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Squill Drug Interactions, Uses, Effectiveness, Safety & More

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Squill Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, Squill drug interactions carry a genuine risk, mainly because squill contains natural heart-active compounds that can add to or amplify the effects of many common medications. One interaction is rated major and all the rest are moderate, with none considered minor.

Interactions deserving the most attention

The clearest concern is digoxin: squill contains similar heart-active compounds, so combining them doubles up the effect and is considered contraindicated due to the risk of toxicity. Also important are potassium-depleting diuretics like furosemide and hydrochlorothiazide, along with corticosteroids and stimulant laxatives, since low potassium makes squill's heart effects more dangerous. Most of these concerns rest on theory rather than human studies, but because they involve heart rhythm, they deserve respect.

What the rest of the list means

Beyond these, the long list of moderate interactions is largely based on what is known about digoxin, not on direct studies of squill itself. Certain antibiotics and quinine, for example, can raise digoxin levels, so experts predict the same could happen with squill. In other words, many of these combinations are cautionary predictions rather than effects proven to be harmful in people.

Check your medications against Squill

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

Interaction report

Drugs that interact with Squill

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

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

2,830 drugs
DigoxinDigitek, Lanoxicaps, Lanoxin› Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual› Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES› AcetazolamideAk-Zol, Diamox› Amiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic› Ammonium ChlorideAmmonium Chloride› Amphotericin, TetracyclineMysteclin-F› ArmodafinilNuvigil› Atenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic› Atenolol, ChlorthalidoneTenoretic› Azelastine Hydrochloride, Fluticasone PropionateDymista› Azilsartan, ChlorthalidoneEdarbyclor› AzithromycinAzasite, Zithromax, Zmax› Beclometasone DipropionateBecotide› BeclomethasoneBeclovent, Vanceril› Beclomethasone DipropionateQNASL, Qvar› Benazepril, HydrochlorothiazideLotensin HCT› BendroflumethiazideAprinox, Naturetin, Neo-NaClex› Bendroflumethiazide, NadololCorzide› Bendroflumethiazide, PotassiumCentyl K, Neo-NaClex-K› Bendroflumethiazide, Rauwolfia SerpentinaRauzide› BenzthiazideExna› BetamethasoneCelestone, Diprolene AF, Diprosone› Betamethasone DipropionateSernivo› Betamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora› Betamethasone ValerateLuxiq› BisacodylDulcolax, Gentlax› Bisacodyl, DocusateDulcolax Laxative Tabs› Bismuth Subsalicylate, Metronidazole, TetracyclineHelidac› Bisoprolol, HydrochlorothiazideZiac›
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 Squill 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 Squill affects

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

All 7 drug categories Squill interacts with
Digoxin (lanoxin)CorticosteroidsDiuretic DrugsMacrolide AntibioticsQuinineStimulant LaxativesTetracycline Antibiotics
Digoxin (Lanoxin)

Squill contains cardiac glycosides. Concomitant use of digoxin and squill is contraindicated due to therapeutic duplication and increased risk of cardiac glycoside toxicity.

Likelihood Probable Evidence D
Corticosteroids

Squill contains cardiac glycosides. Concomitant use of corticosteroids and squill might increase effects and adverse effects of long-term corticosteroid use due to potassium depletion and electrolyte imbalance.

Likelihood Possible Evidence D
Diuretic Drugs

Squill contains cardiac glycosides. Theoretically, concomitant use with potassium-depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.

Likelihood Possible Evidence D
Macrolide Antibiotics

Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of macrolide antibiotics might increase the absorption of the cardiac glycosides found in squill.

Likelihood Possible Evidence D
Quinine

Quinine may reduce the clearance of oral digoxin. Theoretically, concomitant use of quinine with squill might reduce the clearance of cardiac glycosides found in squill and increase the risk of adverse effects.

Likelihood Possible Evidence D
Stimulant Laxatives

Squill contains cardiac glycosides. Concomitant use of squill and stimulant laxatives might increase the risk of cardiac glycoside toxicity due to potassium loss.

Likelihood Possible Evidence D
Tetracycline Antibiotics

Tetracycline antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of tetracycline antibiotics might increase the absorption of the cardiac glycosides found in squill.

Likelihood Possible Evidence D
Monograph

Squill: Uses, Safety & Side Effects

The bottom line

Squill is a bulb plant that contains potent cardiac glycosides, which can affect the heart much like the drug digoxin. While it has a long history of use as a cough remedy and heart tonic, it can be dangerously toxic and there is little solid evidence for its modern use, so we do not recommend taking it without close medical supervision.

