Herb & supplement monograph

Bloodroot Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Bloodroot interacts with medications. The heart of this page is the interaction list — every drug Bloodroot is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Bloodroot is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Interaction report

Drugs that interact with Bloodroot

0 medications have a known interaction with Bloodroot, graded by severity. Select any drug for the full evidence-based detail.

We don’t currently list any known drug interactions for Bloodroot. This doesn’t guarantee none exist — always confirm with your pharmacist before combining supplements with your medications.

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Bloodroot combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
Monograph

Bloodroot: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Bloodroot is a North American plant whose red root sap contains potent alkaloids that are corrosive to skin and tissue. It has a long folk history, but there is no good evidence it safely treats skin cancer or other diseases, and 'black salve' products containing it can cause serious skin damage and scarring. We recommend avoiding internal use and skin-eroding products entirely.

Scientific name
Sanguinaria canadensis
Family
Papaveraceae
Part used
Rhizome (root) and the red-orange sap it contains
Common forms
Pastes and salves (often called 'black salve'), tinctures, mouthwash and toothpaste ingredients, and occasionally capsules
People commonly use it for
  • Skin growths, moles, and warts (topical)
  • Dental plaque and gum health
  • Sore throat and cough (traditional)
  • Antimicrobial uses
  • Folk remedy for skin cancer (unproven and dangerous)

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallBest avoided

Bloodroot is potentially toxic and corrosive, and we do not recommend it for self-treatment.

PregnancyLikely Unsafe

When used orally; avoid using.

Read the full pregnancy detail
BreastfeedingPossibly Unsafe

When used orally; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Bloodroot (Sanguinaria canadensis) is a small flowering plant native to the woodlands of eastern North America. It gets its name from the deep red-orange sap that oozes from its root when it is cut.

Native American and early folk traditions used bloodroot in many ways, including as a skin treatment, a dye, and a remedy for coughs and sore throats. Today it is mostly found in topical 'black salve' products, some natural mouthwashes and toothpastes, and herbal tinctures.

Despite this long history, bloodroot is considered a potentially toxic plant. Modern health authorities urge caution because its active compounds can damage living tissue.

How it works

Bloodroot contains a group of compounds called benzylisoquinoline alkaloids, with sanguinarine being the most studied. These alkaloids are responsible for both its red color and its biological effects.

In laboratory and animal studies, sanguinarine has shown antimicrobial and anti-inflammatory activity, and it can kill cells. This cell-killing action is why some people believe it removes growths. However, the same property means it does not tell the difference between unhealthy and healthy tissue, so it can damage normal skin.

It is important to understand that most of this research comes from test-tube and animal studies, not well-designed human trials.

Effectiveness

Does Bloodroot work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 4 uses evaluated
2 Possibly effective 2 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Possibly Effective Dental plaque
Rating & evidence shown verbatim from Natural Medicines

Rinsing the mouth or brushing the teeth with a bloodroot-containing product may reduce dental plaque.

Possibly Effective Gingivitis
Rating & evidence shown verbatim from Natural Medicines

Rinsing the mouth or brushing the teeth with a bloodroot-containing product may reduce gingivitis.

Also studied for 2 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Irritable bowel syndrome (IBS)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral bloodroot for IBS, there is insufficient reliable information about the clinical effects of bloodroot for this purpose.

Insufficient Reliable Evidence To Rate Periodontitis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical bloodroot is beneficial for periodontitis.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Bloodroot is one of the herbs we treat with the most caution. The same alkaloids that give it activity also make it corrosive and potentially toxic.

Topical 'black salve' or 'escharotic' products can burn through skin, creating painful wounds, permanent scarring, and disfigurement. The FDA considers these products fraudulent and dangerous, especially when marketed as cancer cures.

Taking bloodroot by mouth can cause nausea, vomiting, and other harmful effects, and high amounts may be poisonous. People who are pregnant, breastfeeding, children, older adults, and anyone with a chronic illness should avoid it.

Pregnancy and breastfeeding: Avoid bloodroot completely. Its safety has not been established and it may be toxic.

If you have a mole, skin change, or growth you are worried about, please see a doctor or dermatologist rather than using any home remedy.

