Herb & supplement monograph

Picrorhiza Drug Interactions, Uses, Effectiveness, Safety & More

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Reviewed by licensed pharmacists Sourced from Natural Medicines

Picrorhiza 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 Picrorhiza drug interaction appears low for most people, since none of its known interactions are well documented in humans. No interactions are rated major, and all rest on animal research or theoretical reasoning rather than proven effects in people.

Interactions deserving the most attention

Two groups deserve the most care. Animal research suggests picrorhiza can lower blood sugar, so combining it with diabetes medications could add to their effect and raise the chance of low blood sugar, which makes closer glucose checks sensible. Picrorhiza also appears to stimulate the immune system, so it could work against immunosuppressants such as tacrolimus, cyclosporine, or prednisone, where even a small loss of effect matters, especially for transplant patients.

What the rest of the list means

The long list of interacting medications looks larger than it really is, because it mostly reflects these two broad drug groups. Every concern is theoretical, drawn from animal or laboratory findings, and none has been confirmed to cause meaningful problems in people so far.

Check your medications against Picrorhiza

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

Interaction report

Drugs that interact with Picrorhiza

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

2,830 drugs
6-mercaptopurinePurinethol› AbrocitinibCibinqo› AcarboseGlucobay, Prandase, Precose› AcetohexamideDymelor› AdalimumabHumira› Adalimumab-adazHyrimoz› Adalimumab-adbmCyltezo› Adalimumab-afzbAbrilada› Adalimumab-attoAmjevita› Adalimumab-bwwdHadlima› Adalimumab-fkjpHulio› AlbiglutideTanzeum› AlefaceptAmevive› AlemtuzumabCampath› AlogliptinNesina› Alogliptin, MetforminKazano› Alogliptin, PioglitazoneOseni› Anifrolumab-fniaSaphnelo› Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi› Antithymocyte GlobulinThymoglobulin› AtezolizumabTecentriq› AzamuneImmunoprin› AzathioprineAzamune, Imuran› BasiliximabSimulect› Beclometasone DipropionateBecotide› BeclomethasoneBeclovent, Vanceril› Beclomethasone DipropionateQNASL, Qvar› BetamethasoneCelestone, Diprolene AF, Diprosone› Betamethasone DipropionateSernivo› Betamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora›
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 Picrorhiza 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 Picrorhiza affects

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

All 2 drug categories Picrorhiza interacts with
Antidiabetes DrugsImmunosuppressants
Antidiabetes Drugs

Evidence from animal research suggests that an extract of picrorhiza can reduce fasting and non-fasting blood sugar levels. Theoretically, picrorhiza might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence D
Immunosuppressants

Picrorhiza seems to have immunostimulating activity. Theoretically, picrorhiza may interfere with immunosuppressant therapy. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).

Likelihood Possible Evidence D
Monograph

Picrorhiza: Uses, Safety & Side Effects

The bottom line

Picrorhiza (Picrorhiza kurroa) is a bitter Himalayan herb used in Ayurvedic medicine, mainly for liver and digestive complaints. Early lab and small human studies suggest possible liver-protective and anti-inflammatory effects, but high-quality evidence is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Scientific name
Picrorhiza kurroa
Family
Plantaginaceae
Part used
Roots and rhizomes
Common forms
Capsules, tablets, powder (churna), liquid extracts, and traditional herbal formulas
People commonly use it for
  • Liver support
  • Digestive complaints
  • Asthma and breathing problems
  • Skin conditions
  • Fever
  • Immune support

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

Safety at a glance
OverallUse caution

Generally used in traditional medicine, but human safety data are limited, so use with care.

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.

Jump to a section

Overview

Picrorhiza is an herb that comes from the roots and rhizomes (underground stems) of the plant Picrorhiza kurroa. It grows in the high-altitude regions of the Himalayan mountains, including parts of India, Nepal, and Tibet.

The herb has a very bitter taste and has been used for hundreds of years in Ayurvedic and other traditional medicine systems. In these traditions, it is often called "kutki" or "kutaki." People have used it mainly to support the liver and digestion, and for fevers and breathing problems.

Today it is sold as a dietary supplement in capsules, tablets, powders, and liquid extracts, and it is found in many combination herbal products.

How it works

Picrorhiza contains active compounds called iridoid glycosides, the best known being picroside and kutkoside. These are sometimes grouped together and called "kutkin."

