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Dietary supplement

Hawthorn 4:1 Extract Ingredients & Drug Interactions

by Healths Harmony

Capsule Category: Botanical
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Hawthorn 4:1 Extract is a dietary supplement by Healths Harmony with 1 active ingredient. Its ingredients are commonly taken for heart failure symptoms, high blood pressure, chest pain (angina).Based on those ingredients, 191 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Hawthorn Berry Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Hawthorn 4:1 Extract by Healths Harmony

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: hawthorn berry extract in a 4:1 concentration, meaning the extract is four times more potent than the raw berry. The capsule itself is made from bovine gelatin, with rice powder, magnesium stearate, and silicon dioxide added as inactive ingredients to bind and fill the capsule.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Hawthorn's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: Heart and cardiovascular health support.
  • We looked for evidence on: Angina, Arrhythmia, Cardiovascular disease (CVD), Congestive heart failure (CHF), Hypertension, Anxiety — and 2 related terms.
  • The closest evidence on file: Hawthorn is rated "Insufficient Reliable Evidence To Rate" for Angina (Natural Medicines).
  • Also on file: Hawthorn is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Arrhythmia, Cardiovascular disease (CVD), Congestive heart failure (CHF), and more.

The evidence for hawthorn's effectiveness isn't established in the data we hold. Conditions it's been studied for—including angina, anxiety, heart arrhythmias, atherosclerosis, cardiovascular disease, and cognitive function—all show insufficient reliable evidence to make a confident claim about whether it works.

Talk with your doctor about what hawthorn might or might not do for your specific situation.

The evidence, ingredient by ingredient Hawthorn

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Hawthorn is generally well tolerated when used appropriately, though because it affects your heart, any use should happen under medical supervision. Serious side effects are rare, but multiorgan allergic reactions leading to kidney failure have been reported occasionally.

A small number of people have experienced palpitations, fast heartbeat, or breathing changes. There isn't enough safety information to use hawthorn during pregnancy or while breastfeeding—the facts advise against it.

Side effects, ingredient by ingredient Hawthorn

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Hawthorn.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; heart-rhythm medications.
  • For scale: 191 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, double-check if you're on nitrates or phosphodiesterase-5 inhibitors (Major severity)—the blood-pressure drop could be serious. Also flag beta-blockers, blood thinners, calcium channel blockers, or digoxin with your pharmacist, since hawthorn may intensify their effects.

Because this product affects your heart, bring your complete medication list to discuss.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

Hawthorn may be considered by people looking to support heart health, but because it interacts with common heart and blood-pressure medications, you need to check with your pharmacist or doctor first. Anyone on nitrates, ED medications, beta-blockers, blood thinners, calcium channel blockers, or digoxin should not start this without a conversation about your specific drugs.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2024.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Hawthorn 4:1 Extract, straight from the product label.

Brand Healths Harmony
Net contents 120 Capsule(s)
Market status On market
Date entered into DSLD Aug 22, 2024
DSLD ID 314299
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating), Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Hawthorn 4:1 Extract by Healths Harmony, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
120
IngredientAmount% DV
Hawthorn Berry Extract665 mg--

Other ingredients: Bovine Gelatin, Rice powder, Magnesium Stearate, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Suggested use: 1 capsule daily preferably with a meal or as directed by a healthcare professional.

Precautions

Discontinue use if side effects appear.

Caution: Do not exceed recommended dose.

This product is not intended for pregnant or nursing mothers, children under 18 and individuals with a known medical condition including cardiovascular disorders or hypotension (low blood pressure). If you are currently taking any prescription medication, including those for high blood pressure and have questions about the advisability of taking this product, consult a physician prior to use.

This product is not intended for pregnant or nursing mothers, children under 18 and individuals with a known medical condition including cardiovascular disorders or hypotension (low blood pressure).

This product is manufactured and packaged in a facility which may also process milk, soy, wheat, egg, peanuts, tree nuts, fish and crustacean shellfish.

Keep out of the reach of children.

Do not use if safety seal is damaged or missing.

General Statements

90 days money back guarantee Satisfaction guarantee We offer a full refund on the purchase price of your order within 90 days of purchase. Restrictions apply. Full details please visit: www.healthsharmony.com/refunds Visit us online at: healthsharmony.com

Let us help! For any questions, concerns or refunds: [email protected]

Formula

Concentrated from 2660 mg berries

Formulation

Antioxidant

Non-GMO

Vegan

Herbal extract

FDA Statement of Identity

Dietary Supplement

Storage

Store in a cool, dry place.

Seals/Symbols

Made In USA With Global Ingredients Sourced from a GMP Certified Facility

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

See for yourself

Hawthorn 4:1 Extract by Healths Harmony label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Hawthorn 4:1 Extract by Healths Harmony

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container120 Amounts shown are per serving.

Hawthorn Berry Extract

Interacts with
191 drugs
665 mg per serving

Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when...

Hawthorn Berry Extract monograph & interactions

Other (inactive) ingredients: Bovine Gelatin, Rice powder, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Hawthorn 4:1 Extract by Healths Harmony Drug Interactions

Want to check YOUR meds against Hawthorn 4:1 Extract?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
191Drugs
14 Major 177 Moderate

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Hawthorn 4:1 Extract with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

Hawthorn Berry Extract6 drug types · 191 drugs

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
The maker

Brand information

Manufacturer and brand details for Hawthorn 4:1 Extract, from the product label.