Side effects

Side effects depend on how bloodroot is used:

  • On the skin: burning, redness, pain, tissue death, open sores, and permanent scarring.
  • In the mouth: irritation; long-term use of sanguinarine-containing products has been linked in some reports to abnormal changes in mouth tissue.
  • By mouth (swallowed): nausea, vomiting, dizziness, and potentially serious toxicity in larger amounts.

Serious harm such as deep wounds and disfigurement has been reported with bloodroot salves. Seek medical care right away if you develop a spreading wound, severe pain, or signs of infection.

Bloodroot: Reported Adverse Effects

Documented safety reports on Bloodroot from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, bloodroot is generally well tolerated when used in appropriate doses, short term. Nausea, vomiting, and central nervous system depression have been reported. Higher oral doses can result in glaucoma, hypotension, shock, and coma. Long term use of bloodroot toothpaste or mouthwash has been associated with leukoplakia, keratoses of the mouth, impaired taste, and staining of the tongue, teeth, and fillings. Topically, skin contact with fresh bloodroot can cause irritation or contact dermatitis. Avoid contact with the eyes and mucous membranes because of its irritant properties.

  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Eversole, L. R., Eversole, G. M., and Kopcik, J. Sanguinaria-associated oral leukoplakia: comparison with other benign and dysplastic leukoplakic lesions. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 2000;89(4):455-464.
  5. Allen, C. L., Loudon, J., and Mascarenhas, A. K. Sanguinaria-related leukoplakia: epidemiologic and clinicopathologic features of a recently described entity. Gen.Dent. 2001;49(6):608-614.
  6. Cullinan, M. P., Powell, R. N., Faddy, M. J., and Seymour, G. J. Efficacy of a dentifrice and oral rinse containing sanguinaria extract in conjunction with initial periodontal therapy. Aust.Dent.J. 1997;42(1):47-51.
  7. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Reports by condition
Depression Neurologic/CNS

Orally, bloodroot may cause CNS depression. High oral doses may cause shock and coma.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
Dermatitis Dermatologic

Topically, skin contact with fresh bloodroot can cause irritation or contact dermatitis. Topical application of bloodroot can corrode skin and produce a thick dry scab called an eschar which falls off and results in a depressed scar. There are numerous cases of patients applying bloodroot salves topically for 3-4 hours daily for 3-12 days to skin cancers, moles and blemishes. These patients report experiencing severe pain, burning, skin erosion, and scarring.

  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Affleck, A. G. and Varma, S. A case of do-it-yourself Mohs' surgery using bloodroot obtained from the internet. Br.J Dermatol 2007;157(5):1078-1079.
  3. Cienki JJ, Zaret L. An Internet misadventure: bloodroot salve toxicity. J Altern Complement Med. 2010;16(10):1125-7.
  4. Hou JL, Brewer JD. Black salve and bloodroot extract in dermatologic conditions. Cutis. 2015;95(6):309-11.
  5. Schilling LM, Saedi N. Bloodroot paste: what dermatologists and patients need to know. Dermatol Surg 2016;42(10):1223-4.
  6. Schlichte MJ, Downing CP, Ramirez-Fort M, Gordon R, Tyring S. Bloodroot associated eschar. Dermatol Online J 2014;20(7).
Glaucoma Ocular/Otic

There are reports of worsening vision after small oral doses of bloodroot. Glaucoma has been reported after high oral doses of bloodroot. However, some experts disagree that oral use of bloodroot causes ocular toxicity. Direct contact of bloodroot with the eyes and mucous membranes should be avoided because of its irritant properties.

