Rhubarb Teapills Ingredients & Drug Interactions
by Plum Flower
What is this page for?
First and foremost: checking Rhubarb Teapills against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Rhubarb Teapills is a dietary supplement by Plum Flower with 3 active ingredients. Its ingredients are commonly taken for high cholesterol, heart health support, blood sugar support.Based on those ingredients, 764 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Rheum palmatum Rhizome, Root Extract, Crataegus pinnatifida fruit extract, Hordeum vulgare Fruit Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Rhubarb Teapills by Plum Flower
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HelloPharmacist Scorecard of Rhubarb Teapills by Plum Flower
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.
What’s inside
Low disclosure
Rhubarb Teapills contains three active ingredients. Barley extract is included for its effects on cholesterol and heart health.
Hawthorn fruit extract supports cardiovascular function, though the evidence for specific heart conditions is still being studied. Rhubarb root extract acts as a stimulant laxative and has been used traditionally for other purposes.
The product also contains several inactive ingredients—microcrystalline cellulose, maltose, hydrated magnesium silicate, activated carbon, and china wax—which serve as binders and fillers in the tablet.
Does it work?
Strong evidence
Barley extract is likely effective for high cholesterol and coronary heart disease. The evidence for hawthorn's use in heart conditions like angina, arrhythmias, and general cardiovascular disease is insufficient at this point—more research is needed.
For rhubarb root, the evidence suggests it may be possibly effective for pancreatitis and menopausal symptoms, but data on other uses like constipation is not yet established. The product's overall benefit depends on which of these purposes matters most to you.
How safe is it?
Well-documented data
Barley is well tolerated when eaten as a regular food, but it contains gluten, which matters if you're sensitive or have celiac disease. Concentrated barley supplements haven't been well studied in pregnancy or while breastfeeding.
Hawthorn is generally well tolerated in studies but should only be used under medical supervision if you have a heart condition. The safety data advises against hawthorn in pregnancy and while breastfeeding.
Rhubarb root can cause cramping and should not be used long-term; the safety data advises against medicinal amounts during pregnancy, and it may pass into breast milk so should be avoided while nursing. Common side effects from rhubarb include cramps, diarrhea, nausea, and vomiting.
Chronic overuse can deplete electrolytes, particularly potassium, and in rare cases has been linked to kidney problems.
Meds to double-check
Major interaction found
Before taking Rhubarb Teapills, check with your pharmacist if you use: nitrates or phosphodiesterase-5 inhibitors like sildenafil (Major risk of dangerous blood pressure drop); beta-blockers, calcium channel blockers, or other blood pressure medications; blood thinners like warfarin, aspirin, or other antiplatelet drugs; heart medications like digoxin; diuretics or corticosteroids; drugs that can damage your kidneys or liver; or cyclosporine. Rhubarb's laxative effect can amplify bleeding risk and electrolyte loss with these medications.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with strong clinical evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
Rhubarb Teapills may be worth considering if you're interested in its traditional uses and your doctor okays it—but this is especially important given hawthorn and rhubarb's interactions with heart, blood pressure, and blood-thinning medications. If you take any prescription drugs, especially for your heart, blood pressure, or blood clotting, check your medications with the tool on this page before you start.
Talk with your pharmacist to make sure it's right for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2025.
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
General information
Key facts about Rhubarb Teapills, straight from the product label.
| Brand | Plum Flower |
|---|---|
| Barcode (UPC) | 739934831885 |
| Net contents | 200 Pill(s); 1.2 Ounce(s); 34 Gram(s) |
| Market status | On market |
| Date entered into DSLD | Aug 22, 2025 |
| DSLD ID | 336496 |
| Product type | Botanical |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 Teapills by Plum Flower, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Extract Blend | 1360 mg | -- |
| Hordeum vulgare Fruit Extract | 0 NP | -- |
| Crataegus pinnatifida fruit extract | 0 NP | -- |
| Rheum palmatum Rhizome, Root Extract | 0 NP | -- |
Other ingredients: Microcrystalline Cellulose, Maltose, Magnesium Silicate, Hydrated, Carbon, Activated, China Wax
Tap any ingredient to jump to its full detail below.
