Background

Goldenseal (Hydrastis canadensis) is an herb in the buttercup family. The dried root is very commonly used in supplements in the US.

Goldenseal contains berberine, which might have effects against bacteria and fungi. Berberine also has properties that can lower blood pressure and help irregular heartbeat. But many of the important chemicals in goldenseal aren't absorbed well when taken by mouth. So, it's not clear if goldenseal has the same effects as berberine.

People use goldenseal for the common cold and other upper respiratory tract infections, hay fever, diarrhea, constipation, and many other conditions. But there is no good scientific evidence to support any of these uses.

Safety Safety definitions

When taken by mouth: Goldenseal is possibly safe for most adults when taken as a single dose. There isn't enough reliable information to know if goldenseal is safe to use as more than a single dose.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Using goldenseal during pregnancy or breast-feeding is likely unsafe for the infant. A hazardous chemical in goldenseal can cross the placenta and can also find its way into breast milk. Brain damage has developed in newborn infants exposed to goldenseal. Do not use goldenseal during pregnancy or breast-feeding.

Children: Don't use goldenseal in newborn babies. It is likely unsafe for them. It might cause brain damage.

Bleeding conditions: Use goldenseal with caution. Taking goldenseal might increase the risk of bleeding in individuals with bleeding disorders.

High bilirubin levels in the blood in infants: Bilirubin is a chemical that is produced when the old red blood cells break down. Berberine, a chemical in goldenseal, may keep the liver from removing bilirubin fast enough. This can cause brain problems, especially in infants with high levels of bilirubin in the blood. Avoid using.

Surgery: Goldenseal might increase the risk for bleeding. People who take goldenseal should stop at least 2 weeks before surgery.

Effectiveness

Dosing & administration

There isn't enough reliable information to know what an appropriate dose of goldenseal might be. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult a healthcare professional before using.

Interactions with pharmaceuticals

Dextromethorphan (Robitussin DM, and others)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal contains berberine, which might decrease how quickly the body breaks down dextromethorphan. Taking goldenseal while taking dextromethorphan might increase the effects and side effects of dextromethorphan.

Digoxin (Lanoxin)

Interaction Rating=Moderate Be cautious with this combination.

Taking goldenseal with digoxin might cause slight increases in digoxin levels in the body. If you take digoxin, talk to your healthcare provider before taking goldenseal.

Losartan (Cozaar)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal contains berberine, which might change how quickly the body breaks down losartan. Taking goldenseal while taking losartan might change the effects of losartan.

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal might lower blood sugar levels. Taking goldeneal along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal might lower blood pressure. Taking goldenseal along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications moved by pumps in cells (P-Glycoprotein Substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are moved in and out of cells by pumps. Goldenseal might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal might slow blood clotting. Taking goldenseal along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Metformin (Glucophage)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal might decrease the amount of metformin in the body. Taking goldenseal with metformin might decrease the effects of metformin.

Pentobarbital

Interaction Rating=Moderate Be cautious with this combination.

Pentobarbital is a medication that can cause sleepiness. Goldenseal contains berberine, which might also cause sleepiness and drowsiness. Taking goldenseal with pentobarbital might cause too much sleepiness.

Sedative medications (CNS depressants)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking goldenseal with sedative medications might cause breathing problems and/or too much sleepiness.

Tacrolimus (Prograf)

Interaction Rating=Moderate Be cautious with this combination.

Goldenseal contains berberine, which might decrease how quickly the body breaks down tacrolimus. Taking goldenseal with tacrolimus might increase the effects and side effects of tacrolimus.

Interactions with herbs & supplements

Herbs and supplements that might lower blood pressure: Goldenseal might lower blood pressure. Taking it with other supplements that have the same effect might cause blood pressure to drop too much. Examples of supplements with this effect include andrographis, casein peptides, L-arginine, niacin, and stinging nettle.
Herbs and supplements that might lower blood sugar: Goldenseal might lower blood sugar. Taking it with other supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.
Herbs and supplements that might slow blood clotting: Goldenseal might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.
Herbs and supplements with sedative properties: Goldenseal might cause sleepiness and slowed breathing. Taking it along with other supplements with similar effects might cause too much sleepiness and/or slowed breathing in some people. Examples of supplements with this effect include hops, kava, L-tryptophan, melatonin, and valerian.

Interactions with foods

There are no known interactions with foods.