Herb & supplement monograph

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

But these pages have grown well beyond that into a full monograph — what Kousso 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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Kousso 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 Kousso drug interaction appears low for most people. None of the listed interactions are rated major, and every one traces back to a single theoretical concern rather than documented problems in people.

Interactions deserving the most attention

The only combination that stands out involves diabetes medications such as insulin, metformin, glyburide, and pioglitazone. Animal research suggests kousso may modestly lower blood sugar, so adding it to these drugs could in theory push blood sugar too low. Because blood sugar is closely monitored in people taking these medicines, even a small added effect is worth knowing about. That said, this has only been seen in animal studies, not confirmed in humans.

What the rest of the list means

Although dozens of medications appear on the interaction list, they all belong to one drug class and share the same theoretical concern. A long list here does not mean many separate risks; it simply reflects how many diabetes medicines exist. The predicted effect comes from animal research and has not been shown to cause meaningful changes in people.

Check your medications against Kousso

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

Interaction report

Drugs that interact with Kousso

86 medications have a known interaction with Kousso, 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 Kousso using our pharmacist-reviewed interaction data.

AI summaries are generated from our Kousso 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 Kousso 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 Kousso affects

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

All 1 drug category Kousso interacts with

Antidiabetes Drugs

Theoretically, kousso might have an additive effect with antidiabetes drugs and cause hypoglycemia. Animal research shows that kousso flower extract modestly decreases blood glucose levels in diabetic mice.
Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence D

Monograph

Kousso: Uses, Safety & Side Effects

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

The bottom line

Kousso is the dried flower of the African tree Hagenia abyssinica, used traditionally—especially in Ethiopia—to expel tapeworms. It was once listed in older pharmacopeias as a worm treatment, but it has largely been replaced by safer, more reliable modern medicines and can cause significant side effects. There is no good modern evidence supporting its use, so talk to a pharmacist or doctor before considering it.

Scientific name: Hagenia abyssinica
Family: Rosaceae
Part used: Dried female flowers
Common forms: Dried flower powder, infusion (tea), and traditional liquid preparations

People commonly use it for

Tapeworm infection (traditional anthelmintic)
Other intestinal worms
Traditional digestive remedies

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

Safety at a glance

OverallUse caution

Traditionally used as a worm treatment but can cause nausea, vomiting, and other side effects; modern safety data are limited.

PregnancyUnsafe

When used orally due to abortifacient activity.

Read the full pregnancy detail

BreastfeedingUnsafe

When used orally due to its potential for toxicity.

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

Kousso (also spelled kosso, koso, or cusso) is the dried female flower of Hagenia abyssinica, a flowering tree in the rose family. The tree grows at high elevations in the mountains of eastern Africa, especially Ethiopia, where it has a long history of traditional use.

For centuries, people in this region have used kousso as a remedy to expel tapeworms and other intestinal worms. The dried flowers were usually steeped in water and the liquid swallowed. Kousso was even listed in some older Western pharmacopeias during the 1800s and early 1900s as a treatment for tapeworm.

Today, kousso is rarely used in modern medicine because safer and more effective deworming drugs are widely available. It remains mostly a part of traditional and folk practice.

Uses & effectiveness

The main traditional use of kousso is as an anthelmintic—a treatment to remove intestinal worms, especially tapeworms. This use dates back hundreds of years in Ethiopian medicine and was once accepted in older Western drug references.

However, the scientific evidence behind kousso is very limited by today's standards. Most of what is known comes from historical use and older, low-quality reports rather than well-designed modern clinical trials. There is not enough reliable evidence to confirm how well it works or to recommend it over proven modern deworming medicines.

For any suspected worm infection, modern prescription treatments are far better studied, more reliable, and safer. You should see a healthcare provider for proper diagnosis and treatment rather than relying on kousso.

How it works

Kousso flowers contain compounds historically called kosotoxin and related substances (sometimes grouped as "kosin" or phloroglucinol derivatives). These compounds are thought to be the active ingredients that affect worms.

The traditional idea is that these substances paralyze or weaken the tapeworm so it loosens its grip on the intestinal wall and can be passed out of the body. Much of this understanding comes from older laboratory observations rather than modern, detailed research.

