Skip to Content


Scientific Name(s): Hydrastis canadensis L.
Common Name(s): Eyebalm, Eyeroot, Goldenroot, Goldenseal, Ground raspberry, Indian turmeric, Jaundice root, Orangeroot, Radix Hydrastis, Sceau d'or, Yellow puccoon, Yellowroot

Clinical Overview


Traditional uses of goldenseal are not validated by clinical studies, although it may be of use in diabetes, dyslipidemia, cardiovascular conditions, and cancer.


Clinical evidence is lacking; few well-controlled clinical trials are available to guide dosage for goldenseal root extract.

Recommended dosages vary considerably, from 250 mg to 1 g 3 times daily. Some product labeling suggests higher dosages.

Traditional dosages include 0.5 to 1 g dried rhizomes 3 times daily, and 0.3 to 1 mL 1:1 liquid extract in 60% ethanol 3 times daily.


None well defined.


Avoid use; activity as a uterine stimulant has been documented. Safety in lactation has not been established.


Goldenseal may affect the cytochrome CYP-450 (CYP450) system. The clinical importance of this interaction has not been established.

Adverse Reactions

Information from clinical studies is lacking, but adverse reactions with common doses are rare. Very high doses of goldenseal may occasionally induce nausea, anxiety, depression, seizures, or paralysis.


Toxicological concerns have been reported, with some evidence of carcinogenicity in rodents.


Goldenseal is a perennial herb found in the rich woods of the Ohio River Valley and other locations in the northeastern United States. The single, green-white flower, which has no petals, appears in the spring on a hairy stem above a basal leaf and two palmate, wrinkled leaves. The flower develops into a red-seeded berry. The plant grows from horizontal, bright yellow rhizomes, which have a twisted, knotty appearance.1, 2


Native Americans of the Cherokee, Catawba, Iroquois, and Kickapoo tribes used goldenseal root as an insect repellent, diuretic, stimulant, and wash for sore or inflamed eyes. It was used to treat arrow wounds and ulcers, as well as to produce yellow dye. Early settlers learned of these uses from Native Americans, and the root found its way into most 19th century pharmacopeias. The Eclectic medical movement was particularly enthusiastic in its adoption of goldenseal to treat gonorrhea and urinary tract infections. The widespread harvesting of goldenseal in the 19th century, coupled with loss of habitat, resulted in the depletion of wild populations. In 1997, goldenseal was listed under Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora treaty, which controls exports of the root to other countries. The final listing included roots or live plants, but excluded finished products. As an alternative to wild harvesting, goldenseal is cultivated in the Skagit Valley of Washington state and is being promoted as a cash crop in New York, North Carolina, and Canada. The popular notion that goldenseal can be used to affect the outcome of urinalysis for illicit drugs evolved from the novel Stringtown on the Pike by pharmacist John Uri Lloyd. In the book, goldenseal bitters are mistaken for strychnine in a simple alkaloid test by an expert witness in a murder trial.3, 4, 5, 6, 7 Testing in a small group of healthy volunteers suggests that less sensitive drug assays (threshold higher than 100 ng/mL for morphine) may yield false negative results.


The isoquinoline alkaloids hydrastine (4%), berberine (up to 6%), canadine, and palmatine are present in goldenseal root and are viewed as its principle bioactive components.6, 8 Considerable variation in alkaloid content has been noted among various commercial products, with some not meeting United States Pharmacopeial standards for berberine and hydrastine.6, 9, 10 Some preparations contain alkaloids associated with other herbal substances.9, 11 Other minor alkaloids, such as canadaline and canadinic acid,12, 13 have been isolated. Quinic acid esters were elucidated.14 Traces of calcium, magnesium, potassium, and zinc have been described.15 Quantitation of the alkaloids has been accomplished in a variety of ways, including spectrophotometry, thin-layer chromatography, ion-pair dye colorimetry, high-performance liquid chromatography, capillary electrophoresis, and capillary electrophoresis-mass spectrometry. 2, 7, 10, 11, 16, 17

Uses and Pharmacology

Despite the widespread use of goldenseal, controlled clinical trials are lacking and studies tend to focus on the constituent berberine. The alkaloids are poorly absorbed when taken orally; in vitro and animal studies must be interpreted carefully.17

Antimicrobial activity

Animal data

Goldenseal alkaloids showed modest antimicrobial activity in vitro against Staphylococcus aureus, Klebsiella and Candida species, and Mycobacterium tuberculosis in older studies.18, 19, 20 More recent studies have focused on activity versus Helicobacter pylori,21 methicillin-resistant S. aureus,22 and influenza A virus.23