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.
Formula
Da Huang Jiang Zhi Wan
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Take 8 pills 3 times daily or as directed by your health care practitioner
Precautions
Not for use during pregnancy Caution when nursing
Keep out of reach of children
Seals/Symbols
Plum Flower Guarantee Sourced Sustainably FDA Registered cGMP Compliant Made at a cGMP Certified Facility Lab Tested Quality Verified Species Verified
General Statements
Foci Pharmaceutical 1929 Foci Pharmaceutical
Formulation
US owned & operated since 1969. Made in China in partnership with the award-winning Lanzhou Foci Pharmaceutical Co. Ltd.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Rhubarb Teapills by Plum Flower label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Rhubarb Teapills by Plum Flower
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size8 Pill(s) Dosage formTablet Or Pill Servings per container25 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Extract Blend
Other (inactive) ingredients: Microcrystalline Cellulose, Maltose, Magnesium Silicate, Hydrated, Carbon, Activated, China Wax. These complete the product’s ingredient list but are not active constituents.
Rhubarb Teapills by Plum Flower Drug Interactions
HelloPharmacist Interaction Report
Plum Flower Rhubarb Teapills contains three active ingredients, and two of them carry documented interactions with medications.
The most serious concerns are with hawthorn, which interacts with nitrates and phosphodiesterase-5 inhibitors (like sildenafil/Viagra) at a Major severity level—both can cause additive blood vessel relaxation and a dangerous drop in blood pressure when combined.
Read the full breakdown — every affected drug type, severity by severity
Hawthorn also has Moderate interactions with blood pressure and heart medications (beta-blockers and calcium channel blockers), blood thinners (anticoagulants and antiplatelet drugs), and digoxin (a heart medication). Rhubarb carries Moderate interactions with kidney-damaging drugs, liver-damaging drugs, diuretics, corticosteroids, stimulant laxatives, the blood thinner warfarin, digoxin, and cyclosporine (an immunosuppressant).
The concern with rhubarb centers on electrolyte loss and diarrhea, which can amplify the effects of some of these medications or increase bleeding risk. We could not check the proprietary extract blend itself for interactions.
Barley extract is generally well tolerated with no interactions documented in our data.
Altogether, these interactions span 748 individual medications.
Use the medication checker on this page to look up your exact prescriptions before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Rhubarb Teapills?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Rhubarb Teapills interact with 764 drugs. Click any drug to see the details.
3 of the 3 ingredients in Rhubarb Teapills interact with drugs. Each result below shows which ingredient is responsible. Rheum palmatum Rhizome, Root Extract Crataegus pinnatifida fruit extract Hordeum vulgare Fruit Extract
AvanafilStendra
How Avanafil interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Avanafil interactionFinasteride, TadalafilEntadfi
How Finasteride, Tadalafil interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Finasteride, Tadalafil interactionGlyceryl TrinitrateNitronal
How Glyceryl Trinitrate interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Glyceryl Trinitrate interactionIsosorbide DinitrateAngitak, Cedocard Retard, Isoket, Isoket Retard, Isordil
How Isosorbide Dinitrate interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Isosorbide Dinitrate interactionIsosorbide Dinitrate, HydralazineBiDil
How Isosorbide Dinitrate, Hydralazine interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Isosorbide Dinitrate, Hydralazine interactionIsosorbide MononitrateAngeze, Angeze SR, Chemydur 60XL, Dynamin, Elantan, Elantan LA +13 more
How Isosorbide Mononitrate interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Isosorbide Mononitrate interactionMacitentan, TadalafilOpsynvi
How Macitentan, Tadalafil interacts with Rhubarb Teapills — through 2 ingredients. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Macitentan, Tadalafil interactionRheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Macitentan, Tadalafil interactionNicorandilAprior, Dancor, Ikorel, Sigmart, Zynicor
How Nicorandil interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Nicorandil interactionNitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Nitroglycerin interactionPentaerythritol TetranitratePeritrate, Peritrate SA
How Pentaerythritol Tetranitrate interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractNitrates Major
Interaction Summary
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Read the full Crataegus Pinnatifida Fruit Extract + Pentaerythritol Tetranitrate interactionSildenafilRevatio
How Sildenafil interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Sildenafil interactionSildenafil CitrateViagra
