Meta Information
ID:berberine
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine lowers blood glucose by activating AMPK, which can have an additive effect with other diabetes medications (e.g., Metformin, insulin, SGLT2 inhibitors), increasing the risk of hypoglycemia (dangerously low blood sugar).
Actionable advice:
Monitor blood glucose closely and consult a doctor before combining, as medication dosages may need adjustment.
Target id:
/class/immunosuppressants
Target name:
Calcineurin Inhibitors (e.g., Cyclosporine, Tacrolimus)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine inhibits both the CYP3A4 enzyme and the P-glycoprotein transporter, which can significantly increase blood concentrations of these narrow-therapeutic-index drugs, leading to severe toxicity.
Actionable advice:
Avoid taking berberine with cyclosporine or tacrolimus unless under strict medical supervision with drug level monitoring.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine may stimulate uterine contractions and can displace bilirubin from albumin, posing a risk of neonatal jaundice (kernicterus) to the fetus.
Actionable advice:
Avoid completely during pregnancy.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Due to its ability to displace bilirubin, berberine poses a theoretical risk of causing brain damage (kernicterus) in nursing infants if it passes into breast milk.
Actionable advice:
Avoid completely while breastfeeding.
Target id:
/condition/pediatric
Target name:
Pediatric Population
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The safety of berberine in children has not been established and it is strictly contraindicated in newborns due to the risk of kernicterus.
Actionable advice:
Do not give berberine to children or infants.
Target id:
/class/cyp3a4-substrates
Target name:
Drugs Metabolized by CYP3A4
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine moderately inhibits the CYP3A4 enzyme, which can increase blood levels and the risk of side effects from many common drugs, including certain statins, calcium channel blockers, and benzodiazepines.
Actionable advice:
Consult a pharmacist or doctor to check for interactions if you take any prescription medications.
Target id:
/class/cyp2d6-substrates
Target name:
Drugs Metabolized by CYP2D6
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine inhibits the CYP2D6 enzyme, which can increase blood levels of various medications like certain beta-blockers (metoprolol), antidepressants (SSRIs, TCAs), and antipsychotics, enhancing their effects or toxicity.
Actionable advice:
Use caution and consult a healthcare provider when combining with drugs metabolized by CYP2D6.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine may have its own antiplatelet effects and can inhibit the metabolism of warfarin (via CYP2C9), which can potentiate the action of blood thinners and increase the risk of bleeding.
Actionable advice:
Use extreme caution and consult a doctor before combining with any blood-thinning medications.
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine can lower blood pressure, which adds to the effect of antihypertensive drugs and may cause hypotension (blood pressure that is too low).
Actionable advice:
Monitor blood pressure regularly when starting berberine if you are on blood pressure medication.
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine inhibits the P-glycoprotein (P-gp) transporter responsible for clearing digoxin, which can lead to increased digoxin levels and a higher risk of cardiac toxicity.
Actionable advice:
Avoid combining berberine and digoxin unless under strict medical supervision with drug level monitoring.
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
By inhibiting CYP3A4, berberine can increase blood levels of statins like atorvastatin, simvastatin, and lovastatin, raising the risk of muscle-related side effects (myopathy or rhabdomyolysis).
Actionable advice:
Discuss with your doctor before combining; statins not metabolized by CYP3A4 (e.g., pravastatin, rosuvastatin) may be safer.
Target id:
/procedure/surgery
Target name:
Scheduled Surgery
Severity:
moderate
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
Berberine's effects on blood sugar, blood pressure, and potential antiplatelet activity can interfere with hemodynamic stability during and after surgery and may increase bleeding risk.
Actionable advice:
Discontinue berberine at least 2 weeks before any scheduled surgery.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
moderate
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking berberine with food can significantly reduce gastrointestinal side effects like cramping and diarrhea, and may also improve its otherwise poor absorption.
Actionable advice:
Always take berberine with or immediately after a meal.
Target id:
/intervention/metformin_systemic_healthspan
Target name:
Metformin
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Both berberine and metformin activate the AMPK pathway, leading to synergistic improvements in glucose control. However, this combination also increases the risk of hypoglycemia and GI side effects.
Actionable advice:
Combine only under medical supervision to monitor blood sugar and adjust dosages to prevent hypoglycemia.
Target id:
/class/cyp2c9-substrates
Target name:
Drugs Metabolized by CYP2C9
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine is a weak inhibitor of the CYP2C9 enzyme, which may slightly increase levels of drugs metabolized by this pathway, such as warfarin and losartan.
Actionable advice:
Be aware of a potential interaction and monitor for effects if taking medications like warfarin or losartan.
Target id:
/class/serotonergic-agents
Target name:
Serotonergic Medications (SSRIs, SNRIs, TCAs, Triptans)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Berberine may possess weak monoamine oxidase (MAO) inhibitory properties, which could theoretically increase the risk of serotonin syndrome when combined with other serotonergic drugs.
Actionable advice:
Be aware of the symptoms of serotonin syndrome (e.g., agitation, rapid heart rate) if combining with antidepressants.
Target id:
/intervention/curcumin
Target name:
Curcumin
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Curcumin and berberine may have synergistic effects on improving insulin sensitivity, reducing inflammation, and supporting metabolic health through complementary pathways.
Actionable advice:
Taking curcumin and berberine together may enhance overall metabolic health benefits.
Target id:
/intervention/silybin-milk-thistle
Target name:
Silybin (from Milk Thistle)
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Silybin can inhibit the P-glycoprotein efflux pump in the gut, which may increase the absorption and bioavailability of berberine, enhancing its effectiveness.
Actionable advice:
Consider using a berberine formula that includes a bioavailability enhancer like silybin.