In laboratory and animal studies, these compounds appear to have antioxidant and anti-inflammatory effects. Researchers think these actions may help protect liver cells from damage and calm inflammation in the body.

It's important to remember that most of this research has been done in test tubes or animals. How well these effects apply to people taking the supplement is still not clear.

Effectiveness

Does Picrorhiza work?

Evidence overview · 4 uses evaluated
1 Possibly effective 1 Leans ineffective 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 Vitiligo
Rating & evidence shown verbatim from Natural Medicines

Taking picrorhiza orally for up to 1 year, in combination with oral and topical methoxsalen, seems to help treat vitiligo in adults and children.

Sources Ref 11493
Possibly Ineffective Asthma
Rating & evidence shown verbatim from Natural Medicines

Taking picrorhiza orally for up to 12 weeks does not seem to help asthma symptoms or improve measurements of lung function.

Sources Ref 11858
Also studied for 2 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Chronic obstructive pulmonary disease (COPD)
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with COPD and chronic cough shows that taking two capsules of a specific combination product (AKL1, AKL International Ltd.) containing picrorhiza ginkgo extract, and ginger twice daily for 8 weeks does not improve cough or other respiratory symptoms when compared with placebo.

Sources Ref 89702
Insufficient Reliable Evidence To Rate Hepatitis
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research suggests that picrorhiza, given orally for 2 weeks, might help acute viral hepatitis. It seems to improve symptoms such as anorexia, nausea, and malaise, as well as lower bilirubin and transaminase levels. Picrorhiza has not been tested in patients with hepatitis B.

Sources Ref 11848

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

Picrorhiza has a long history of traditional use, but there is limited modern safety information from well-controlled studies. Use it cautiously and under the guidance of a healthcare professional.

Pregnancy and breastfeeding: There is not enough reliable safety information for these times. To be safe, avoid Picrorhiza if you are pregnant, trying to become pregnant, or breastfeeding.

People with liver disease should be especially careful and check with a doctor before using any liver herb, since herbal products can sometimes affect the liver. People with autoimmune conditions may also want to be cautious because of possible effects on the immune system.

Because supplements are not tightly regulated, product quality and purity can vary. Choose products from reputable brands and consider those that are third-party tested.

Side effects

When used in typical amounts, Picrorhiza is usually well tolerated, but solid safety data are limited.

The most commonly reported side effects involve the digestive system, such as nausea, stomach upset, or loose stools, partly because the herb is very bitter.

Rarely, herbal products taken by mouth can cause allergic reactions or, in some cases, liver irritation. Stop taking it and seek medical care if you notice yellowing of the skin or eyes, dark urine, severe stomach pain, or signs of an allergic reaction such as rash, swelling, or trouble breathing.

Picrorhiza: Reported Adverse Effects

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

Orally, picrorhiza may cause vomiting, rash, anorexia, diarrhea, itching, and giddiness.

  1. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89-95.
Reports by condition
Anorexia Gastrointestinal
Pruritus Dermatologic
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 standard dose of Picrorhiza. The amount used can vary widely depending on the form (powder, capsule, or extract) and how concentrated the product is.

The safest approach is to follow the dosing directions on the product label and not to exceed them. Because the right dose depends on your health, other medicines, and the specific product, it's best to check with your pharmacist or doctor before starting.

Do not give Picrorhiza to children or use it long-term without professional guidance.

Pregnancy & Breastfeeding

Picrorhiza & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Picrorhiza & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

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 7 references that drive our Picrorhiza 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. Sharma ML, Rao CS, Duda PL. Immunostimulatory activity of Picrorhiza kurroa leaf extract. J Ethnopharmacol 1994;41:185-92. PubMed
  2. Bedi KL, Zutshi U, Chopra CL, Amla V. Picrorhiza kurroa, an ayurvedic herb, may potentiate photochemotherapy in vitiligo. J Ethnopharmacol 1989;27:347-52. PubMed
  3. Vaidya AB, Antarkar DS, Doshi JC, et al. Picrorhiza kurroa (Kutaki) Royle ex Benth as a hepatoprotective agent--experimental & clinical studies. J Postgrad Med 1996;42:105-8.
  4. Baruah CC, Gupta PP, Nath A, et al. Anti-allergic and anti-anaphylactic activity of picroliv--a standardised iridoid glycoside fraction of Picrorhiza kurroa. Pharmacol Res 1998;38:487-92.
  5. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89-95.
  6. Joy, K. L. and Kuttan, R. Anti-diabetic activity of Picrorrhiza kurroa extract. J Ethnopharmacol 11-1-1999;67(2):143-148. PubMed
  7. Brockwell C, Ampikaipakan S, Sexton DW, Price D, Freeman D, Thomas M, Ali M, Wilson AM. Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2014;9:715-21. 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

