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Dietary supplement

Rhubarb Ingredients & Drug Interactions

by Herb Pharm

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Rhubarb is a dietary supplement by Herb Pharm with 1 active ingredient. Its ingredients are commonly taken for constipation, digestive upset, menopausal symptoms.Based on those ingredients, 658 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Rhubarb rhizome with root (Rheum palmatum) extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Rhubarb by Herb Pharm

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: rhubarb rhizome with root (Rheum palmatum) extract. The extract is prepared in certified organic cane alcohol and distilled water.

Does it work?

Moderate evidence
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
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: gastrointestinal system restoration and function.
  • We looked for evidence on: Constipation, Gastrointestinal bleeding, Pancreatitis, digestive health, bowel function.
  • The strongest evidence on file: Rhubarb is rated "Possibly Effective" for Pancreatitis (Natural Medicines).
  • Also on file: Rhubarb is rated "Insufficient Reliable Evidence To Rate" for Constipation, Gastrointestinal bleeding.

The evidence we hold shows rhubarb is possibly effective for pancreatitis and menopausal symptoms. For constipation, appendicitis, nasopharyngeal cancer, and nonalcoholic fatty liver disease, the data isn't established enough to rate it.

The evidence, ingredient by ingredient Rhubarb

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.

Rhubarb root is well tolerated in food amounts and appears well tolerated in medicinal doses, though the most common side effects are cramping, diarrhea, gastrointestinal discomfort, nausea, and vomiting. Long-term or heavy use can cause potassium loss, dehydration, and kidney problems — one case report documented kidney failure after six weeks of use.

The rhubarb leaf itself contains oxalic acid and can be toxic, so don't use that part. The safety data advises against taking medicinal amounts during pregnancy, as rhubarb may stimulate the uterus and bowels.

Also avoid it while nursing, because laxative compounds can pass into breast milk. Don't use this supplement long-term.

Side effects, ingredient by ingredient Rhubarb

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Rhubarb.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; heart-rhythm medications.
  • For scale: 659 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.

Check with your doctor or pharmacist before taking this if you use diuretics (water pills), corticosteroids, digoxin, warfarin, cyclosporine, or any other nephrotoxic or hepatotoxic drugs — all carry Moderate interaction risk. Don't combine it with other stimulant laxatives.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Rhubarb extract may help with pancreatitis or menopausal symptoms, but it's a stimulant laxative with real risks if you take it for weeks at a time or combine it with certain medications — especially heart drugs, blood thinners, water pills, or steroids. Talk with your doctor or pharmacist before starting it, especially if you take any regular medications or have kidney or liver concerns.

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 Dec 22, 2019.

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 Rhubarb, straight from the product label.

Brand Herb Pharm
Barcode (UPC) 090700002176
Net contents 4 fl. Oz.; 120 mL
Market status On market
Date entered into DSLD Dec 22, 2019
DSLD ID 210214
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Organic, Gluten 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 Rhubarb by Herb Pharm, 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:
0.7 mL
Maximum serving Sizes:
0.7 mL
Servings per container
168
UPC/BARCODE
090700002176
IngredientAmount% DV
Rhubarb rhizome with root (Rheum palmatum) extract623 mg--

Other ingredients: certified organic Cane Alcohol, distilled Water

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 Shake well before using Add 1 full squeeze of the dropper bulb to 2 oz. of water or juice, 2 or 3 times per day. Best taken between meals.

Precautions

Caution: Seek expert medical advice before taking during pregnancy or nursing.

Not for use in intestinal obstruction, abdominal pain of unknown origin or intestinal inflammation or during menstruation.

Not for use in excess of 8 consecutive days or in children less than 12 years of age.

Not for use in excess of 8 consecutive days or in children less than 12 years of age. Keep out of the reach of children

Storage

Store away from heat & light

Formula

Rheum palmatum

Rhubarb Liquid Extract

We prepare our Rhubarb Extract from the rhizome with root of certified organically grown Rheum palmatum plants.

Formulation

System restoration Gastrointestinal

Gluten-free

Dry herb/menstruum ratio: 1:4

Certified organic by Organic Certifiers

Seals/Symbols

USDA Organic

FDA Statement of Identity

Herbal Supplement

FDA Disclaimer Statement

This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.

See for yourself

Rhubarb by Herb Pharm label

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

What’s inside

The Ingredients in Rhubarb by Herb Pharm

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

Serving size0.7 mL Dosage formLiquid Servings per container168 Amounts shown are per serving.

623 mg per serving

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal clai...

Rhubarb rhizome with root (Rheum palmatum) extract monograph & interactions

Other (inactive) ingredients: Certified organic Cane Alcohol, Distilled Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Rhubarb by Herb Pharm Drug Interactions

Want to check YOUR meds against Rhubarb?

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.

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658Drugs
658 Moderate

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Rhubarb 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.

Rhubarb rhizome with root (Rheum palmatum) extract8 drug types · 658 drugs

Corticosteroids

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia when taken with corticosteroids.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might compound corticosteroid-induced potassium loss.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, taking rhubarb with cyclosporine might reduce cyclosporine levels.
Animal research shows that co-administration of rhubarb decoction 0.25 or 1 gram/kg with cyclosporine 2.5 mg/kg, decreases cyclosporine maximum plasma concentration and overall exposure levels when compared with taking cyclosporine alone. The authors theorize that rhubarb might reduce cyclosporine bioavailability by inducing of P-glycoprotein and/or cytochrome P450 3A4. However, since rhubarb was administered as a single oral dose and enzyme induction usually occurs after multiple doses, it is possible that cyclosporine absorption was actually reduced via rhubarb's stimulant laxative effects. Also, the composition of the rhubarb decoction was not described.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, overuse of rhubarb might increase the risk of adverse effects when taken with digoxin.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion, increasing the risk of digoxin toxicity.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion and compound diuretic-induced potassium loss.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.