Clinical data

Older, limited clinical studies evaluated berberine in treating diarrhea due to E. coli and cholera,24, 25 and for use against microbes such as Giardia and Trichomonas.2 Goldenseal has traditionally been used for eye ailments.26 Berberine has been evaluated against sulfacetamide in ocular trachoma infections with comparable effects; however, a phototoxic reaction between berberine alkaloid and ultraviolet A (UVA) light leading to decreased lens epithelial cell viability has been described.26, 27


Animal data

Induction of apoptosis and cell cycle arrest, inhibition of glucose uptake, and tumor promotion have been shown in vitro by both goldenseal and berberine extracts.28, 29, 30, 31 In mice, an ethanolic extract of goldenseal showed some protective activity against induced hepatocarcinoma (lower incidence and slower growth of tumors).32 In a 2-year toxicity study of goldenseal root powder, it was shown to decrease the incidence of mammary gland tumor rates in female rats, possibly because of resulting weight loss.33, 34

Clinical data

Research reveals no clinical data regarding the use of goldenseal in cancer. Berberine alone has been evaluated as an adjunct to prevent adverse effects of radiation.35

Cardiovascular effects

Animal data

Experiments have shown goldenseal and berberine to affect the cardiovascular system, though the mechanisms remain poorly understood. Positive inotropic, negative chronotropic, vasodilatory, and hypotensive effects have been described.36, 37 In a 2-year toxicity study of goldenseal root powder, the incidence of cardiomyopathy was decreased in male and female rats; however, cardiovascular effects were not the focus of the study.33, 34 Inhibitory activity of goldenseal alkaloids on isolated rabbit aorta stimulated by epinephrine has been evaluated; a weak synergistic effect was found for berberine, canadine, and canadaline, but not for hydrastine.38 Similar studies have been conducted on ileum, trachea, and prostate preparations.39, 40, 41

Clinical data

There is a case report of reversible hypernatremia in a child due to the sodium-sparing diuretic effect of goldenseal.37 In a clinical study (N = 130), patients with acute coronary syndrome following percutaneous coronary intervention who received berberine as adjunctive therapy showed improvements in inflammatory indices.42 Study assessments did not include outcome measures.


Animal data

When administered to mice with induced diabetes, berberine lowered the elevated fasting blood glucose level. Whether this action is via modulation of CYP450 expression or by some other mechanism is unestablished.43

Clinical data

Berberine exerted a hypoglycemic action in a small trial of patients with type 2 diabetes.44 In women with metabolic-associated polycystic ovary syndrome, berberine administered over 3 months decreased fasting blood glucose levels.45 Findings from a larger, multicenter clinical trial evaluating this effect have yet to be published.46


Animal data

Goldenseal decreased low-density lipoprotein in hyperlipidemic rats.47, 48

Clinical data

Berberine alone improved the lipid profile in dyslipidemia in several clinical trials among participants with various conditions, including familial hyperchosterolemia, obesity, and diabetes.44, 49, 50, 51 Clinical trials evaluating goldenseal root powder in dyslipidemia are lacking.

Other uses

Goldenseal administered to rats protected against acetaminophen-induced hepatotoxicity, possibly via modulation of the cytochrome P450 system.52 In a 2-year toxicity study of goldenseal root powder, it was shown to decrease chronic lung and nasal inflammation.33, 34

Studies evaluating berberine alone have described immunostimulation and antioxidant activity.53, 54, 55 Berberine as a gel has been used orally to treat minor recurrent aphthous stomatitis.56

Although hydrastine is closely related to the convulsant isoquinoline alkaloid bicuculline, it had no activity in a gamma-aminobutyric acid–receptor binding assay at high concentrations.57

Further effects for berberine alone have been described in studies using barberry (see Barberry monograph).


Clinical evidence is lacking; few well-controlled clinical trials are available to guide dosage for goldenseal root extract. Recommended dosages vary considerably, from 250 mg to 1 g 3 times daily. Some product labeling suggests higher dosages.47

Berberine alone has been used at 300 to 500 mg 3 times daily in clinical studies.42, 50

Traditional dosages include 0.5 to 1 g dried rhizomes 3 times daily, and 0.3 to 1 mL 1:1 liquid extract in 60% ethanol 3 times daily.2 Ten to 30 drops of the extract 2 to 4 times a day has been recommended for influenza.58

Pregnancy / Lactation

Avoid use; activity as a uterine stimulant has been documented.2, 59, 60, 61 Safety in lactation has not been established.2 Berberine has been reported to displace bilirubin in rat experiments62 and should not be used in infants with jaundice.