Product directory

Supplement products with Picrorhiza

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

Herbal Liver Complex by Solgar Capsule 50 Vegetable Capsule(s) View ingredients & interactions Histoplex by Biotics Research Corporation Capsule 90 Capsule(s) View ingredients & interactions Kutki by Banyan Botanicals Liquid 1 fl. Oz. · 30 mL View ingredients & interactions Kutki Powder by Banyan Botanicals Powder View ingredients & interactions Kutki Supreme by Harmony Nutraceuticals Capsule 120 Vegan Capsule(s) View ingredients & interactions Kyolic Liver Support by Kyolic Capsule 50 Veggie Cap(s) View ingredients & interactions L-Detox 13 A.M. Formula by Patient One 1 MediNutritionals Capsule 60 Vegetarian Capsule(s) View ingredients & interactions L-Detox A.M. Formula by Patient One MediNutritionals Capsule 42 Vegetable Capsule(s) View ingredients & interactions Liv-First by Herbal Hills Tablet Or Pill 900 Tablet(s) View ingredients & interactions Liv-First by Herbal Hills Tablet Or Pill 900 Tablet(s) View ingredients & interactions Liv-First by Herbal Hills Tablet Or Pill 120 Tablet(s) View ingredients & interactions LIVER by Core Nutritionals Lifeline Capsule 90 Vegetable Cap(s) View ingredients & interactions Liver 10 Complex by Botanic Choice Capsule 60 Capsule(s) View ingredients & interactions Liver 10 Complex by Indiana Botanic Gardens Capsule 30 Capsule(s) View ingredients & interactions Liver Balance Complete by NatureWise Capsule 120 Vegetarian Capsule(s) View ingredients & interactions Liver Balance Complete by NatureWise Capsule 60 Vegetarian Capsule(s) View ingredients & interactions Liver Cleanse by Natures Nectar Capsule 60 Capsule(s) View ingredients & interactions Liver Cleanse by The Vitamin Shoppe Capsule 60 Vegetable Capsule(s) View ingredients & interactions Liver Cleanser by GNC Preventive Nutrition Capsule 2 Liquid Cleanse 4 fl. oz. Bottle(s) · 5 Cleansing Fiber Sachet(s) · 5 Cleansing Herbal Pack(s) · 7 Herbal Restore Pack(s) · 7 12.5 Billion Probiotic CFU Capsule(s) View ingredients & interactions Liver Cleanser - PM Packet by GNC Preventive Nutrition Tablet Or Pill 7 PM Packet(s) View ingredients & interactions Liver D-TOX by ALLMAX Capsule 42 Capsule(s) View ingredients & interactions Liver Detox by Bronson Capsule 250 Vegetarian Capsule(s) View ingredients & interactions Liver Detox by Bronson Capsule 100 Vegetarian Capsule(s) View ingredients & interactions Liver DTOX by ALLMAX Capsule 42 Capsule(s) View ingredients & interactions
Pharmacist Counseling Corner

Picrorhiza: Common Questions

What is Picrorhiza used for, and does it work?
People use Picrorhiza for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Picrorhiza for Vitiligo. 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 Picrorhiza interact with prescription medications?
Yes. We list 207 medications with a known interaction with Picrorhiza. Use the checker above to see how Picrorhiza interacts with a specific drug.
How are Picrorhiza 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 Picrorhiza 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 Picrorhiza 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 Picrorhiza used for?
It is used in traditional Ayurvedic medicine mainly for liver support and digestive complaints, and also for fever, asthma, and skin conditions. Modern evidence for these uses is limited and not strong.
Is Picrorhiza safe to take?
It has a long history of traditional use and is usually well tolerated, but modern safety data are limited. Use it cautiously and talk with your pharmacist or doctor first, especially if you have liver problems.
Can I take Picrorhiza while pregnant or breastfeeding?
No. There isn't enough reliable safety information, so it's best to avoid Picrorhiza during pregnancy and while breastfeeding.
What are the side effects of Picrorhiza?
The most common side effects are stomach upset, nausea, or loose stools because the herb is very bitter. Rarely, allergic reactions or liver irritation can occur, so stop and seek care if you notice yellowing of the skin or eyes or a rash.

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

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