Drinking Essiac Tea While Taking Toprol XL
In our latest question and answer, our pharmacist discusses drinking Essiac tea while being on medication therapy with Toprol-XL.

Question
Hi, am I able to continue drinking Essiac tea while on a beta blocker such as Toprol XL? The tea consists of burdick root, sheep sorrel root, slippery elm bark, and turkey rhubarb. Thanks!

Answered by Dr. Brian Staiger, PharmD
Medical Content Reviewed By HelloPharmacist
Staff
Last updated Apr 12, 2025
Key points
- Essiac is a blend of different herbs and typically consists of burdock root, sheep sorrel, slippery elm bark, and turkey rhubarb root.
- There is a general lack of data regarding the safety of combining Essiac with prescription or over-the-counter medications.
- Some evidence suggests that slippery elm, a component of Essiac, may slow the absorption of some drugs, but it likely is clinically insignificant in this scenario.
Answer
Thanks for reaching out! We don't have a dedicated herbal detail page for Essiac since it is a blend of different herbs. Although there are variations of the blend, generally, Essiac consists of four main herbs: burdock root, sheep sorrel, slippery elm bark, and turkey rhubarb root.
So, in regard to drinking Essiac tea, I'll break down whether or not there is an interaction between any of the components and Toprol XL (metoprolol succinate).
Burdock Root With Metoprolol
The first herb we'll look at is burdock root.
Burdock has not been well studied when it comes to potential drug interactions, but there is no known interaction between it and metoprolol.
Burdock isn't known to significantly affect blood pressure or cause changes to the heartbeat. The only interaction we have listed for burdock is a theoretical one with antiplatelet/anticoagulant drugs, as animal studies show it may have a mild antiplatelet effect. This has not been seen in humans, however.
Sorrel Root With Metoprolol
Sorrel is a perennial herb that is known for its distinct sour taste and has been traditionally used for a variety of purported health benefits as it may have antioxidant, anti-inflammatory, and antimicrobial properties.
Like burdock, sorrel is not known to have many clinically significant drug interactions. It may interact with antiplatelet drugs and drugs that are affected by certain protein transporters (i.e., OATPs), but there is no known interaction with metoprolol.
Slippery Elm Bark With Metoprolol
Slippery elm is most commonly used for its mucilaginous properties. Specifically, it is thought to stimulate the release of mucus, which can help protect the throat and stomach lining. Additionally, it contains a gummy substance known as mucilage, that can coat and soothe the digestive tract.
Slippery elm has a theoretical interaction with essentially all oral drugs as it is thought that the increase in mucus production, and the mucilage that slippery elm itself contains, could potentially delay the absorption of other drugs.
It isn't known how clinically significant this interaction is, but as a general rule of thumb, to avoid any potential interactions, you should separate the administration of slippery elm from other medications, and this includes metoprolol. It is important to note, however, that the small amount of slippery elm contained in Essiac tea likely won't cause any problems.
Turkey Rhubarb With Metoprolol
Turkey rhubarb is known for its laxative properties and is often used to treat constipation and other digestive issues. It may also have mild diuretic effects. Although we have a number of potential drug interactions listed with it, there is no known interaction with metoprolol
Pharmacist Thoughts
Based on all the available information we have, it's unlikely there is a clinically significant drug interaction between Essiac and Toprol-XL (metoprolol extended-release).
The only potential issue I came across is taking metoprolol with slippery elm due to the potential of delayed drug absorption, but this is unlikely to have a major impact on how metoprolol works. Additionally, there is only a relatively small amount of slippery elm in Essiac tea.
While you want to make you let your doctor know about everything you are taking, you likely are safe combining Toprol and Essiac tea.
Final Words
Thanks for reaching out and do so again anytime!
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Dr. Brian Staiger, PharmD
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