Herb & supplement monograph

Borage Drug Interactions, Uses, Effectiveness, Safety & More

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

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

But these pages have grown well beyond that into a full monograph — what Borage 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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Borage Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Borage drug interaction appears low for most people. None of the listed interactions are rated major, and every one rests on theoretical or limited evidence rather than well-documented effects in people.

Interactions deserving the most attention

The combination that deserves the most care is borage with anticoagulant or antiplatelet drugs, since a fatty acid in borage seed oil reduced platelet clumping in some research, which could add to bleeding risk, even though studies in healthy people showed no effect. There is also an old, limited concern that borage seed oil could lower the seizure threshold when taken with phenothiazines. Finally, some borage plant parts (though not typically the seed oil) contain compounds that certain medications may convert into liver-toxic byproducts, so borage leaf or flower is best avoided with those drugs.

What the rest of the list means

Although borage is linked to a long list of medications, that number comes from a few broad drug categories, not hundreds of separate proven problems. Nearly all of these concerns are theoretical, based on what borage's components might do in the body, and some predicted effects, such as changes in platelet function, have not appeared in studies of healthy people.

Check your medications against Borage

Based on HelloPharmacist’s Borage interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Borage

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

2,830 drugs
AbciximabReoPro
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Abciximab interaction
AbrocitinibCibinqo
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcenocoumarolSintrom
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Acenocoumarol interaction
AcepromazineAtravet
Moderate Phenothiazines

Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.

Read the full Borage + Acepromazine interaction
Acetaminophen, AspirinGemnisyn
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, IbuprofenCombogesic
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Acetaminophen, Ibuprofen interaction
Acetylsalicylic AcidEntrophen
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Acetylsalicylic Acid interaction Acetylsalicylic Acid drug page: uses, dosage & side effects
Alteplase, TpaActilyse, Activase
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Alteplase, Tpa interaction
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction
Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interaction Aluminum Hydroxide, Aspirin, Magnesium Hydroxide drug page: uses, dosage & side effects
AminoglutethimideCytadren
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Aminoglutethimide interaction
Amitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
Moderate Phenothiazines

Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.

Read the full Borage + Amitriptyline, Perphenazine interaction
Amoxicillin, Omeprazole Magnesium, RifabutinTalicia
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Amoxicillin, Omeprazole Magnesium, Rifabutin interaction
Anacaulase-bcdbNexoBrid
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Anacaulase-bcdb interaction
AnagrelideAgrylin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Anagrelide interaction Anagrelide drug page: uses, dosage & side effects
AnisindioneMiradon
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Anisindione interaction
Antithrombin IiiThrombate III
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Antithrombin Iii interaction
ApalutamideErleada
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Apalutamide interaction Apalutamide drug page: uses, dosage & side effects
ApixabanEliquis
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Apixaban interaction Apixaban drug page: uses, dosage & side effects
AprepitantCinvanti, Emend
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Aprepitant interaction Aprepitant drug page: uses, dosage & side effects
Aprobarbital, Butabarbital, PhenobarbitalTriple Barbital
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Aprobarbital, Butabarbital, Phenobarbital interaction
AprocitentanTryvio
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Aprocitentan interaction Aprocitentan drug page: uses, dosage & side effects
ArgatrobanArgatroban
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Argatroban interaction
ArmodafinilNuvigil
Moderate Cytochrome P450 3a4 (cyp3a4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Read the full Borage + Armodafinil interaction Armodafinil drug page: uses, dosage & side effects
AspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aspirin interaction Aspirin drug page: uses, dosage & side effects
Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interaction
Aspirin, ButalbitalAxotal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aspirin, Butalbital interaction
Aspirin, Butalbital, CaffeineFiorinal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aspirin, Butalbital, Caffeine interaction Aspirin, Butalbital, Caffeine drug page: uses, dosage & side effects
Aspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Borage + Aspirin, Butalbital, Caffeine, Codeine Phosphate interaction
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 Borage combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Borage affects

Every type of medication (drug category) Borage is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 3 drug categories Borage interacts with
Anticoagulant/antiplatelet DrugsCytochrome P450 3a4 (cyp3a4) InducersPhenothiazines
Anticoagulant/Antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation. However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research.

Likelihood Possible Evidence B
Cytochrome P450 3A4 (Cyp3A4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure. In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures.

