Herb & supplement monograph

Gravel Root Drug Interactions, Uses, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

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

But these pages have grown well beyond that into a full monograph — what Gravel Root 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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Gravel Root 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 Gravel Root drug interaction appears fairly low for most people, though a couple of combinations deserve real caution. None of the listed interactions are rated major, and most rest on theoretical reasoning rather than proven effects in people.

Interactions deserving the most attention

The best-documented concern is lithium: gravel root may act as a mild diuretic, which could slow how the body clears lithium and push its levels up, and lithium is a medicine with a narrow safety margin. The other concern involves seizure medications and certain antibiotics such as carbamazepine, phenytoin, phenobarbital, and rifampin. These speed up an enzyme the body uses to process natural compounds in gravel root, and in theory that could turn more of those compounds into byproducts that can harm the liver.

What the rest of the list means

The long list of interacting medications largely reflects that single enzyme-based theory, since many common drugs affect that enzyme. A drug appearing on the list does not mean the combination has been shown to cause harm; for most of these medications, the concern remains unconfirmed in people.

Check your medications against Gravel Root

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

Interaction report

Drugs that interact with Gravel Root

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

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Gravel Root using our pharmacist-reviewed interaction data.

AI summaries are generated from our Gravel Root interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

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 Gravel Root 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 Gravel Root affects

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

All 2 drug categories Gravel Root interacts with

Cytochrome P450 3a4 (cyp3a4) InducersLithium

Cytochrome P450 3A4 (Cyp3A4) Inducers

Hepatotoxic pyrrolizidine alkaloids (PA) are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Likelihood Possible Evidence D

Lithium

Gravel root is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, gravel root might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D

Monograph

Gravel Root: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Gravel Root is a traditional North American herb long used by herbalists for kidney stones and urinary problems, but there is very little modern scientific evidence to support these uses. Because it contains compounds that may harm the liver and its safety is poorly studied, it should be used with caution, if at all, and avoided in pregnancy and breastfeeding.

Scientific name: Eutrochium purpureum
Family: Asteraceae
Part used: Root and rhizome
Common forms: Tea (decoction), tincture, capsules, dried root

People commonly use it for

Kidney stones
Urinary tract complaints
Fluid retention
Gout and joint pain
Bladder irritation

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

Safety at a glance

OverallUse caution

Limited safety data and possible liver-toxic compounds mean it should be used cautiously and short-term.

PregnancyLikely Unsafe

When used orally. Gravel root preparations containing hepatotoxic pyrrolizidine alkaloid (PA) constituents might be teratogenic and hepatotoxic. There...

Read the full pregnancy detail

BreastfeedingLikely Unsafe

When used orally. Hepatotoxic pyrrolizidine alkaloid (PA) constituents in gravel root are excreted in milk. There is insufficient reliable information...

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

Gravel Root is an herbal remedy made from the root and underground stem (rhizome) of a tall flowering plant native to North America. It grows in moist meadows, wetlands, and along streams. The plant is also known by names like Joe-Pye weed and queen of the meadow.

The name "Gravel Root" comes from its traditional use for "gravel," an old term for kidney or bladder stones. Native American and early American herbalists used it as a remedy for urinary and kidney complaints. Today it is sold as a tea, tincture, or capsule, mostly within traditional and folk herbal practice.

Uses & effectiveness

People most often use Gravel Root for kidney stones, urinary tract problems, fluid retention, and gout. These uses come from long-standing folk traditions rather than from solid modern research.

There is very little quality scientific evidence to show that Gravel Root works for any of these conditions. We do not have good human clinical trials testing it for kidney stones or urinary problems. Because the evidence is so limited, it should not be relied on to treat or prevent any medical condition.

If you have kidney stones, a urinary infection, or other urinary symptoms, see a healthcare provider. These conditions can become serious and need proper diagnosis and treatment.

How it works

Gravel Root contains a mix of plant compounds, including flavonoids and other substances thought to act as a mild diuretic (something that increases urine flow). Herbalists have suggested this could help "flush" the urinary tract, but this idea has not been confirmed in well-designed human studies.

Importantly, plants in this group may contain pyrrolizidine alkaloids, natural compounds that can be toxic to the liver, especially with long-term or high-dose use. Most of what we know about how Gravel Root affects the body is based on tradition and limited laboratory information, not strong clinical research.

Safety & precautions

Gravel Root has not been well studied for safety. A key concern is that it may contain pyrrolizidine alkaloids, which have been linked to liver damage when taken in large amounts or over long periods. For this reason, many experts advise against long-term use.

People with liver disease, kidney disease, or any chronic health condition should avoid Gravel Root unless a doctor or pharmacist approves it. Children should not take it.

Pregnancy and breastfeeding: There is not enough safety information, and the possible liver-toxic compounds make it especially risky. Avoid Gravel Root if you are pregnant or breastfeeding.