Antihypertensives: Herbs (Hypotensive Properties) may enhance the hypotensive effect of Antihypertensives. Monitor therapy.63, 64

ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. CYP2D6 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Monitor therapy.65, 66, 67, 68

Cyclosporine: CYP3A4 inhibitors may increase cyclosporine blood concentrations. Avoid combination.69

Herbs (Hypotensive Properties): May enhance the adverse/toxic effect of other Herbs (Hypotensive Properties). Excessive blood pressure lowering may manifest. Monitor therapy.63, 64

Losartan: CYP2C9 inhibitors may decrease metabolism of losartan to its active metabolite. Avoid combination.70

Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Consider therapy modification.71

Midazolam: CYP3A4 inhibitors may increase serum concentrations of midazolam. Avoid combination.70, 72

Oseltamivir: In vitro data suggests that oseltamivir’s conversion to the active carboxylate metabolite may be hindered by goldenseal.81

Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide. Avoid combination.73, 74, 75, 76

Adverse Reactions

Information from clinical studies is lacking, but adverse reactions with common doses are rare. Very high doses of goldenseal may rarely induce nausea, anxiety, depression, seizures, or paralysis.2

Caution is warranted in patients with cardiovascular conditions because of the actions of the constituent alkaloids. A large, retrospective evaluation of patient data related to blood pressure and herbal product use found a significantly higher mean systolic blood pressure, but not diastolic blood pressure, in users of goldenseal compared with non-users.80 There is a case report of photosensitivity with the use of a combination product containing ginseng, goldenseal, and bee pollen.77


Findings from a 2-year toxicity study of goldenseal root powder in male and female mice and rats have been published.33, 34 Evidence of carcinogenic activity of the root powder exists, based on an increased incidence of hepatocellular adenoma and carcinoma in both male and female rats, and some evidence in male, but not female, mice after 2 years exposure to goldenseal. An increased incidence of non-neoplastic hepatic lesions has also been demonstrated in rodents.33, 34 DNA damage has been suggested to be due, at least in part, to inhibition of topoisomerases.78

Goldenseal root powder did not show mutagenicity in S. typhimurium or E. coli strains;33, 34 however, berberine showed mutagenicity in yeast cells and the Ames test.2, 61

A phototoxic reaction between berberine alkaloid and UVA light has been described.26, 27