Likelihood Possible Evidence D
Monograph

Borage: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arthritis with mixed results. The plant's leaves and flowers can contain liver-toxic pyrrolizidine alkaloids, so only use products clearly labeled 'PA-free' and talk to your pharmacist or doctor before taking it.

Borage
Scientific name
Borago officinalis
Family
Boraginaceae
Part used
Seeds (for oil), leaves, and flowers
Common forms
Borage seed oil capsules, topical oil, tea, dried leaf/flower
People commonly use it for
  • Eczema and dry skin
  • Rheumatoid arthritis
  • Inflammation
  • Respiratory complaints
  • Mood and stress

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

Safety at a glance
OverallUse caution

Seed oil that is certified pyrrolizidine alkaloid (PA)-free is generally better tolerated, but other parts may harm the liver.

PregnancyLikely Unsafe

When products containing hepatotoxic pyrrolizidine alkaloids (PA) are used orally. Borage plant parts, such as the leaf, flower, and seed, can contain...

Read the full pregnancy detail
BreastfeedingLikely Unsafe

When products containing hepatotoxic pyrrolizidine alkaloids (PA) are used orally. Borage plant parts, such as the leaf, flower, and seed, can contain...

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.

Jump to a section

Overview

Borage (Borago officinalis) is a flowering herb native to the Mediterranean region but now grown in many parts of the world. It is easy to recognize by its bright blue, star-shaped flowers and its rough, hairy leaves and stems.

The herb has a long history in traditional medicine, where the leaves and flowers were used for breathing problems, fever, mood, and other complaints. Today, the most common product is borage seed oil, which is pressed from the plant's seeds and is one of the richest plant sources of gamma-linolenic acid (GLA), an omega-6 fatty acid.

People take borage seed oil as a capsule or apply it to the skin. Dried leaves and flowers are sometimes used as a tea or in cooking, though this raises safety concerns discussed below.

How it works

The main active ingredient in borage seed oil is gamma-linolenic acid (GLA). The body converts GLA into substances that may help calm inflammation. This is the proposed reason it has been studied for inflammatory conditions like eczema and arthritis.

The leaves and flowers also contain mucilage (a gel-like substance) and other plant compounds that were traditionally thought to soothe tissues. Much of what we know about how borage's compounds act comes from laboratory and animal research, so the effects in people are not fully proven.

Effectiveness

Does Borage work?

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

Evidence overview · 19 uses evaluated
1 Leans ineffective 18 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 Ineffective Atopic dermatitis (eczema)
Rating & evidence shown verbatim from Natural Medicines

Oral borage seed oil does not seem to improve symptoms of atopic dermatitis.

Also studied for 18 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Acne
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral borage seed oil is beneficial for acne.

Insufficient Reliable Evidence To Rate Acute respiratory distress syndrome (ARDS)
Rating & evidence shown verbatim from Natural Medicines

Enteral borage seed oil has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

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

Although there is interest in using oral borage seed oil for alcoholism, there is insufficient reliable information about the clinical effects of borage seed oil for this condition.

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

It is unclear if oral borage seed oil is beneficial for asthma.

Insufficient Reliable Evidence To Rate Attention deficit-hyperactivity disorder (ADHD)
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral borage seed oil for ADHD, there is insufficient reliable information about the clinical effects of borage seed oil for this condition.

Insufficient Reliable Evidence To Rate Cardiovascular disease (CVD)
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral borage seed oil for CVD prevention, there is insufficient reliable information about the clinical effects of borage seed oil for this purpose.

Insufficient Reliable Evidence To Rate Coronavirus disease 2019 (COVID-19)
Rating & evidence shown verbatim from Natural Medicines

Oral borage seed oil has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

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

Although there is interest in using oral borage seed oil for diabetes, there is insufficient reliable information about the clinical effects of borage seed oil for this condition.

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

Although there is interest in using oral borage seed oil for symptoms of hangover, there is insufficient reliable information about the clinical effects of borage seed oil for this purpose.

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

Although there is interest in using oral borage seed oil for neurodermatitis, there is insufficient reliable information about the clinical effects of borage seed oil for this condition.

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

It is unclear if oral borage seed oil is beneficial in patients with obesity.

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

It is unclear if oral borage seed oil is beneficial for periodontitis.

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

It is unclear if formula containing borage seed oil is beneficial for neurodevelopment in premature infants.