Always tell your pharmacist or doctor about any herbal product you take, and stop using it if you notice any unusual symptoms.

Side effects

Because Gravel Root has not been studied carefully, its full side effect profile is unknown. Possible effects include digestive upset and increased urination.

The most serious concern is potential liver damage from pyrrolizidine alkaloids. Warning signs of liver trouble include yellowing of the skin or eyes (jaundice), dark urine, belly pain, nausea, and unusual tiredness. If any of these occur, stop the herb and seek medical care right away.

Gravel Root: Reported Adverse Effects

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

Orally, the major concern with gravel root use is its pyrrolizidine alkaloid (PA) content. These constituents can cause liver and lung injury. Chronic exposure to other plants containing hepatotoxic PA constituents has been associated with veno-occlusive disease. Sub-acute veno-occlusive disease can cause vague symptoms, including colicky pains, vomiting, diarrhea, and ascites within several days; persistent liver enlargement occurs within a few weeks.

Topically, PA can be absorbed through the skin in quantities sufficient to cause systemic toxicity when applied to broken skin or in large quantities.

Gravel root products containing PAs should be avoided. There is currently a limited amount of information available about the adverse effects of PA-free gravel root.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
Stickel F, Seitz HK. The efficacy and safety of comfrey. Public Health Nutr 2000;3:501-8.

Reports by condition

Diarrhea Hepatic

Orally, gravel root might cause liver damage. The major concern with gravel root use is its hepatotoxic pyrrolizidine alkaloid (PA) content. Chronic exposure to other plants containing hepatotoxic PA constituents is associated with veno-occlusive disease. Sub-acute veno-occlusive disease can cause vague symptoms, including colicky pains, vomiting, diarrhea, and ascites within several days; persistent liver enlargement occurs within a few weeks.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.

Hypertension Pulmonary/Respiratory

Orally, gravel root might cause lung damage. The major concern with gravel root use is its pyrrolizidine alkaloid (PA) content. These constituents can cause lung damage with pulmonary-arterial hypertension.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established or standardized safe dose for Gravel Root. Different products vary widely in strength and quality.

If you choose to use it, follow the directions on the product label and keep use short-term. Talk with a pharmacist or doctor before starting, since dosing is not well defined and there are real safety concerns. Do not assume that "natural" means safe.

Pregnancy & Breastfeeding

Gravel Root & Pregnancy

Likely Unsafe

When used orally. Gravel root preparations containing hepatotoxic pyrrolizidine alkaloid (PA) constituents might be teratogenic and hepatotoxic. There is insufficient reliable information available about the safety of using gravel root products that do not contain hepatotoxic PAs during pregnancy.

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

Gravel Root & Breastfeeding

Likely Unsafe

When used orally. Hepatotoxic pyrrolizidine alkaloid (PA) constituents in gravel root are excreted in milk. There is insufficient reliable information available about the safety of using gravel root products that do not contain hepatotoxic PAs during lactation.

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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 5 references that drive our Gravel Root 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.

WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
Stickel F, Seitz HK. The efficacy and safety of comfrey. Public Health Nutr 2000;3:501-8. PubMed
Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
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

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.

Brand directory

Brands that make products with Gravel Root

13 brands in our database make a supplement containing Gravel Root.

Amazing Herbs 80 products Christopher's Original Formulas 140 products Energetix 283 products Extreme Products 32 products Herbal Terra 3,138 products HerbaMe 15 products Musclegen Performance Nutrition 24 products Nature's Way 3,426 products PurePremium Supplements 15 products RidgeCrest Herbals 67 products Source Naturals 1,780 products TerraVita 2,475 products Vibrant Life Supplements 7 products

Product directory

Supplement products with Gravel Root

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

Pharmacist Counseling Corner

Gravel Root: Common Questions

Does Gravel Root interact with prescription medications?

Yes. We list 88 medications with a known interaction with Gravel Root. Use the checker above to see how Gravel Root interacts with a specific drug.

How are Gravel Root 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 Gravel Root 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 Gravel Root 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 Gravel Root used for?

It is traditionally used for kidney stones, urinary tract complaints, fluid retention, and gout. These are folk uses, and there is little scientific evidence that it actually works for them.

Is Gravel Root safe to take?

Its safety is not well studied, and it may contain compounds that can harm the liver. It should be used cautiously, only short-term, and ideally after checking with a pharmacist or doctor.

Can I take Gravel Root during pregnancy or while breastfeeding?

No. There is not enough safety data, and the possible liver-toxic compounds make it too risky during pregnancy and breastfeeding.

Does Gravel Root actually dissolve kidney stones?

There is no good scientific proof that it dissolves or prevents kidney stones. If you have kidney stones, see a healthcare provider for proper evaluation and treatment.

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

Keep exploring

Products that contain Gravel Root

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

See all 20 products with Gravel Root →

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