Healths Harmony

See all Healths Harmony products
Name
Healths Harmony USA Supplements LLC
Street Address
30 N. Gould St. Ste 6594
City
Sheridan
State
WY
ZipCode
82801
Pharmacist Counseling Corner

Hawthorn 4:1 Extract by Healths Harmony: Common Questions

Does Hawthorn 4:1 Extract by Healths Harmony interact with any medications?
Yes. Based on its ingredients, Hawthorn 4:1 Extract has a known interaction with 191 medications, including 14 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Hawthorn 4:1 Extract contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take hawthorn if I'm on a blood thinner like warfarin?
Not without checking first. Hawthorn may increase bleeding risk when combined with blood thinners or antiplatelet drugs—though the human evidence is limited. Your pharmacist or doctor needs to weigh the benefit against that risk for your situation.
What's a 4:1 extract?
It means the extract is four times more concentrated than the raw hawthorn berry. You're getting more hawthorn compounds in each capsule than you would from the whole dried berry.
Is hawthorn proven to work for heart health?
The evidence isn't solid enough for us to make that claim. Studies have looked at hawthorn for angina, arrhythmias, and cardiovascular disease, but the results don't give us reliable proof that it works.
Are there any side effects?
Most people tolerate hawthorn well, but palpitations and fast heartbeat have been reported by a small number of users. Very rarely, serious allergic reactions affecting multiple organs have occurred.
Can I take this while pregnant or breastfeeding?
No—there isn't enough safety information, and the facts advise against it during pregnancy and while breastfeeding. Talk with your doctor about alternatives.

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

Not sure if Hawthorn 4:1 Extract is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Hawthorn 4:1 Extract label
Go deeper

The Full Monographs Behind Hawthorn 4:1 Extract’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Sources

Sources & How We Checked

Hawthorn 4:1 Extract's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 25 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Hawthorn 25 references
  1. Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002;143:910-5. PubMed
  2. Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114:665-74.. PubMed
  3. Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
  4. Holubarsch CJ, Colucci WS, Meinertz T, et al. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail 2008;10:1255-63. PubMed
  5. Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
  6. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11:990-99. PubMed
  7. Werner NS, Duschek S, and Schandry R. D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo controlled double blind study. Phytomedicine. 2009;16:1077-82. PubMed
  8. Dalli E, Colomer E, Tormos MC, et al. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 6-15-2011;18:769-75. PubMed
  9. Maek-a-nantawat W, Phonrat B, Dhitavat J, et al. Safety and efficacy of CKBM-A01, a Chinese herbal medicine, among asymptomatic HIV patients. Southeast Asian J Trop.Med Public Health 2009;40:494-501.
  10. Asher GN, Viera AJ, Weaver MA, et al. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC.Complement Altern.Med 2012;12:26. PubMed
  11. Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen.Pract 2006;56:437-43.
  12. Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
  13. Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J.Clin.Pharmacol. 2003;43:637-42. DOI
  14. Tauchert, M., Gildor, A., and Lipinski, J. [High-dose Crataegus extract WS 1442 in the treatment of NYHA stage II heart failure]. Herz 1999;24(6):465-474.
  15. Horoz, M., Gok, E., Genctoy, G., Ozcan, T., Olmaz, R., Akca, M., Kiykim, A., and Gurses, I. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern.Med 2008;47(23):2039-2042. PubMed
  16. Dalli, E., Valles, J., Cosin-Sales, J., Santos, M. T., Moscardo, A., Milara, J., and Sotillo, J. F. Effects of hawthorn (Crataegus laevigata) on platelet aggregation in healthy volunteers. Thromb.Res 2011;128(4):398-400. PubMed
  17. Rogov VD. [Toxiderma due to the fruits of the hawthorn]. Vestn Dermatol Venerol 1984;7(7):46-47.
  18. Loew D, Albrecht M, and Podzuweit H. Efficacy and tolerability of a Hawthorn preparation in patients with heart failure Stage I and II according to NYHA - a surveillance study. Phytomedicine 1996;3(Suppl 1):92.
  19. Rababa'h AM, Altarabsheh SE, Haddad O, Deo SV, Obeidat Y, Al-Azzam S. Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach. Heart Surg Forum 2016;19(4):E175-9. PubMed
  20. Shatoor AS, Soliman H, Al-Hashem F, Gamal BE, Othman A, El-Menshaw N. Effect of hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino wistar rats. Thromb Res 2012;130(1):75-80. PubMed
  21. Vibes J, Lasserre B, Gleye J, Declume C. Inhibition of thromboxane A2 biosynthesis in vitro by the main components of Crataegus oxyacantha (hawthorn) flower heads. Prostaglandins Leukot Essent Fatty Acids 1994;50(4):173-5. PubMed
  22. Rogers KL, Grice ID, Griffiths LR. Inhibition of platelet aggregation and 5-HT release by extracts of Australian plants used traditionally as headache treatments. Eur J Pharm Sci 2000;9(4):355-63. PubMed
  23. Zhou CC, Huang XX, Gao PY, et al. Two new compounds from Crataegus pinnatifida and their antithrombotic activities. J Asian Nat Prod Res 2014;16(2):169-74.
  24. Palmer KG, Lebin JA, Cronin MT, Mazor SS, Burns RA. Crataegus mexicana (Tejocote) Exposure Associated with Cardiotoxicity and a Falsely Elevated Digoxin Level. J Med Toxicol. 2019;15(4):295-298. PubMed
  25. Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6. PubMed

See these in context on the Hawthorn monograph →

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

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