1. Hydrastis canadensis L. [Hydrastis canadensis L. goldenseal] USDA, NRCS. 2013. The PLANTS Database (, 22 November 2013). National Plant Data Team, Greensboro, NC 27401-4901 USA. Accessed February 24, 2014.
2. Rhizoma Hydrastis. In: WHO Monographs On Selected Medicinal Plants. Vol 3. Geneva, Switzerland: World Health Organization; 2001:194-203.
3. Hobbs C. Golden seal in early American medical botany. Pharm Hist. 1990;32(2):79-82.11622733
4. Bolyard J. Medicinal Plants and Home Remedies of Appalachia. Springfield, IL: Charles C. Thomas; 1981.
5. Foster S. Goldenseal. Hydrastis canadensis. Botanical Series, No. 309. 2nd ed. Austin, TX: American Botanical Council; 1996.
6. Weber HA, Zart MK, Hodges AE, et al. Chemical comparison of goldenseal (Hydrastis canadensis L.) root powder from three commercial suppliers. J Agric Food Chem. 2003;51(25):7352-7358.14640583
7. Dawes ML, Brettell T. Analysis of goldenseal, Hydrastis canadensis L., and related alkaloids in urine using HPLC with UV detection. J Chromatogr B Analyt Technol Biomed Life Sci. 2012;880(1):114-118.22177787
8. Inbaraj JJ, Kukielczak BM, Bilski P, He YY, Sik RH, Chignell CF. Photochemistry and photocytotoxicity of alkaloids from goldenseal (Hydrastis canadensis L.). 2. Palmatine, hydrastine, canadine, and hydrastinine. Chem Res Toxicol. 2006;19(6):739-744.16780351
9. Edwards DJ, Draper EJ. Variations in alkaloid content of herbal products containing goldenseal. J Am Pharm Assoc. 2003;43(3):419-423.12836794
10. Govindan M, Govindan G. A convenient method for the determination of the quality of goldenseal. Fitoterapia. 2000;71(3):232-235.10844160
11. Van Berkel GJ, Tomkins BA, Kertesz V. Thin-layer chromatography/desorption electrospray ionization mass spectrometry: investigation of goldenseal alkaloids. Anal Chem. 2007;79(7):2778-2789.17338504
12. Genest K, Hughes DW. Natural products in Canadian pharmaceuticals. IV. Hydrastis canadensis. Can J Pharm Sci. 1969;4:41-445.
13. Galeffi C, Cometa MF, Tomassini L, Nicoletti M. Canadinic acid: an alkaloid from Hydrastis canadensis. Planta Med. 1997;63(2):194.17252348
14. Gentry E, Jampani HB, Keshavarz-Shokri A, et al. Antitubercular natural products: berberine from the roots of commercial Hydrastis canadensis powder. Isolation of inactive 8-oxotetrahydrothalifendine, canadine, beta-hydrastine, and two new quinic acid esters, hycandinic acid esters-1 and -2. J Nat Prod. 1998;61(10):1187-1193.9784149
15. Grippo AA, Hamilton B, Hannigan R, Gurley BJ. Metal content of ephedra-containing dietary supplements and select botanicals. Am J Health Syst Pharm. 2006;63(7):635-644.16554287
16. Abourashed EA, Khan IA. High-performance liquid chromatography determination of hydrastine and berberine in dietary supplements containing goldenseal. J Pharm Sci. 2001;90(7):817-822.11458331
17. Yao M, Ritchie HE, Brown-Woodman PD. A reproductive screening test of goldenseal. Birth Defects Res B Dev Reprod Toxicol. 2005;74(5):399-404.16193497
18. Scazzocchio F, Cometa MF, Palmery M. Antimicrobial activity of Hydrastis canadensis extract and its major isolated alkaloids. Fitoterapia. 1998;69(suppl 5):58-59.
19. Amin AH, Subbaiah TV, Abbasi KM. Berberine sulfate: antimicrobial activity, bioassay, and mode of action. Can J Microbiol. 1969;15(9):1067-1076.4906191
20. Sun D, Courtney HS, Beachey EH. Berberine sulfate blocks adherence of Streptococcus pyogenes to epithelial cells, fibronectin, and hexadecane. Antimicrob Agents Chemother. 1988;32(9):1370-1374.3058020
21. Mahady GB, Pendland SL, Stoia A, Chadwick LR. In vitro susceptibility of Helicobacter pylori to isoquinoline alkaloids from Sanguinaria canadensis and Hydrastis canadensis. Phytother Res. 2003;17(3):217-221.12672149
22. Cech NB, Junio HA, Ackermann LW, Kavanaugh JS, Horswill AR. Quorum quenching and antimicrobial activity of goldenseal (Hydrastis canadensis) against methicillin-resistant Staphylococcus aureus (MRSA). Planta Med. 2012;78(14):1556-1561.22814821
23. Cecil CE, Davis JM, Cech NB, Laster SM. Inhibition of H1N1 influenza A virus growth and induction of inflammatory mediators by the isoquinoline alkaloid berberine and extracts of goldenseal (Hydrastis canadensis). Int Immunopharmacol. 2011;11(11):1706-1714.21683808
24. Rabbani GH, Butler T, Knight J, Sanyal SC, Alam K. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis. 1987;155(5):979-984.3549923
25. Khin-Maung U, Myo-Khin, Nyunt-Nyunt-Wai, Aye-Kyaw, Tin-U. Clinical trial of berberine in acute watery diarrhoea. Br Med J (Clin Res Ed). 1985;291(6509):1601-1605.3935203
