Drug & supplement interaction

Vitamin B6 + Guanethidine, Hydrochlorothiazide

Guanethidine, Hydrochlorothiazide brand name: Esimil.

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

Vitamin B6 has a moderate interaction with Guanethidine, Hydrochlorothiazide. Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.

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

Vitamin B6 and Guanethidine, Hydrochlorothiazide

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Guanethidine, Hydrochlorothiazide

Guanethidine, Hydrochlorothiazide falls under ANTIHYPERTENSIVE DRUGS — the group Vitamin B6 interacts with.

Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
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

Esimil combines guanethidine and hydrochlorothiazide, two medicines that work together to lower your blood pressure. Here's the wrinkle with vitamin B6: high doses may have their own mild blood-pressure-lowering effect. Stack that on top of your medication and the two could add up, nudging your numbers lower than intended.

If that happens, you might feel dizzy or lightheaded, especially when standing up quickly, since guanethidine already tends to cause that kind of drop. Keep in mind this is mostly based on animal studies and a few human trials, so it's a possible effect, not a sure thing. Everyday B6 from food won't matter. If you're considering a high-dose supplement, run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hatzitolios, A., Iliadis, F., Katsiki, N., and Baltatzi, M. Is the anti-hypertensive effect of dietary supplements via aldehydes reduction evidence based? A systematic review. Clin Exp.Hypertens. 2008;30(7):628-639. PubMed
  2. Vasdev, S., Ford, C. A., Parai, S., Longerich, L., and Gadag, V. Dietary vitamin B6 supplementation attenuates hypertension in spontaneously hypertensive rats. Mol.Cell Biochem. 1999;200(1-2):155-162.
  3. Aybak, M., Sermet, A., Ayyildiz, M. O., and Karakilcik, A. Z. Effect of oral pyridoxine hydrochloride supplementation on arterial blood pressure in patients with essential hypertension. Arzneimittelforschung. 1995;45(12):1271-1273.
  4. Lal, K. J., Dakshinamurti, K., and Thliveris, J. The effect of vitamin B6 on the systolic blood pressure of rats in various animal models of hypertension. J Hypertens. 1996;14(3):355-363. 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

Vitamin B6 Also Interacts With Other Medications

Vitamin B6 has 204 moderate, 5 minor known drug interactions in our database — the Guanethidine, Hydrochlorothiazide one above is one of them. If you take anything else, check it against the full list below.

Moderate 204 Minor 5 No known interaction 2,621 (incl. Guanethidine, Hydrochlorothiazide)
Taking anything else?

Check Another of Your Medications Against Vitamin B6

Covers the 2,830 medications we’ve checked against Vitamin B6. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Guanethidine, Hydrochlorothiazide

This page covers Vitamin B6 only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guanethidine, Hydrochlorothiazide 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 Guanethidine, Hydrochlorothiazide page

“Guanethidine with hydrochlorothiazide (Esimil) lowers blood pressure two ways at once, and 231 supplement and herbal ingredients on file can interfere with it, ten rated major and just 25 minor, so treat this page with genuine care. Most of the 196 moderate entries pile extra blood-pressure-lowering on top of the drug, and a second lar…”

Reviewed by 2 · Jul 18, 2026

Open the Guanethidine, Hydrochlorothiazide interaction page

One more smart check

Taking Vitamin B6 as Part of a Dietary Supplement Product? Check It for Interactions

We hold 24,838 real supplement products containing Vitamin B6, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Vitamin B6. Your product may carry other ingredients that interact with Guanethidine, Hydrochlorothiazide too, on top of Vitamin B6 — 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 Vitamin B6 and Guanethidine, 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 Vitamin B6
Top 10

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

29 days ago today
Medication Guanethidine, Hydrochlorothiazide
Steady interest

#1,862 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 Vitamin B6

What is Vitamin B6?

  • Morning sickness in pregnancy
  • Premenstrual syndrome (PMS)
  • Preventing or treating B6 deficiency
  • Nerve health and metabolism support
  • Nausea

Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-related nausea and may help some people with PMS, but taking very high doses for long periods can cause nerve damage. Get most of your B6 from food, and check with a pharmacist or doctor before taking high-dose supplements.

Read the full Vitamin B6 monograph & all interactions
Keep checking

Other Drugs & Vitamin B6

Browse every other medication we’ve checked against Vitamin B6 — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
204Moderate
5Minor
2,620No known interaction
204 Moderate 5 Minor 2,620 No interaction
Moderate

204 interactions

Showing 60 of 204 moderate interactions — see all 204 on the Vitamin B6 page.

Minor

5 interactions

No interaction 2,620 drugs checked — show the list

We also checked Vitamin B6 against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,620 medications checked with no known interaction — see the full Vitamin B6 list.

See the full Vitamin B6 interactions page
See every supplement checked against Guanethidine, Hydrochlorothiazide, 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
Vitamin B6 monograph › Uses, safety, and every drug interaction in one place Guanethidine, Hydrochlorothiazide supplement interactions › Every supplement checked against Guanethidine, Hydrochlorothiazide, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Vitamin B6 and Guanethidine, Hydrochlorothiazide Together: Common Questions

Can you take Vitamin B6 with Guanethidine, 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 Vitamin B6 and Guanethidine, 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 Guanethidine, Hydrochlorothiazide and Vitamin B6?

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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.