Berberine: Side effects, drawbacks and interactions

Berberine: Side effects, drawbacks and interactions

Berberine is a supplement with low cholesterol, antidiabetic, antidiarrheal and anti-inflammatory agents and properties. Thanks to this, a space is being made, on its own merits, in the shelves and virtual catalogues of herbal shops and establishments specialised in nutrition. But does berberine have any drawbacks or side effects?

Because, despite this being an all-natural substance, you can’t underestimate the possibility that taking it will produce certain side effects.

The way in which food supplements are used must always be respected.

You need to keep in mind a number of drawbacks and interactions that could occur and be detrimental to your health.

And we can tell you about them!

Berberine side effects

At the same time, you may be interested in reviewing all the properties and benefits of Berberine. You can do that here click here.

Side effects of Berberine

Berberine is considered by the North American Food and Drug Administration (FDA) as a safe substance.

So you should not have any problems when starting your supplementation.

Similarly, the European Food Safety Authority (EFSA) does not ban its use, although the toxicity risk of some plants of the Berberis family, from which it is extracted, is questioned.

That’s why the berberine side effects that are known today are limited to the usual ones when talking about food supplements, and are limited mainly to the gastrointestinal sphere: nausea, constipation, intestinal pain, diarrhoea, burning and/or reflux

Mostly caused by exceeding the prescribed dosages or by consuming berberine on an empty stomach.

They are benign side effects with no major clinical relevance, which are usually resolved by continued use of the product or discontinuation of use.

Attention! Note that there has been no case of hypoglycaemia .

However, everything that has to do with health requires caution, and it’s recommended that the circumstances that lead to certain groups of patients suffering from these berberine side effects are reviewed:

  • Diabetics: should be cautious with insulin to avoid a sharp decrease.
  • Hypertensives: Although berberine could theoretically cause an additional decrease in blood pressure, in extreme cases it could lead to so-called “hypovolemic shock”.
  • Pregnant and Lactating Women: They should also avoid consumption of berberine, as in pregnant mothers it can interfere with the placenta and cause harm to the foetus. In the case of nursing mothers, colostrum or milk can be leaked to the baby and the consequences are not known.
  • Children: it is advisable to avoid administering Berberine to children due to the risk of toxicity involved, which has not been thoroughly evaluated, although interactions with hepatic metabolism via CYP450 are known. Berberine can significantly slow down the removal of bilirubin by the liver and cause problems with bilirubin toxicity.

Main interactions with medicines

The starting premise is that, if you are taking medication, consult your doctor before supplementing with berberine. In particular, there is a risk that medication can undermine the efficacy of the treatment in question, especially if it is tetracycline.

One of the peculiarities of berberine is its ability to counter irregular/strong heartbeat, which requires caution when receiving medication based on drugs known to modify it.

Berberine behaves as a platelet aggregation inhibitor.

Although it may also neutralise the effect of anticoagulant medicines such as, for example, acetylsalicylic, warfarin or clopidogrel, by competing for their binding sites and leading to a risk of haemodynamic clotting disorder in patients using these drugs.

As it is an anti-inflammatory agent, berberine may interact with cyclooxygenase inhibitors, such as ibuprofen or celecoxib. At the same time, it can neutralise the effect of non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen.

Reports of strong (and potentially lethal) cardiac toxicity have been observed from the combined use of berberine with macrolide group antibiotics, such as the famous and widely used azithromycin.

Therefore, for safety reasons, during the use of any pharmacological therapy the use of berberine is discouraged except by medical prescription and under the optional knowledge of the assets used.

Herbal ingredients

Interactions with herbs and supplements

At the level of herbal supplements, berberine acts in synergy with:


Berberine may cause drowsiness. This effect can be enhanced if ingested together with other preparations of similar effect such as those with content of calypso, catnip herb, hops, guamá, kava, tryptophan, melatonin, sage or skullcap, amongst others.

Blood thinners

Taking berberine along with angelica, cloves, garlic, ginger, ginkgo biloba or ginseng, amongst other substances, may decrease clotting.. Increases the likelihood of bruising and bleeding.


When swallowed at the same time as supplements intended to lower blood pressure, it can cause pronounced hypertension in addition to bradycardia. Examples are milk casein peptides, cat’s claw, fish oil, L-arginine, garlic extract, green coffee extract and theanine.


Certain natural products have a strong hypoglycaemic tendency, such as α-lipoic acid, garlic, bitter melon, devil’s claw, fenugreek, guar gum, cinnamon or ginseng, without exhausting the catalogue. Consistent with this, caution should be exercised with regard to the taking of berberine.

Other substances rich in Berberine

Simultaneously consuming other herbs in whose chemical composition berberine is found can bring a risk of toxicity. Among them we could cite bloodroot or celandine.

At the same time, when considering a treatment with berberine it is advisable to be cautious with the taking of other supplements, as is the case with fermented red rice yeast.

Is it safe to take it?

Yes, as we have already stated, taking berberine is safe, provided that the recommended daily doses are respected, and confirming with a doctor that there are no interactions with other drugs and/or supplements used.

Keeping this in mind, you may benefit from its many positive effects on the body.
Berberine Drawbacks Review

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About José Miguel Olivencia
José Miguel Olivencia
José Miguel Olivencia is a professional in communication and sport who relates his training and experience in every post he writes.
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