How Sildenafil Citrate interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Sildenafil Citrate interactionTadalafilCialis, Tadliq
How Tadalafil interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Tadalafil interactionVardenafilLevitra, Staxyn
How Vardenafil interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractPhosphodiesterase-5 Inhibitors Major
Interaction Summary
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Read the full Crataegus Pinnatifida Fruit Extract + Vardenafil interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + 6-mercaptopurine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Crataegus Pinnatifida Fruit Extract + Abciximab interactionAbiraterone
How Abiraterone interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Crataegus Pinnatifida Fruit Extract + Abrocitinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Rhubarb Teapills — through 2 ingredients. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Acebutolol interactionCrataegus Pinnatifida Fruit ExtractBeta-blockers Moderate
Interaction Summary
Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Read the full Crataegus Pinnatifida Fruit Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Crataegus Pinnatifida Fruit Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Rhubarb Teapills — through 2 ingredients. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rheum Palmatum Rhizome, Root Extract + Acetaminophen, Aspirin interactionCrataegus Pinnatifida Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Crataegus Pinnatifida Fruit Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Rhubarb Teapills — through 2 ingredients. Tap an ingredient for the detail:
Crataegus Pinnatifida Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Crataegus Pinnatifida Fruit Extract + Acetaminophen, Aspirin, Caffeine interactionRheum Palmatum Rhizome, Root ExtractNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rheum Palmatum Rhizome, Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Rheum Palmatum Rhizome, Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Rhubarb Teapills — through 1 ingredient. Tap an ingredient for the detail:
Rheum Palmatum Rhizome, Root ExtractHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Rheum Palmatum Rhizome, Root Extract + Acetaminophen, Butalbital, Caffeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Rhubarb Teapills with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Rheum palmatum Rhizome, Root Extract
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.
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.
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.
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.
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.
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.
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.
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.
Crataegus pinnatifida fruit extract
Nitrates
Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Some evidence shows that hawthorn might lower blood pressure due to vasodilatory effects.
Phosphodiesterase-5 Inhibitors
Theoretically, concomitant use might result in additive vasodilation and hypotension.
Hawthorn might inhibit PDE-5 and cause vasodilation.
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.
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.
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.
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.
Hordeum vulgare Fruit Extract
Triclabendazole (Egaten)
Theoretically, barley might decrease the clinical effects of triclabendazole.
Animal research suggests that a diet supplemented with barley can reduce the bioavailability of triclabendazole when taken concomitantly. This effect has not been shown in humans.
Brand information
Manufacturer and brand details for Rhubarb Teapills, from the product label.
Plum Flower
- Name
- Mayway Herbs
- City
- Oakland
- State
- CA
- Web Address
- plumflowerherbs.com
Rhubarb Teapills by Plum Flower: Common Questions
Does Rhubarb Teapills by Plum Flower interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Does this product contain gluten?
Can I take this while pregnant or breastfeeding?
What are the most common side effects?
Is hawthorn effective for heart conditions?
Can I use this long-term?
What is rhubarb root used for in this product?
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The Full Monographs Behind Rhubarb Teapills’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Barley
Interacts with 1 drugBarley is a nutritious whole grain that is a good source of soluble fiber called beta-glucan, which has solid evidence for modestly lowering LDL ('bad') cholesterol when eaten regularly. It...
Read the full Barley monograph → Herb & supplement monographHawthorn
Interacts with 191 drugsHawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the ev...
Read the full Hawthorn monograph → Herb & supplement monographRhubarb
Interacts with 658 drugsRhubarb 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 claims are backed by limited or low-quality...
