood pressure is often the same person browsing the supplement aisle for heart health, and that is exactly where this list bites. Of the 236 ingredients on file, 10 are rated major, enough to make this a genuine safety review, not trivia.”

Reviewed by 2 · Jul 18, 2026

Open the Captopril, Hydrochlorothiazide interaction page

How much people look this up

Where Swamp Milkweed and Captopril, 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 Swamp Milkweed
Steady interest

#1,237 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Captopril, Hydrochlorothiazide
Top 25%

#366 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 Swamp Milkweed

What is Swamp Milkweed?

  • Traditional digestive remedy
  • Diuretic (increasing urine)
  • Cough and respiratory complaints
  • Worm or parasite remedy (folk use)
  • Pollinator/garden plant rather than medicine

Swamp Milkweed is a native North American wetland plant best known today as a butterfly and pollinator garden plant, not a proven medicine. It contains toxic milky sap with cardiac glycoside-like compounds, and there is very little reliable human research to support any health use. Because of its potential toxicity, it should not be used as a supplement without professional guidance.

Read the full Swamp Milkweed monograph & all interactions
Medication

About Captopril and Hydrochlorothiazide

What Is Captopril and Hydrochlorothiazide Used For?

Brand names: Capozide, Acezide

Captopril and hydrochlorothiazide tablets are used to treat high blood pressure (hypertension). The two ingredients work together to lower blood pressure more effectively than either one alone.

This combination may be started as initial therapy or substituted when a patient has already been adjusted on both ingredients separately. It is approved for patients with normal kidney function, and is used more cautiously in those with impaired kidney function.

See full Captopril and Hydrochlorothiazide drug information
Keep checking

Other Drugs & Swamp Milkweed

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

3Major
152Moderate
0Minor
2,674No known interaction
Major

3 interactions

Moderate

152 interactions

Showing 60 of 152 moderate interactions — see all 152 on the Swamp Milkweed 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

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Pharmacist Counseling Corner

Taking Swamp Milkweed and Captopril, Hydrochlorothiazide Together: Common Questions

Can you take Swamp Milkweed with Captopril, 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.
How serious is the Swamp Milkweed and Captopril, 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

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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.