Herb & supplement monograph

Hawthorn Drug Interactions, Uses, Effectiveness, Safety & More

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

What is this page for?

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

But these pages have grown well beyond that into a full monograph — what Hawthorn 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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On this page

Hawthorn Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of clinically significant Hawthorn drug interactions is moderate for most people, with the greatest concern for those taking heart or blood pressure medicines. A small share of the listed interactions are rated major and the rest moderate, and nearly all involve possible additive effects on blood pressure or the heart.

Interactions deserving the most attention

The combinations that deserve the most care are nitrates and PDE-5 inhibitors, where hawthorn's possible blood-vessel-widening effect could add up and lower blood pressure too much. Beta-blockers and calcium channel blockers carry a similar additive blood pressure concern. With digoxin, hawthorn may strengthen the drug's effects, and one hawthorn species has caused digoxin-like effects and misleading blood test results. Hawthorn may also add to bleeding risk with blood thinners, though the human evidence is unclear.

What the rest of the list means

A long interaction list does not mean every combination is harmful. Most of these concerns are theoretical, drawn from lab or animal research or from hawthorn's possible effect on blood pressure rather than proven problems in people. For example, hawthorn does not appear to change how the body clears digoxin, and the predicted bleeding effect has not been clearly confirmed in humans.

Check your medications against Hawthorn

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

Interaction report

Drugs that interact with Hawthorn

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

14 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Hawthorn.

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

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

AI summaries are generated from our Hawthorn 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 Hawthorn 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 Hawthorn affects

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

All 6 drug categories Hawthorn interacts with

NitratesPhosphodiesterase-5 InhibitorsAnticoagulant/antiplatelet DrugsBeta-blockersCalcium Channel BlockersDigoxin (lanoxin)

Nitrates

Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.

Likelihood Probable Evidence D

Phosphodiesterase-5 Inhibitors

Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.

Likelihood Probable Evidence D

Anticoagulant/Antiplatelet Drugs

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans.

Likelihood Possible Evidence D

Beta-Blockers

Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Some evidence shows that hawthorn might lower blood pressure and heart rate.

Likelihood Possible Evidence D

Calcium Channel Blockers

Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.

Likelihood Possible Evidence D

Digoxin (Lanoxin)

Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Hawthorn appears to improve cardiac output; however, hawthorn does not appear to affect digoxin pharmacokinetics. Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels.

Likelihood Possible Evidence D

Monograph

Hawthorn: Uses, Safety & Side Effects

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

The bottom line

Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the evidence is mixed and it should never replace prescribed heart medicines. Always talk to your pharmacist or doctor before using hawthorn, especially if you have a heart condition.

Scientific name: Crataegus monogyna
Family: Rosaceae
Part used: Leaves, flowers, and berries (fruit)
Common forms: Capsules, tablets, standardized extracts, liquid tinctures, teas

People commonly use it for

Heart failure symptoms
High blood pressure
Chest pain (angina)
Irregular heartbeat
Digestive upset
Anxiety

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

Safety at a glance

OverallUse caution

Generally well tolerated in studies, but heart conditions need medical supervision.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail

BreastfeedingInsufficient reliable information

Insufficient reliable information available; 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

Hawthorn is a thorny shrub or small tree in the rose family. It grows across Europe, Asia, and North America and produces small white or pink flowers in spring and small red berries (called haws) in the fall.

People have used hawthorn in traditional medicine for hundreds of years, mostly for heart and circulation problems. Today, supplements are usually made from standardized extracts of the leaves, flowers, and berries. You can find it as capsules, tablets, tinctures, and teas.

How it works

Hawthorn contains plant compounds called flavonoids and oligomeric proanthocyanidins (OPCs). These are believed to act as antioxidants and may affect blood vessels and the heart.

Laboratory and animal research suggests hawthorn may help widen (relax) blood vessels, improve blood flow, and possibly strengthen how the heart pumps. Some studies suggest it may also help the heart muscle use oxygen more efficiently.

It is important to know that many of these effects come from test-tube or animal studies. How well they translate to people is not fully understood.

Effectiveness

Does Hawthorn work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 11 uses evaluated

11 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.

For Hawthorn, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 11 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Angina