Drug & supplement interaction

White Horehound + Eplerenone

Eplerenone brand name: Inspra.

Moderate Interaction
The bottom line Moderate

White Horehound has a moderate interaction with Eplerenone. 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 Eplerenone

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Eplerenone

Eplerenone 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 has shown some blood-pressure-lowering activity, but only in animal studies. Eplerenone (Inspra) already lowers your blood pressure by blocking aldosterone, so the worry is that stacking the two could push your pressure down a little too far.

If that happened, you might feel lightheaded, dizzy, tired, or faint when standing up. The honest truth, though, is that this is a theoretical concern based on lab and animal data, not proven in people. A cough drop flavored with horehound is very unlikely to matter; concentrated supplement doses are the bigger question mark. Don't change your eplerenone, but do check with your pharmacist or doctor before adding horehound, and keep an eye on your home readings.

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 Eplerenone 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.

From our Q&A

Questions About White Horehound or Eplerenone

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

This page covers White Horehound only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Eplerenone page lists 136 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), Tyramine (major) and Adrafinil (moderate).

By severity: 4 major · 111 moderate · 21 minor.

Open the Eplerenone interaction page

How much people look this up

Where White Horehound and Eplerenone 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 Eplerenone
Steady interest

#2,240 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 Eplerenone

What Is Eplerenone Used For?

Brand name: Inspra

Eplerenone treats two conditions. First, it is used to lower high blood pressure (hypertension) in adults. Lowering blood pressure reduces the risk of stroke and heart attack. It can be used alone or alongside other blood pressure medicines.

Second, eplerenone is used to improve survival in stable adults who have heart failure with reduced ejection fraction (HFrEF) — meaning the heart pumps less blood than normal — following an acute myocardial infarction (heart attack).

See full Eplerenone 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 Eplerenone Together: Common Questions

Can you take White Horehound with Eplerenone?
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 Eplerenone 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 Eplerenone and White Horehound?

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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.