  1. Frankos, V. H., Brusick, D. J., Johnson, E. M., Maibach, H. I., Munro, I., Squire, R. A., and Weil, C. S. Safety of Sanguinaria extract as used in commercial toothpaste and oral rinse products. J.Can.Dent.Assoc. 1990;56(7 Suppl):41-47.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
Hypotension Cardiovascular

Orally, high doses of bloodroot may cause hypotension.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
Nausea and vomiting Gastrointestinal

Orally, bloodroot may cause nausea and vomiting. Some research shows that bloodroot-containing toothpastes and mouth rinses can be used for up to six months without evidence of adverse effects. However observational research has found an association between chronic use of bloodroot toothpaste or mouthwash and leukoplakia or keratoses of the mouth and lip. Discontinuing these products did not always result in a resolution of leukoplakia. Prolonged use of bloodroot oral rinse causes impaired sensation of taste, as well as staining of the tongue, teeth, and fillings. The impaired taste and staining do seem to resolve after discontinuation of the bloodroot rinse.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Kuftinec, M. M., Mueller-Joseph, L. J., and Kopczyk, R. A. Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short- and long-term trials. J.Can.Dent.Assoc. 1990;56(7 Suppl):31-33.
  3. Eversole, L. R., Eversole, G. M., and Kopcik, J. Sanguinaria-associated oral leukoplakia: comparison with other benign and dysplastic leukoplakic lesions. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 2000;89(4):455-464.
  4. Allen, C. L., Loudon, J., and Mascarenhas, A. K. Sanguinaria-related leukoplakia: epidemiologic and clinicopathologic features of a recently described entity. Gen.Dent. 2001;49(6):608-614.
  5. Cullinan, M. P., Powell, R. N., Faddy, M. J., and Seymour, G. J. Efficacy of a dentifrice and oral rinse containing sanguinaria extract in conjunction with initial periodontal therapy. Aust.Dent.J. 1997;42(1):47-51.
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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established safe or standardized dose of bloodroot for any health condition. Because of its toxicity and corrosive nature, we do not recommend self-dosing with bloodroot products in any form.

If you are considering a product that contains bloodroot, talk with a pharmacist or doctor first. Always read product labels, and never apply skin-eroding 'black salve' products to moles, warts, or any growth.

Pregnancy & Breastfeeding

Bloodroot & Pregnancy

Likely Unsafe

When used orally; avoid using.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

Bloodroot & Breastfeeding

Possibly Unsafe

When used orally; avoid using.

  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 14 references that drive our Bloodroot 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. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Eversole, L. R., Eversole, G. M., and Kopcik, J. Sanguinaria-associated oral leukoplakia: comparison with other benign and dysplastic leukoplakic lesions. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 2000;89(4):455-464. PubMed
  6. Allen, C. L., Loudon, J., and Mascarenhas, A. K. Sanguinaria-related leukoplakia: epidemiologic and clinicopathologic features of a recently described entity. Gen.Dent. 2001;49(6):608-614.
  7. Kuftinec, M. M., Mueller-Joseph, L. J., and Kopczyk, R. A. Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short- and long-term trials. J.Can.Dent.Assoc. 1990;56(7 Suppl):31-33.
  8. Frankos, V. H., Brusick, D. J., Johnson, E. M., Maibach, H. I., Munro, I., Squire, R. A., and Weil, C. S. Safety of Sanguinaria extract as used in commercial toothpaste and oral rinse products. J.Can.Dent.Assoc. 1990;56(7 Suppl):41-47.
  9. Cullinan, M. P., Powell, R. N., Faddy, M. J., and Seymour, G. J. Efficacy of a dentifrice and oral rinse containing sanguinaria extract in conjunction with initial periodontal therapy. Aust.Dent.J. 1997;42(1):47-51. PubMed
  10. Affleck, A. G. and Varma, S. A case of do-it-yourself Mohs' surgery using bloodroot obtained from the internet. Br.J Dermatol 2007;157(5):1078-1079. PubMed
  11. Cienki JJ, Zaret L. An Internet misadventure: bloodroot salve toxicity. J Altern Complement Med. 2010;16(10):1125-7. PubMed
  12. Hou JL, Brewer JD. Black salve and bloodroot extract in dermatologic conditions. Cutis. 2015;95(6):309-11.
  13. Schilling LM, Saedi N. Bloodroot paste: what dermatologists and patients need to know. Dermatol Surg 2016;42(10):1223-4. PubMed
  14. Schlichte MJ, Downing CP, Ramirez-Fort M, Gordon R, Tyring S. Bloodroot associated eschar. Dermatol Online J 2014;20(7). DOI
Keep reading

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.