Squill
Scientific name
Drimia maritima
Family
Asparagaceae
Part used
Dried inner bulb scales
Common forms
Dried bulb, tinctures, liquid extracts, syrups, and some traditional cough preparations
People commonly use it for
  • Cough and chest congestion
  • Fluid retention (diuretic)
  • Heart conditions (traditional 'cardiac tonic')
  • Hair loss (topical use)
  • Rodenticide (red squill, non-medicinal)

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

Safety at a glance
OverallUse caution

Squill contains heart-active glycosides that can be toxic, so it should only be used under medical supervision.

PregnancyUnsafe

When used orally because it can have an abortifacient effect.

Read the full pregnancy detail
BreastfeedingUnsafe

When used orally.

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

Squill comes from the bulb of a plant in the lily and asparagus family. The most common type, sometimes called sea squill or sea onion (Drimia maritima, formerly Urginea maritima), grows wild around the Mediterranean Sea and the Black Sea coast. A related plant called Indian squill (Urginea indica) is used in parts of Asia.

People have used squill in traditional medicine for hundreds of years. The dried inner part of the bulb is the part used for medicine. It has been taken to loosen mucus and ease coughs, to help the body get rid of extra fluid, and as a remedy for certain heart problems.

It is important to know that there is also a kind called red squill that is used as a rat poison. This shows how powerful and potentially dangerous the chemicals in this plant can be.

How it works

Squill's main active compounds are cardiac glycosides, including scillaren A and related substances. These chemicals act on the heart in a way that is similar to the prescription drug digoxin. They can make the heart contract more strongly and can change the heart's rhythm.

These same compounds are thought to be behind its traditional use as a diuretic and expectorant. In small amounts, squill may have triggered the body to make more mucus that is easier to cough up, and changes in fluid handling may explain the diuretic effect.

Much of what we understand about how squill works comes from older research and from its known chemistry rather than from large, modern human studies. Because the active compounds are so potent, the line between a possibly helpful amount and a toxic amount is very narrow.

Effectiveness

Does Squill work?

Evidence overview · 2 uses evaluated
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.

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

Also studied for 2 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Alopecia areata
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in adolescents and adults with alopecia areata shows that applying squill 2% solution to patches of hair loss on the scalp twice daily for 12 weeks increases hair regrowth, but not hair growth rate, when compared with clobetasol 0.05% lotion.

Sources Ref 104983
Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in adults with moderate to severe asthma currently treated with inhaled corticosteroids and beta-agonist medications shows that taking a syrup containing squill 0.5 mg twice daily for 6 weeks modestly improves lung function and symptoms of airway obstruction when compared with placebo. The frequency of asthma exacerbations was not evaluated.

Sources Ref 94852

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

Squill should be treated with great caution. Its cardiac glycosides can be toxic, and overdose can be life-threatening. People should not use squill on their own without guidance from a doctor or pharmacist.

Who should avoid it: People with heart conditions, irregular heartbeat, kidney problems, or low potassium levels are at higher risk of harm. Older adults and children may also be more sensitive to its effects.

Pregnancy: Avoid squill during pregnancy. There is not enough safety information, and its heart-active chemicals could be harmful.

Breastfeeding: Avoid squill while breastfeeding because its safety is unknown and the active compounds are potentially toxic.

If you are considering any product that contains squill, talk to a pharmacist or doctor first, and never exceed the amount on the label.

Side effects

Even at lower amounts, squill can cause stomach upset, nausea, vomiting, and diarrhea. Some people may notice headache or a slow or irregular heartbeat.

Serious effects can occur because of the cardiac glycosides. These include dangerous changes in heart rhythm, very low blood pressure, confusion, vision changes, seizures, and in severe cases, death. The risk goes up with higher doses, with low potassium levels, and in people with existing heart problems.

If someone takes too much squill or has symptoms like an irregular heartbeat, fainting, or severe vomiting, seek emergency medical care right away.

Squill: Reported Adverse Effects

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

Squill is generally regarded as unsafe for use. Any benefits of therapy might not outweigh the risk of toxicity. Orally, squill can cause gastric irritation, loss of appetite, diarrhea, nausea, vomiting, stomach disorders, headache, irregular pulse, and convulsions. Squill poisoning resembles digoxin poisoning. Symptoms of squill poisoning include restlessness, nausea, vomiting, life-threatening arrhythmias, stupor, vision disorders, depression, confusion, hallucinations, psychosis, seizure, cardiac arrest, asphyxiation, and death.