Because high-quality modern studies are lacking, the exact way kousso acts in the body—and how strong or consistent that effect is—remains poorly understood.

Safety & precautions

Kousso is not considered a gentle herb. In traditional use it was known to cause stomach upset, nausea, and vomiting, which were sometimes seen as part of the "purging" effect. Larger doses can be more toxic.

Modern safety information is limited, and there are no clear, agreed-upon standards for purity, strength, or dosing of kousso products. This makes it hard to use safely on your own.

People who are pregnant or breastfeeding should avoid kousso, because there is not enough safety data and the herb may be harmful. Children, older adults, and people with liver, kidney, or digestive problems should also avoid it unless guided by a healthcare professional. Always talk to a pharmacist or doctor before using kousso.

Side effects

The most commonly reported side effects of kousso are nausea, vomiting, and abdominal cramping or discomfort. Diarrhea and a general feeling of being unwell may also occur.

At higher doses, kousso has historically been linked to more serious problems, which may include dizziness, vision disturbances, and other signs of toxicity. Because product strength is not standardized, the risk of taking too much is a real concern.

If you take kousso and feel very unwell—especially with severe vomiting, confusion, vision changes, or signs of dehydration—seek medical help right away.

Kousso: Reported Adverse Effects

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

Orally, kousso can cause gastrointestinal irritation, resulting in salivation, nausea, and diarrhea. It can also cause headache and general weakness. At high doses, vision disorders, spasms, and syncope can occur, progressing to acidosis, and shock.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

Reports by condition

Cluster headache Neurologic/CNS

Orally, kousso can cause headache and general weakness. At high doses, kousso can cause spasms.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

Diarrhea Gastrointestinal

Orally, kousso can cause gastrointestinal irritation, resulting in salivation, nausea, and diarrhea.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

Syncope Cardiovascular

Orally, kousso can cause syncope when used in high doses.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

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 well-established, standardized modern dose for kousso. Traditional preparations varied widely and were not measured in the careful way modern medicines are.

Because of the lack of standardization and the risk of side effects, we cannot recommend a specific amount. If you are considering a kousso product, follow the directions on the label and, more importantly, check with a pharmacist or doctor first.

For worm infections, a prescription deworming medicine prescribed by a healthcare provider is a safer and more reliable choice.

Pregnancy & Breastfeeding

Kousso & Pregnancy

Unsafe

When used orally due to abortifacient activity.

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Thomsen H, Reider K, Franke K, et al. Characterization of constituents and anthelmintic properties of Hagenia abyssinica. Sci Pharm 2012;80(2):433-46.

Kousso & Breastfeeding

Unsafe

When used orally due to its potential for toxicity.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 4 references that drive our Kousso 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.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Thomsen H, Reider K, Franke K, et al. Characterization of constituents and anthelmintic properties of Hagenia abyssinica. Sci Pharm 2012;80(2):433-46. PubMed
Kifle ZD, Yesuf JS, Atnafie SA. Evaluation of in vitro and in vivo Anti-Diabetic, Anti-Hyperlipidemic and Anti-Oxidant Activity of Flower Crude Extract and Solvent Fractions of Hagenia Abyssinica (Rosaceae). J Exp Pharmacol. 2020 Jun 9;12:151-167.

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.

Pharmacist Counseling Corner

Kousso: Common Questions

Does Kousso interact with prescription medications?

Yes. We list 86 medications with a known interaction with Kousso. Use the checker above to see how Kousso interacts with a specific drug.

How are Kousso 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 Kousso 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 Kousso 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 Kousso used for?

Kousso is a traditional herbal remedy made from the dried flowers of an African tree, used mainly to expel tapeworms and other intestinal worms. Modern medicine generally favors safer, better-studied deworming drugs instead.

Is Kousso safe to take?

Kousso can cause nausea, vomiting, and other side effects, and modern safety data are limited. It is best to avoid using it on your own and to talk with a pharmacist or doctor first.

Can I use Kousso during pregnancy or while breastfeeding?

No. There is not enough safety information, and the herb may be harmful, so it should be avoided during pregnancy and breastfeeding.

Should I use Kousso instead of a prescription deworming medicine?

No. Prescription deworming medicines are much better studied, more reliable, and safer. See a healthcare provider for proper diagnosis and treatment of any suspected worm infection.

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

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