Insufficient Reliable Evidence To Rate Premenstrual syndrome (PMS)
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral borage seed oil for PMS symptoms, there is insufficient reliable information about the clinical effects of borage seed oil for this purpose.

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

Enteral borage seed oil has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Rheumatoid arthritis (RA)
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that borage seed oil may be beneficial for reducing symptoms of RA.

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

Preliminary research suggests that topical borage seed oil is beneficial for infantile seborrheic dermatitis.

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

Although there is interest in using oral borage seed oil for stress, there is insufficient reliable information about the clinical effects of borage seed oil for this purpose.

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

The biggest safety concern with borage is that the plant can contain pyrrolizidine alkaloids (PAs), natural compounds that can damage the liver and may be cancer-causing over time. These are mostly found in the leaves, flowers, and stems. If you use borage by mouth, only choose products labeled 'PA-free' or 'certified free of pyrrolizidine alkaloids.'

People with liver disease should be especially cautious or avoid borage entirely. Because of the alkaloid concern and a theoretical effect on the uterus, pregnant women should avoid borage. Breastfeeding women should also avoid it due to lack of safety data and possible PA exposure to the baby.

Borage oil may also affect bleeding, so people with bleeding disorders or who are scheduled for surgery should talk to their doctor and stop the product as advised before a procedure. Always check with a pharmacist or doctor before starting borage.

Side effects

Borage seed oil is usually well tolerated. The most common side effects are mild and digestive, such as upset stomach, nausea, bloating, or soft stools.

More serious concerns come from products that are not PA-free, which could cause liver damage with long-term use. Signs of liver trouble include yellowing of the skin or eyes, dark urine, severe tiredness, or belly pain. Stop the product and seek medical care if these occur. Allergic reactions are possible, especially in people sensitive to plants in the same family.

Borage: Reported Adverse Effects

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

Orally, borage seed oil seems to be well tolerated. However, borage plant parts, such as the leaf, flower, and seed, that contain hepatotoxic pyrrolizidine alkaloid (PA) constituents should be avoided.

Most Common Adverse Effects:

Orally: Belching, bloating, diarrhea, and soft stools.

Serious Adverse Effects (Rare):

Orally: Borage plant parts that contain PA constituents can be hepatotoxic.

Reports by condition
Diarrhea Gastrointestinal

Orally, borage seed oil can cause soft stools, diarrhea, belching, and bloating.

  1. Fan YY, Chapkin RS. Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr 1998;128:1411-4.
  2. Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ 2003;327:1385.
Diarrhea Hepatic

The pyrrolizidine alkaloid (PA) constituents of borage can cause significant hepatotoxicity. PAs can occur in borage leaf, flower, and seed; borage seed oil contains little to no PAs. Chronic exposure to other plants containing hepatotoxic PA constituents has been associated with veno-occlusive disease (VOD). Subacute VOD causes vague symptoms with persistent liver enlargement. Symptoms of acute VOD include colicky pains in epigastrium, vomiting and diarrhea, and ascites within several days. Enlargement and induration of the liver occurs within a few weeks.

  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
  2. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
  3. WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
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 official, standardized dose of borage. Borage seed oil products are usually sold as capsules standardized to a certain amount of GLA, and the right amount can vary by product and purpose.

The safest approach is to follow the directions on the product label and to choose a brand that states it is free of pyrrolizidine alkaloids. Because individual needs and health conditions differ, check with your pharmacist or doctor before starting borage and to confirm a sensible amount for you.

Pregnancy & Breastfeeding

Borage & Pregnancy

Likely Unsafe

When products containing hepatotoxic pyrrolizidine alkaloids (PA) are used orally. Borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Repeated exposure to low concentrations of hepatotoxic PAs can cause severe veno-occlusive disease. Hepatotoxic PAs might also be carcinogenic, mutagenic, and teratogenic. These constituents are also excreted in breast milk. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free. There is insufficient reliable information available about the safety of borage seed oil when used orally or topically during pregnancy or lactation.

  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
  2. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.

Borage & Breastfeeding

Likely Unsafe

When products containing hepatotoxic pyrrolizidine alkaloids (PA) are used orally. Borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Repeated exposure to low concentrations of hepatotoxic PAs can cause severe veno-occlusive disease. Hepatotoxic PAs might also be carcinogenic, mutagenic, and teratogenic. These constituents are also excreted in breast milk. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free. There is insufficient reliable information available about the safety of borage seed oil when used orally or topically during pregnancy or lactation.

