Drug & supplement interaction

White Hellebore + Macitentan

Macitentan brand name: Opsumit.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Oct 4, 2026
The bottom line No known interaction

We found no known interaction between White Hellebore and Macitentan in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

White Hellebore and Macitentan

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Macitentan and White Hellebore in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for White Hellebore at all — not against Macitentan, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

White Hellebore safety at a glance

White Hellebore overall Avoid The plant is highly poisonous and can cause life-threatening heart and nerve problems.
Pregnancy Likely Unsafe When used orally or topically because it could be teratogenic; avoid using. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally or topically; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Macitentan and White Hellebore? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests White Hellebore and Macitentan May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • A stuffy or runny nose Additional detail

    White Hellebore

    “Orally, white hellebore is toxic and can cause respiratory depression in large doses (6,101431).

    By inhalation, the powdered root induces violent sneezing and runny nose (6).”

    White Hellebore · Natural Medicines adverse-effect record, reported in depression.

    2 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 101431. Gilotta I, Brvar M. Accidental poisoning with Veratrum album mistaken for wild garlic (Allium ursinum). Clin Toxicol (Phila). 2010;48(9):949-52.

    Macitentan

    Listed in the ADVERSE REACTIONS section of the FDA label for Macitentan. Read the label on DailyMed ›

  • Low blood pressure Additional detail

    White Hellebore

    “Orally, white hellebore can cause bradycardia, and hypotension. Large doses of white hellebore can cause more severe bradycardia and hypotension and even cardiac arrythmias (6,553,95892,95893,101431,109467,115960).”

    White Hellebore · Natural Medicines adverse-effect record, reported in hypotension.

    6 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 553. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
    3. 95892. Grobosch T, Binscheck T, Martens F, Lampe D. Accidental intoxication with Veratrum album. J Anal Toxicol. 2008;32(9):768-73. PubMed
    4. 95893. Rauber-Lüthy C, Halbsguth U, Kupferschmidt H, et al. Low-dose exposure to Veratrum album in children causes mild effects--a case series. Clin Toxicol (Phila). 2010;48(3):234-7.
    5. 101431. Gilotta I, Brvar M. Accidental poisoning with Veratrum album mistaken for wild garlic (Allium ursinum). Clin Toxicol (Phila). 2010;48(9):949-52.
    6. 109467. Melnik EV, Belova MV, Potskhveriya MM, Simonova AY, Tyurin IA, Ramenskaya GV. Veratrum alkaloid determination in four cases of Veratrum aqua poisonings. J Anal Toxicol 2022;46(1):e42-e47.

    Macitentan

    Listed in the ADVERSE REACTIONS section of the FDA label for Macitentan. Read the label on DailyMed ›

  • Headache reported in 12.1% of FDA reports for Macitentan Additional detail

    White Hellebore

    “Orally, white hellebore is toxic and can cause vertigo, confusion, numbness, headache, paresthesia, seizures, loss of consciousness, and shock.”

    White Hellebore · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 553. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
    2. 101431. Gilotta I, Brvar M. Accidental poisoning with Veratrum album mistaken for wild garlic (Allium ursinum). Clin Toxicol (Phila). 2010;48(9):949-52.
    3. 95893. Rauber-Lüthy C, Halbsguth U, Kupferschmidt H, et al. Low-dose exposure to Veratrum album in children causes mild effects--a case series. Clin Toxicol (Phila). 2010;48(3):234-7.

    Macitentan

    Listed in the ADVERSE REACTIONS section of the FDA label for Macitentan, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for White Hellebore but not commonly for Macitentan: fainting, muscle weakness, stomach pain and blurred vision.

Effects for Macitentan come from the ADVERSE REACTIONS section of its FDA label; effects for White Hellebore come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 68,860 voluntary FDA FAERS reports for Macitentan that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

White Hellebore in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally or topically because it could be teratogenic; avoid using.

Lactation Likely Unsafe

When used orally or topically; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Macitentan

This page covers White Hellebore only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Macitentan page lists 253 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), Beer (major) and Grapefruit (major).

By severity: 9 major · 205 moderate · 39 minor.