Read the full Rhubarb monograph →Sources & How We Checked
Rhubarb Teapills'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 60 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.
Barley 15 references
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Fernandez-Anaya S, Crespo JF, Rodriguez JR, et al. Beer anaphylaxis. J Allergy Clin Immunol 1999;103:959-60.
- Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8. . PubMed
- Ferre, I., Giraldez, F. J., Alvarez-Bujidos, M. L., and Mantecon, A. R. Influence of barley supplement on plasma concentration of triclabendazole metabolites in sheep. Vet.Rec. 11-22-1997;141(21):549-551. PubMed
- Curioni, A., Santucci, B., Cristaudo, A., Canistraci, C., Pietravalle, M., Simonato, B., and Giannattasio, M. Urticaria from beer: an immediate hypersensitivity reaction due to a 10- kDa protein derived from barley. Clin Exp Allergy 1999;29(3):407-413. PubMed
- Fernandez-Anaya, S., Crespo, J. F., Rodriguez, J. R., Daroca, P., Carmona, E., Herraez, L., and Lopez-Rubio, A. Beer anaphylaxis. J Allergy Clin Immunol. 1999;103(5 Pt 1):959-960.
- Cronin, E. Contact dermatitis from barley dust. Contact Dermatitis 1979;5(3):196. PubMed
- Block, G., Tse, K. S., Kijek, K., Chan, H., and Chan-Yeung, M. Baker's asthma. Studies of the cross-antigenicity between different cereal grains. Clin Allergy 1984;14(2):177-185.
- van Ketel, W. G. Immediate type allergy to malt in beer. Contact Dermatitis 1980;6(4):297-298. PubMed
- Ellis, H. J., Doyle, A. P., Day, P., Wieser, H., and Ciclitira, P. J. Demonstration of the presence of coeliac-activating gliadin-like epitopes in malted barley. Int Arch Allergy Immunol. 1994;104(3):308-310. PubMed
- Vidal, C. and Gonzalez-Quintela, A. Food-induced and occupational asthma due to barley flour. Ann Allergy Asthma Immunol. 1995;75(2):121-124.
- Gutgesell, C. and Fuchs, T. Contact urticaria from beer. Contact Dermatitis 1995;33(6):436-437. PubMed
- Baker, P. G. and Read, A. E. Oats and barley toxicity in coeliac patients. Postgrad.Med J 1976;52(607):264-268. PubMed
- Nakase, M., Usui, Y., Alvarez-Nakase, A. M., Adachi, T., Urisu, A., Nakamura, R., Aoki, N., Kitajima, K., and Matsuda, T. Cereal allergens: rice-seed allergens with structural similarity to wheat and barley allergens. Allergy 1998;53(46 Suppl):55-57. PubMed
- Pereira, F., Rafael, M., and Lacerda, M. H. Contact dermatitis from barley. Contact Dermatitis 1998;39(5):261-262. PubMed
Hawthorn 25 references
- 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
- 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
- Chang Q, Zuo Z, Harrison F, Chow MS. Hawthorn. J Clin Pharmacol 2002;42:605-12.
- 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
- Pittler MH, Guo R, and Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane.Database.Syst Rev 2008:CD005312. PubMed
- 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
- 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
- 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
- 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.
- 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
- 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.
- Daniele C, Mazzanti G, Pittler MH, et al. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006;29:523-35. PubMed
- 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
- 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.
- 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
- 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
- Rogov VD. [Toxiderma due to the fruits of the hawthorn]. Vestn Dermatol Venerol 1984;7(7):46-47.
- 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.
- 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
- 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
- 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
- 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
- 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.
- 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
- Espinosa J, Bassett R, Lucerna A, Finn D. Hawthorne root (Crataegus mexicana) toxicity. Am J Emerg Med. 2024;78:242.e5-242.e6. PubMed
Rhubarb 20 references
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- 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
- 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.
- Fairbairn JW. The anthraquinone laxatives. Biological assay and its relation to chemical structure. Pharmacology 1976;14:48-61. PubMed
- 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
- 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.
- 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
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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
- 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
- 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
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