Topically, the fresh squill bulb can cause dermatitis.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Nejatbakhsh F, Karegar-Borzi H, Amin G, et al. Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial. J Eth
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33:83-6.
Reports by condition
Arrhythmia Cardiovascular

Orally, squill can cause irregular pulse.

Squill poisoning resembles digoxin poisoning. The cardiovascular symptoms of squill poisoning include cardiac arrest and life-threatening arrhythmias, including ventricular tachycardia, atrial tachycardia with atrioventricular block, and ventricular fibrillation. In one case report, a 55-year-old woman experienced atrioventricular block and ventricular arrythmias after ingesting two squill bulbs, resulting in death.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Nejatbakhsh F, Karegar-Borzi H, Amin G, et al. Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial. J Eth
  3. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33:83-6.
Cluster headache Neurologic/CNS

Orally, squill can cause headache and convulsions.

Squill poisoning resembles digoxin poisoning. The neurologic symptoms of squill poisoning include confusion, restlessness, stupor, and seizure.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33:83-6.
Depression Psychiatric

Squill poisoning resembles digoxin poisoning. The psychiatric symptoms of squill poisoning include depression, confusion, hallucinations, and psychosis.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33:83-6.
Dermatitis Dermatologic

Topically, the fresh squill bulb can cause dermatitis. In one case report, a 52-year-old woman presented with non-allergic irritant contact dermatitis after topical application of a squill preparation to the knee and wrist. The squill preparation was kept under occlusive dressing for 24 hours.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Nejatbakhsh F, Karegar-Borzi H, Amin G, et al. Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial. J Eth
Diarrhea Gastrointestinal

Orally, squill can cause gastric irritation, loss of appetite, diarrhea, nausea, vomiting, and stomach disorders.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Nejatbakhsh F, Karegar-Borzi H, Amin G, et al. Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial. J Eth
Poisoning Ocular/Otic

Squill poisoning resembles digoxin poisoning. The ocular symptoms of squill poisoning include various vision disorders.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33:83-6.
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 safe dose of squill for general use. Because the active compounds are so potent and the toxic dose is close to any possibly effective dose, self-dosing is not recommended.

If a product contains squill, follow the label exactly and do not take more than directed. It is safest to check with a pharmacist or doctor before using any squill-containing product, especially if you take other medicines or have a health condition.

We do not provide specific milligram amounts here because of the serious risk of toxicity.

Pregnancy & Breastfeeding

Squill & Pregnancy

Unsafe

When used orally because it can have an abortifacient effect.

  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.

Squill & Breastfeeding

Unsafe

When used orally.

  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
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 9 references that drive our Squill 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. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  5. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  6. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  7. Tuncok Y, Kozan O, Cavdar C, et al. Urginea maritima (squill) toxicity. J Toxicol Clin Toxicol 1995;33:83-6.
  8. Nejatbakhsh F, Karegar-Borzi H, Amin G, et al. Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial. J Eth PubMed
  9. Moosavi ZB, Aliabdi M, Golfakhrabadi F, Namjoyan F. The comparison of therapeutic effect of Clobetasol propionate lotion and squill extract in alopecia areata: a randomized, double-blind clinical trial. Arch Dermatol Res. 2020 Apr;312(3):173-178. 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 Squill

1 brand in our database make a supplement containing Squill.

Product directory

Supplement products with Squill

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

Pharmacist Counseling Corner

Squill: Common Questions

What is Squill used for, and does it work?
People use Squill 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 Squill interact with prescription medications?
Yes. We list 156 medications with a known interaction with Squill, including 1 rated major. Use the checker above to see how Squill interacts with a specific drug.
How are Squill 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 Squill 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 Squill 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 Squill used for?
Traditionally, Squill has been used as a cough remedy (expectorant), a diuretic to remove extra fluid, and a heart tonic. Modern evidence supporting these uses is limited, and safer options usually exist.
Is Squill safe to take?
Squill can be dangerous because it contains heart-active chemicals (cardiac glycosides) that may cause irregular heartbeat, very low blood pressure, and even death. It should only be used under medical supervision, if at all.
Can I use Squill while pregnant or breastfeeding?
No. You should avoid Squill during pregnancy and breastfeeding because of its potential toxicity and the lack of safety information.
Is Squill the same plant used in rat poison?
A type called red Squill has been used as a rodenticide, which highlights how toxic the plant's compounds can be. This is one reason to be very cautious with any Squill product.

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

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