Drug & supplement interaction

White Horehound + Ambrisentan

Ambrisentan brand names: Letairis, Volibris.

Moderate Interaction
The bottom line Moderate

White Horehound has a moderate interaction with Ambrisentan. Evidence from animal research suggests that taking white horehound extract lowers blood pressure.

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

White Horehound and Ambrisentan

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Ambrisentan

Ambrisentan falls under ANTIHYPERTENSIVE DRUGS — the group White Horehound interacts with.

Evidence from animal research suggests that taking white horehound extract lowers blood pressure. Theoretically, taking white horehound with antihypertensive drugs might enhance therapeutic effects and increase the risk of hypotension. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many 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 gist: white horehound may have a mild blood-pressure-lowering effect, at least based on animal studies. Since ambrisentan already works by relaxing and opening up blood vessels in your lungs, stacking the two together could, in theory, drop your blood pressure a little more than expected.

If your pressure dips too low, you might feel dizzy, lightheaded, tired, or notice some swelling in your legs (ankle swelling is already a common ambrisentan side effect). I want to be honest though: this is a theoretical concern drawn from lab and animal data, not from real cases in people. An occasional horehound cough drop almost certainly won't matter. Before adding a concentrated horehound supplement, please run it by your pharmacist or doctor first.

References
  1. El Bardai, S., Lyoussi, B., Wibo, M., and Morel, N. Pharmacological evidence of hypotensive activity of Marrubium vulgare and Foeniculum vulgare in spontaneously hypertensive rat. Clin Exp Hypertens. 2001;23(4):329-343.
  2. El Bardai, S., Lyoussi, B., Wibo, M., and Morel, N. Comparative study of the antihypertensive activity of Marrubium vulgare and of the dihydropyridine calcium antagonist amlodipine in spontaneously hypertensive rat. Clin Exp Hypertens. 2004;26(6):465-474 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

White Horehound Also Interacts With Other Medications

White Horehound has 257 moderate known drug interactions in our database — the Ambrisentan 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 White Horehound

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

Everything else you take

See Every Supplement That Interacts With Ambrisentan

This page covers White Horehound only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ambrisentan page lists 256 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 · 210 moderate · 37 minor.

Open the Ambrisentan interaction page

How much people look this up

Where White Horehound and Ambrisentan 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 Horehound
Steady interest

#1,038 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ambrisentan
Steady interest

#1,556 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 White Horehound

What is White Horehound?

White Horehound
  • Cough and chest congestion
  • Sore throat
  • Bronchitis
  • Digestive upset and poor appetite
  • Bloating and gas

White horehound is a traditional bitter herb used mainly for coughs, sore throats, and mild digestive complaints, and it is a common flavoring in old-fashioned cough drops. Solid human evidence supporting these uses is limited, so view it as a folk remedy rather than a proven treatment. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy.

Read the full White Horehound monograph & all interactions
Medication

About Ambrisentan

What Is Ambrisentan Used For?

Brand names: Letairis, Volibris

Ambrisentan tablets and Letairis tablets are both used to treat pulmonary arterial hypertension (PAH, WHO Group 1) — a condition where the blood pressure in the arteries leading to the lungs is dangerously high. Both are approved to help adults exercise better and slow the worsening of PAH.

Both ambrisentan tablets and Letairis are also approved to be used together with tadalafil (another PAH medicine) to further reduce the risk of disease progression, lower the chance of hospitalization for worsening PAH, and improve exercise ability. Most of the clinical evidence was in patients with mild-to-moderate symptoms and PAH caused by unknown or inherited causes, or PAH linked to connective tissue diseases.

See full Ambrisentan drug information
Keep checking

Other Drugs & White Horehound

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

0Major
257Moderate
0Minor
2,572No known interaction
Moderate

257 interactions

Showing 60 of 257 moderate interactions — see all 257 on the White Horehound page.

No interaction 2,572 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 White Horehound and Ambrisentan Together: Common Questions

Can you take White Horehound with Ambrisentan?
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 White Horehound and Ambrisentan 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.