  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
  2. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
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 11 references that drive our Borage 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. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
  2. WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
  3. Fan YY, Chapkin RS. Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr 1998;128:1411-4.
  4. Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ 2003;327:1385. PubMed
  5. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  6. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
  7. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
  8. Holman CP and Bell AF. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orhtomolecular Psych 1983;12:302-304.
  9. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. PubMed
  10. Bard, J. M., Luc, G., Jude, B., Bordet, J. C., Lacroix, B., Bonte, J. P., Parra, H. J., and Duriez, P. A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers. Fundam.Clin.Pharmacol. 1997;1
  11. Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed
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 Borage

266 brands in our database make a supplement containing Borage.

Product directory

Supplement products with Borage

1,095 products in our database contain Borage. Open any to see its full ingredient list and every drug interaction we check.

Anxiety Care by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Anxiety Care by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Arthaffect by Reliv Powder 9 Ounce(s) View ingredients & interactions Arthaffect by Reliv Powder 9 Ounce(s) View ingredients & interactions Arthaffect by Reliv Powder 9 oz. View ingredients & interactions Astaxanthol by Progressive Professional from Progressive Laboratories Capsule 60 Vegetable Capsule(s) View ingredients & interactions Attencia by Metagenics Softgel Capsule 60 Softgel(s) View ingredients & interactions Attention by BodSmith Liquid 1 Quart(s) · 32 Fluid Ounce(s) · 946 mL View ingredients & interactions Attention by Liquid Health Liquid 1 Quart(s) · 32 fl. Oz. · 946 mL View ingredients & interactions Baby Care Prenatal Omega 3-6-9 by Country Life Softgel Capsule 90 Softgel(s) View ingredients & interactions Balance Omega Twin by Barlean's Liquid 12 fl. Oz. · 355 mL View ingredients & interactions Beauty Essentials by Bronson Laboratories Softgel Capsule 90 Softgel(s) View ingredients & interactions Bio-Detox Packs by Biotics Research Corporation Unknown 30 Pack(s) View ingredients & interactions BioEFA with CLA by 4Life Softgel Capsule 60 Softgel(s) View ingredients & interactions Biotone by MBi Nutraceuticals Softgel Capsule 100 Softgel(s) View ingredients & interactions Biotone by MBi Nutraceuticals Softgel Capsule 200 Softgel(s) View ingredients & interactions Bone & Joint + by Herbal Goodness Liquid 12 Ounce(s) · 354 mL View ingredients & interactions Borage by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Borage by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Borage by Herbal Terra Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions Borage by Hawaii Pharm Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Borage & Evening Primrose by SuperSmart Softgel Capsule 120 Softgel(s) View ingredients & interactions Borage 1000 by OmegaWorks Softgel Capsule View ingredients & interactions Borage 4:1 Extract Powder by TerraVita Premium Collection Powder 1 Ounce(s) View ingredients & interactions
Pharmacist Counseling Corner

Borage: Common Questions

What is Borage used for, and does it work?
People use Borage for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Borage interact with prescription medications?
Yes. We list 226 medications with a known interaction with Borage. Use the checker above to see how Borage interacts with a specific drug.
How are Borage 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 Borage 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 Borage 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 Borage used for?
People most often use Borage seed oil for skin conditions like eczema and for inflammatory problems such as rheumatoid arthritis. The evidence for these uses is limited and mixed, so it is not a proven treatment.
Is Borage safe to take?
Borage seed oil that is certified free of pyrrolizidine alkaloids is generally well tolerated, but other parts of the plant can contain liver-toxic compounds. Always pick a 'PA-free' product and talk to your pharmacist or doctor first.
Can I take Borage while pregnant or breastfeeding?
No. Borage is best avoided during pregnancy and breastfeeding because of possible liver-toxic alkaloids, a theoretical effect on the uterus, and a lack of safety data.
What is GLA and why is it in Borage oil?
GLA (gamma-linolenic acid) is an omega-6 fatty acid found in high amounts in Borage seeds. It is the compound thought to be responsible for Borage oil's possible anti-inflammatory effects.

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

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Products that contain Borage

A rotating sample of real supplements in our database that list Borage — open any to see its full ingredients and every drug interaction we check.

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