Berberine With Lansoprazole Interaction Discussion

Answer

Hello and thank you for reaching out!

Our drug-herbal interaction checker shows a 'moderate' interaction between lansoprazole (generic Prevacid) and berberine. It's possible that berberine may increase the levels of lansoprazole in your system via CYP3A4 inhibition, which I detail in the section below.

Interaction Details

Lansoprazole is primarily metabolized by two enzymes in the liver, CYP3A4 and CYP2C19.

Berberine has been reported in laboratory studies and some small human studies to mildly inhibit CYP3A4. This inhibition causes lansoprazole not to be metabolized as quickly as it would normally, resulting in increased drug concentrations. This increase in drug concentrations has the potential to not only potentiate the effects of the lansoprazole but also increase the risk of side effects.

For example, in one small study with 52 renal transplant recipients, berberine increased blood concentration and altered the metabolism profile of a drug known as cyclosporin A. Berberine-treated patients showed significantly higher cyclosporine concentrations and decreased clearance, and the study concluded that the interaction was likely due to CYP3A4 inhibition by berberine. Specifically, it concluded:

"The BBR [berberine] can markedly elevate the blood concentration of CsA [cyclosporin A] in renal-transplant recipients in both clinical and pharmacokinetic studies. This combination may allow a reduction of the CsA [cyclosporin A] dosage. The mechanism for this interaction is most likely explained by inhibition of CYP3A4 by BBR [berberine] in the liver and/or small intestine."

Theoretically, if berberine increased lansoprazole concentrations, the risk of side effects increases, which are mainly gastrointestinal in nature. This includes nausea, diarrhea, constipation, bloating, etc.

It's worth noting though that lansoprazole, in general, is considered a pretty safe drug with a fairly wide safe dosage range. You mentioned 15mg in your question and some studies suggest that doses up to 180mg per day are safe.

It also should be noted that not all studies report that berberine inhibits CYP3A4 to a clinically significant extent, and the study I referenced above was fairly small. It's possible that an interaction between lansoprazole and berberine would be clinically insignificant.

We unfortunately don't have a lot of data to go off of, so like many supplements, I recommend caution when combining with any prescription medication. If the benefits outweigh the risks, it's certainly a possibility you could take berberine with lansoprazole, but make sure you talk to your doctor first so you can be appropriately monitored and evaluated.

Final Words

Thank you again for contacting us, and please do so again anytime.

I recommend looking at our specific berberine-lansoprazole interaction page, which has more references to look into.