Drug & supplement interaction

White Horehound + Sacubitril, Valsartan

Sacubitril, Valsartan brand name: Entresto.

Moderate Interaction
The bottom line Moderate

White Horehound has a moderate interaction with Sacubitril, Valsartan. 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 Sacubitril, Valsartan

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Sacubitril, Valsartan

Sacubitril, Valsartan 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

Entresto (the sacubitril and valsartan combo) already does a good job of relaxing your blood vessels and easing the workload on your heart. The concern here is that white horehound may have a mild blood-pressure-lowering effect of its own, so stacking it on top could push your numbers down a little too far.

If that happens, you might feel dizzy, lightheaded, unusually tired, or wobbly when you stand up quickly. I want to be honest though, this interaction is theoretical and comes mostly from animal studies, so we don't have strong human proof it's a real problem. The occasional horehound cough drop is unlikely to matter much; concentrated supplement doses are the bigger question mark. Either way, check with your pharmacist or doctor before adding it.

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 Sacubitril, Valsartan 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 Sacubitril, Valsartan

This page covers White Horehound only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sacubitril, Valsartan page lists 249 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), Lithium (major) and Oleander (major).

By severity: 7 major · 206 moderate · 36 minor.

From our pharmacist’s overview on the Sacubitril, Valsartan page

“Entresto (sacubitril and valsartan) is a heart failure medicine, and heart failure patients tend to be heavy supplement users, reaching for fish oil, potassium, and herbal blood-pressure remedies. That instinct carries real risk here.”

Reviewed by 2 · Jul 18, 2026

Open the Sacubitril, Valsartan interaction page

How much people look this up

Where White Horehound and Sacubitril, Valsartan 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
Top half

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

29 days ago today
Medication Sacubitril, Valsartan
Top 5%

#130 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 Valsartan and Sacubitril

What Is Valsartan and Sacubitril Used For?

Brand name: Entresto

Sacubitril and valsartan is used to reduce the risk of cardiovascular death and hospitalization for heart failure in adult patients with chronic heart failure. The benefit is most clearly seen in patients whose heart pumps with a lower-than-normal ejection fraction (the percentage of blood the heart pushes out with each beat).

It is also approved to treat symptomatic heart failure with reduced left ventricular function in children aged 1 year and older. In pediatric patients, it lowers a blood marker of heart stress (NT-proBNP) and is expected to improve heart outcomes.

See full Valsartan and Sacubitril 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 Sacubitril, Valsartan Together: Common Questions

Can you take White Horehound with Sacubitril, Valsartan?
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 Sacubitril, Valsartan 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.