From our pharmacist’s overview on the Macitentan page

“If you take macitentan (Opsumit) for pulmonary arterial hypertension, study this page rather than skim it. It lists 253 supplement and herbal ingredients, nine rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Macitentan interaction page

One more smart check

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

We hold 2 real supplement products containing White Hellebore, each one broken down to its full ingredient list — and combination products often carry several ingredients besides White Hellebore. Even though White Hellebore itself has no known interaction with Macitentan, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where White Hellebore and Macitentan 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 White Hellebore
Steady interest

#1,328 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Macitentan
Top 25%

#507 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every White Hellebore reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified October 4, 2026. The White Hellebore and Macitentan records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About White Hellebore

What is White Hellebore?

  • Homeopathic remedy for nausea and diarrhea
  • Traditional use for high blood pressure (historical)
  • Folk use as an emetic
  • Insecticide and pesticide use
  • Topical preparations for skin and lice (historical)

White Hellebore (Veratrum album) is a highly toxic plant that contains powerful compounds that can dangerously affect the heart and nervous system. It is not a safe dietary supplement, and the only forms with any history of safe human use are extremely dilute homeopathic preparations. Do not consume any raw or concentrated form of this plant.

Veratrum album · Melanthiaceae · Roots and rhizomes (historically); occasional use of dried plant material · Historically used in homeopathic dilutions and topical preparations; rarely sold as a modern supplement

An interaction check asks whether these two react with each other — it does not ask whether White Hellebore is a good idea for someone in your situation. Here is what our White Hellebore record says about it on its own.

White Hellebore: dosing

There is no established safe dose of White Hellebore for use as a supplement, and we do not recommend taking it. The plant is toxic, and the margin between any traditional "dose" and a poisonous one is very small.The only forms with a history of human use are extremely dilute homeopathic preparations, which contain little or no measurable plant material.

From our White Hellebore monograph — the full record covers uses, side effects and every documented interaction.

Read the full White Hellebore monograph & all interactions
Medication

About Macitentan

What Is Macitentan Used For?

Brand name: Opsumit

Macitentan tablets — sold under the brand name Opsumit — are used to treat pulmonary arterial hypertension (PAH, WHO Group I), a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to lower the chance of being hospitalized because of PAH.

In the key clinical study, macitentan was used in adults with mainly moderate-to-severe PAH symptoms. Patients had PAH caused by unknown or inherited causes, connective tissue disorders, or congenital heart disease with repaired shunts.

Most-Reported Side Effects for Macitentan

From FAERS, the FDA’s public side-effect reporting system (68,860 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 11,958 reports
Headache 8,323 reports
Diarrhea 6,584 reports
Nausea 5,972 reports
Fatigue 5,041 reports
See full Macitentan drug information
Keep checking

Other Drugs & White Hellebore

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full White Hellebore list.

See the full White Hellebore interactions page
See every supplement checked against Macitentan, ranked by severity
Evidence & sources

White Hellebore References

The 8 references that drive our White Hellebore monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
  4. Grobosch T, Binscheck T, Martens F, Lampe D. Accidental intoxication with Veratrum album. J Anal Toxicol. 2008;32(9):768-73. PubMed
  5. Rauber-Lüthy C, Halbsguth U, Kupferschmidt H, et al. Low-dose exposure to Veratrum album in children causes mild effects--a case series. Clin Toxicol (Phila). 2010;48(3):234-7.
  6. Gilotta I, Brvar M. Accidental poisoning with Veratrum album mistaken for wild garlic (Allium ursinum). Clin Toxicol (Phila). 2010;48(9):949-52.
  7. Melnik EV, Belova MV, Potskhveriya MM, Simonova AY, Tyurin IA, Ramenskaya GV. Veratrum alkaloid determination in four cases of Veratrum aqua poisonings. J Anal Toxicol 2022;46(1):e42-e47.
  8. Taldaev A, Terekhov RP, Melnik EV, et al. Insights into the Cardiotoxic Effects of Veratrum Lobelianum Alkaloids: Pilot Study. Toxins (Basel) 2022;14(7):490. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking White Hellebore and Macitentan Together: Common Questions

Is it safe to take White Hellebore with Macitentan?
We do not list a known interaction between White Hellebore and Macitentan. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do White Hellebore and Macitentan have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Macitentan interact with any supplements?
Yes. Macitentan has documented interactions with 253 supplements in our database — White Hellebore is not one of them. The Macitentan interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

White Hellebore monograph Uses, safety profile, and every drug interaction in one place Macitentan drug information The full plain-English guide to this medication Macitentan supplement interactions Every supplement checked against Macitentan, 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 References The 8 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Macitentan and White Hellebore?

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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.