Likelihood Possible Evidence D
Nephrotoxic Drugs

Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
The anthraquinone constituents of rhubarb have been shown to induce nephrotoxicity in animal research. Additionally, in a case report, a 23-year old female presented with kidney failure after taking 6 tablets of a proprietary slimming agent (found to contain the anthraquinones emodin and aloe-emodin from rhubarb) daily for 6 weeks and then adding diclofenac 25 mg 4 times daily for 2 days. The authors postulate that the anthraquinone constituents of rhubarb contributed to the renal dysfunction, and the addition of diclofenac, a nephrotoxic drug, led to renal failure. Until more is known, advise patients to avoid taking rhubarb if they are taking other potentially nephrotoxic drugs.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, rhubarb might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Rhubarb has stimulant laxative effects. Concomitant use with stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, excessive use of rhubarb might increase the risk of bleeding when taken with warfarin.
Rhubarb has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of rhubarb.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Rhubarb, from the product label.

Herb Pharm

See all Herb Pharm products
Name
Herb Pharm
City
Williams
State
OR
ZipCode
97544
Phone Number
800-348-4372
Web Address
www.herb-pharm.com
Pharmacist Counseling Corner

Rhubarb by Herb Pharm: Common Questions

Does Rhubarb by Herb Pharm interact with any medications?
Yes. Based on its ingredients, Rhubarb has a known interaction with 658 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Rhubarb 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 this while pregnant or nursing?
No — the safety data advises against medicinal amounts during pregnancy because rhubarb may stimulate the uterus and bowels. Also avoid it while nursing, because laxative compounds can pass into breast milk. Talk with your doctor or pharmacist about what's safe for you.
What side effects should I watch for?
The most common are cramping, diarrhea, gastrointestinal discomfort, nausea, and vomiting. Long-term or heavy use can cause potassium loss and dehydration. Anaphylaxis is rare but serious. Don't use this long-term.
Does this really work for constipation?
The evidence we hold on constipation isn't established enough to rate it. Rhubarb does have laxative effects, but we don't have solid data on how well it works for that purpose. Ask your doctor or pharmacist if it's right for your situation.
Why are there so many interactions listed?
Rhubarb is a stimulant laxative, so it causes potassium and fluid loss — a risk that compounds with diuretics, heart drugs, and steroids. The anthraquinones in it may also affect your liver and kidneys. These are theoretical risks from overuse, but they're serious enough that you need to check your specific medications before taking it.
Is this safe to use long-term?
No — the safety data advises against long-term use. Chronic use or abuse can cause potassium loss, dehydration, and kidney problems. Use it short-term only.

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

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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.

Rhubarb label
Sources

Sources & How We Checked

Rhubarb'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 20 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.

Rhubarb 20 references
  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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  6. Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
  7. Fairbairn JW. The anthraquinone laxatives. Biological assay and its relation to chemical structure. Pharmacology 1976;14:48-61. PubMed
  8. Siegers, C. P., Hertzberg-Lottin, E., Otte, M., and Schneider, B. Anthranoid laxative abuse--a risk for colorectal cancer? Gut 1993;34(8):1099-1101. PubMed
  9. Fan, J. G. Evaluating the efficacy and safety of Danning Pian in the short-term treatment of patients with non-alcoholic fatty liver disease: a multicenter clinical trial. Hepatobiliary.Pancreat.Dis.Int 2004;3(3):375-380.
  10. Yan, M., Zhang, L. Y., Sun, L. X., Jiang, Z. Z., and Xiao, X. H. Nephrotoxicity study of total rhubarb anthraquinones on Sprague Dawley rats using DNA microarrays. J Ethnopharmacol. 4-15-2006; PubMed
  11. Zhang, J. H., Li, L. S., and Zhang, M. Clinical effects of rheum and captopril on preventing progression of chronic renal failure. Chin Med J (Engl.) 1990;103(10):788-793.
  12. Mitsuma, T., Yokozawa, T., Oura, H., and Terasawa, K. [Rhubarb therapy in patients with chronic renal failure (Part 2)]. Nippon Jinzo Gakkai Shi 1987;29(2):195-207.
  13. Wu, C. X. [A preliminary study on the effect of a single Rheum officinale in heavy doses in the treatment of acute icteric hepatitis]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(2):88-89.
  14. Jiao, D. H. [Clinical research on the hemostatic effect of rhubarb on peptic ulcer with acute bleeding]. Zhong.Xi.Yi.Jie.He.Za Zhi.(Chinese Journal of Modern Developments in Traditional Medicine) 1984;4(10):597-600, 579.
  15. Jiao, D. H., Ma, Y. H., Chen, S. J., Liu, C. T., Shu, H. N., and Chu, C. M. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-130.
  16. Zhang, JH, Yao, XD, Song, Y, and et al. [Long-term treating effects of rhubarb and captopril in delaying the progression of renal failure]. Chinese Kidney Disease Journal 1993;9(4):197-201.
  17. Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. 2015 Mar;12(1):61-9.
  18. Yu CP, Lin HJ, Lin SP, Shia CS, Chang PH, Hou YC, Hsieh YW. Rhubarb decreased the systemic exposure of cyclosporine, a probe substrate of P-glycoprotein and CYP 3A. Xenobiotica. 2016 Aug;46(8):677-82. PubMed
  19. Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019;233:190-6. PubMed
  20. Zhao D, Feng SX, Zhang HJ, et al. Pharmacokinetics, tissue distribution and excretion of five rhubarb anthraquinones in rats after oral administration of effective fraction of anthraquinones from rheum officinale. Xenobiotica. 2021;51(8):916-925. PubMed

See these in context on the Rhubarb 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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