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

Brand directory

Brands that make products with Bloodroot

18 brands in our database make a supplement containing Bloodroot.

Product directory

Supplement products with Bloodroot

69 products in our database contain Bloodroot. Open any to see its full ingredient list and every drug interaction we check.

Osha Root Rocky Mountain Throat Syrup by Herbs, Etc. Liquid 2 fl. Oz. · 59 mL View ingredients & interactions TG&P-W by Pure Herbs Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions TG&P-W by Pure Herbs Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Blood Support by BN Baseline Nutritionals Liquid 2 fl. Oz. · 59 mL Off market View ingredients & interactions Bloodroot by Herbalist & Alchemist Liquid 2 fl. Oz. · 60 mL Off market View ingredients & interactions Bloodroot by Herb Pharm Liquid 1 fl. Oz. · 29.6 mL Off market View ingredients & interactions Bloodroot by Herb Pharm Liquid 1 fl. Oz. · 29.6 mL Off market View ingredients & interactions Bloodroot by Herb Pharm Liquid 1 fl. Oz. · 29.6 mL Off market View ingredients & interactions Bloodroot by Herb Pharm Liquid 4 fl. Oz. · 118.4 mL Off market View ingredients & interactions Bloodroot by Herb Pharm Liquid 4 fl. Oz. · 118.4 mL Off market View ingredients & interactions Mouth Tonic by Herbs, Etc. Liquid 1 fl. Oz. · 30 mL Off market View ingredients & interactions Mouth Tonic by Herbs, Etc. Liquid 2 fl. Oz. · 59 mL Off market View ingredients & interactions Mouth Tonic by Herbs, Etc. Liquid 2 fl. Oz. · 59 mL Off market View ingredients & interactions Mouth Tonic by Herbs, Etc. Liquid 1 fl. Oz. · 29.5 mL Off market View ingredients & interactions Osha Root Cough Syrup by Herbs, Etc. Liquid 2 fl. Oz. · 59 mL Off market View ingredients & interactions Osha Root Cough Syrup by Herbs, Etc. Liquid 4 fl. Oz. · 118 mL Off market View ingredients & interactions Osha Root Cough Syrup by Herbs, Etc. Liquid 2 fl. Oz. · 59 mL Off market View ingredients & interactions Osha Root Cough Syrup by Herbs, Etc. Liquid 4 fl. Oz. · 118 mL Off market View ingredients & interactions Osha Root Rocky Mountain Throat Syrup by Herbs, Etc. Liquid 4 fl. Oz. · 118 mL Off market View ingredients & interactions Osha Root Rocky Mountain Throat Syrup by Herbs, Etc. Liquid 2 fl. Oz. · 59 mL Off market View ingredients & interactions Osha Root Rocky Mountain Throat Syrup by Herbs, Etc. Liquid 4 fl. Oz. · 118 mL Off market View ingredients & interactions
Pharmacist Counseling Corner

Bloodroot: Common Questions

What is Bloodroot used for, and does it work?
People use Bloodroot for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Bloodroot for Dental plaque and Gingivitis. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Bloodroot interact with prescription medications?
We do not currently list any known drug interactions for Bloodroot. This does not guarantee that none exist, so always confirm with your pharmacist before combining it with your medications.
How are Bloodroot interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Bloodroot with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Bloodroot interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Bloodroot used for?
Traditionally it has been used on the skin for growths and warts, in some dental products, and as a folk remedy for sore throats and coughs. However, there is little reliable evidence that it works for these uses, and it carries real safety risks.
Can Bloodroot or 'black salve' cure skin cancer?
No. There is no good evidence that Bloodroot removes skin cancer safely, and the FDA has warned that these products are dangerous. They can destroy healthy skin and leave cancer behind, so see a dermatologist instead.
Is Bloodroot safe to take by mouth?
We do not recommend taking Bloodroot internally. It can cause nausea and vomiting, and larger amounts may be poisonous.
Is Bloodroot safe during pregnancy or breastfeeding?
No. Bloodroot should be avoided during pregnancy and breastfeeding because it may be toxic and its safety has not been studied.

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

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