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Berberine: Drug Interactions, Pregnancy and Evidence
Also known as berberine HCl, berberine hydrochloride, barberry, goldenseal, Berberis vulgaris, nature's Ozempic
Short answer
Berberine is a plant compound found in barberry, goldenseal, goldthread, Oregon grape and tree turmeric [1]. It is studied for blood sugar and cholesterol, but NIH's NCCIH calls the evidence weak [1]. It may interact with medicines, and reviews flag liver enzymes that process many drugs [1][4]. NCCIH says not to use it in pregnancy, breastfeeding or infants [1].
Last reviewed · 5 sources
What is Berberine?
Berberine is an isoquinoline alkaloid found in plants such as barberry, goldenseal, goldthread, Oregon grape and tree turmeric [1][3]. Plants containing it have been used in Ayurvedic and traditional Chinese medicine [1]. It is studied for effects on blood sugar, cholesterol and body weight, but NCCIH says the evidence is weak and leads to no clear conclusions [1][2]. Very little of an oral dose reaches the bloodstream [3].
Forms of Berberine you'll see on labels
Berberine supplements
Sold as a single ingredient; a 2026 review says product quality is not standardized and European national limits differ widely [3].
Goldenseal
Contains berberine, but very little berberine may be absorbed from goldenseal, so berberine study results may not apply to it [2]. Some goldenseal products contained unlisted ingredients or other herbs [2].
Barberry (Berberis vulgaris)
A plant source of berberine; it also affects many drug-processing liver enzymes [4].
How Berberine appears on a label
Berberine has no FDA Daily Value, so it is listed by weight (mg) with "Daily Value not established" [5]. Plant sources, such as barberry or goldenseal, must name the part of the plant used [5]. In a proprietary blend, only the blend's total weight must be shown [5].
When to take Berberine
No source we checked names a best time of day or says whether to take berberine with food.
What to keep apart from Berberine
Metformin and other diabetes medicines
An NCCIH-funded study found goldenseal extract lowered metformin levels by about 25%, enough to possibly affect glucose control [2]. A 2026 review also lists additive low blood sugar as an interaction concern [3]. Ask your pharmacist.
Cyclosporine
Berberine increased cyclosporine exposure in kidney transplant recipients, the best documented human interaction [3]. Ask your transplant team.
Medicines processed by CYP3A4, CYP2D6 or CYP2C9
Berberine inhibits these drug-processing liver enzymes in studies, which could change levels of many common medicines [3][4]. Ask your pharmacist, especially for narrow-margin drugs.
Blood pressure or heart rhythm medicines
A review lists possible additive effects on low blood pressure and QT prolongation, mostly from mechanistic data [3]. Ask your doctor.
Who should ask a doctor or pharmacist first
Do not use berberine if you are pregnant or breastfeeding, and do not give it to infants: NCCIH says exposure has been linked to a harmful buildup of bilirubin in infants that can cause brain damage [1][2]. Talk to a doctor or pharmacist first if you take any medicine, especially diabetes medicines, cyclosporine or other drugs where small level changes matter [1][3].
Keep Berberine in a routine that fits
Supin schedules what you take by time of day, reminds you, and tells you when a bottle runs low.
Berberine: questions people ask
Common side effects reported with berberine supplements include mild-to-moderate nausea, diarrhea, bloating and constipation [1].
It causes mostly digestive side effects, but it may interact with medicines and should not be used in pregnancy, breastfeeding or infants [1]. Ask your doctor or pharmacist first.
No. NCCIH says berberine should not be used during pregnancy or breastfeeding or given to infants [1].
It is being studied. NCCIH calls the evidence weak: a 2021 review of 46 studies had mostly Chinese participants, variable results and some poor-quality studies [1].
No. Goldenseal is a plant that contains berberine, but very little berberine may be absorbed from it, so berberine results may not apply to goldenseal [2].
Sources
- Diabetes and Dietary Supplements: What You Need To Know — NIH National Center for Complementary and Integrative Health (NCCIH)
- Goldenseal: Usefulness and Safety — NIH National Center for Complementary and Integrative Health (NCCIH)
- Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification - A Narrative Review (Dumitru CN et al. Pharmaceuticals, 2026) — Pharmaceuticals (peer-reviewed review, via PubMed)
- Effects of Berberis vulgaris, and its active constituent berberine on cytochrome P450: a review (Bathaei P et al. Naunyn-Schmiedeberg's Archives of Pharmacology, 2025) — Naunyn-Schmiedeberg's Archives of Pharmacology (peer-reviewed review, via PubMed)
- 21 CFR 101.36 – Nutrition labeling of dietary supplements — U.S. Food and Drug Administration (Electronic Code of Federal Regulations)
Educational information, not medical advice. The amounts above are official reference values, not a recommendation for you. Check with your doctor or pharmacist before starting or changing supplements, especially if you take medication, are pregnant or have a health condition. Supin sells a subscription, not supplements. Last reviewed .