26. Inbaraj JJ, Kukielczak BM, Bilski P, Sandvik SL, Chignell CF. Photochemistry and photocytotoxicity of alkaloids from goldenseal (Hydrastis canadensis L.) 1. Berberine. Chem Res Toxicol. 2001;14(11):1529-1534.11712911
27. Chignell CF, Sik RH, Watson MA, Wielgus AR. Photochemistry and photocytotoxicity of alkaloids from goldenseal (Hydrastis canadensis L.) 3: effect on human lens and retinal pigment epithelial cells. Photochem Photobiol. 2007;83(4):938-943.17645667
28. Creasey WA. Biochemical effects of berberine. Biochem Pharmacol. 1979;28(7):1081-1084.444265
29. Nishino H, Kitagawa K, Fujiki H, Iwashima A. Berberine sulfate inhibits tumor-promoting activity of teleocidin in two-stage carcinogenesis on mouse skin. Oncology. 1986;43(2):131-134.3081844
30. Kim JB, Yu JH, Ko E, et al. The alkaloid Berberine inhibits the growth of Anoikis-resistant MCF-7 and MDA-MB-231 breast cancer cell lines by inducing cell cycle arrest. Phytomedicine. 2010;17(6):436-440.19800775
31. Saha SK, Sikdar S, Mukherjee A, Bhadra K, Boujedaini N, Khuda-Bukhsh AR. Ethanolic extract of the Goldenseal, Hydrastis canadensis, has demonstrable chemopreventive effects on HeLa cells in vitro: Drug-DNA interaction with calf thymus DNA as target. Environ Toxicol Pharmacol. 2013;36(1):202-214.23628949
32. Karmakar SR, Biswas SJ, Khuda-Bukhsh AR. Anti-carcinogenic potentials of a plant extract (Hydrastis canadensis): I. Evidence from in vivo studies in mice (Mus musculus). Asian Pac J Cancer Prev. 2010;11(2):545-551.20843149
33. Dunnick JK, Singh B, Nyska A, Peckham J, Kissling GE, Sanders JM. Investigating the potential for toxicity from long-term use of the herbal products, goldenseal and milk thistle. Toxicol Pathol. 2011;39(2):398-409.21300790
34. National Toxicology Program. Toxicology and carcinogenesis studies of goldenseal root powder (Hydrastis canadensis) in F344/N rats and B6C3F1 mice (feed studies). Natl Toxicol Program Tech Rep Ser. 2010;(562):1-188.21372858
35. Li GH, Wang DL, Hu YD, et al. Berberine inhibits acute radiation intestinal syndrome in human with abdomen radiotherapy. Med Oncol. 2010;27(3):919-925.19757213
36. Lau CW, Yao XQ, Chen ZY, Ko WH, Huang Y. Cardiovascular actions of berberine. Cardiovasc Drug Rev. 2001;19(3):234-244.11607041
37. Bhowmick SK, Hundley OT, Rettig KR. Severe hypernatremia and hyperosmolality exacerbated by an herbal preparation in a patient with diabetic ketoacidosis. Clin Pediatr. 2007;46(9):831-834.17585008
38. Palmery M, Cometa MF, Leone MG. Further studies of the adrenolytic activity of the major alkaloids from Hydrastis canadensis L. on isolated rabbit aorta. Phytother Res. 1996;10(suppl 1):S47-S49.
39. Cometa MF, Galeffi C, Palmery M. Acute effect of alkaloids from Hydrastis canadensis L. on guinea pig ileum: structure-activity relationships. Phytother Res. 1996;10:S56-S58.
40. Baldazzi C, Leone MG, Casini ML, Tita B. Effects of the major alkaloid of Hydrastis canadensis L., berberine, on rabbit prostate strips. Phytother Res. 1998;12(8):589-591.
41. Abdel-Haq H, Cometa MF, Palmery M, Leone MG, Silvestrini B, Saso L. Relaxant effects of Hydrastis canadensis L. and its major alkaloids on guinea pig isolated trachea. Pharmacol Toxicol. 2000;87(5):218-222.11129501
42. Meng S, Wang LS, Huang ZQ, et al. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp Pharmacol Physiol. 2012;39(5):406-411.22220931
43. Chatuphonprasert W, Nemoto N, Sakuma T, Jarukamjorn K. Modulations of cytochrome P450 expression in diabetic mice by berberine. Chem Biol Interact. 2012;196(1-2):23-29.22342832
44. Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008;57(5):712-717.18442638
45. Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012;166(1):99-105.22019891
46. Li Y, Ma H, Zhang Y, et al. Effect of berberine on insulin resistance in women with polycystic ovary syndrome: study protocol for a randomized multicenter controlled trial. Trials. 2013;14:226-6215-14-226.23866924
47. Abidi P, Chen W, Kraemer FB, Li H, Liu J. The medicinal plant goldenseal is a natural LDL-lowering agent with multiple bioactive components and new action mechanisms. J Lipid Res. 2006;47(10):2134-2147.16885565
48. Zhou JY, Zhou SW, Zhang KB, et al. Chronic effects of berberine on blood, liver glucolipid metabolism and liver PPARs expression in diabetic hyperlipidemic rats. Biol Pharm Bull. 2008;31(6):1169-1176.18520050
49. Pisciotta L, Bellocchio A, Bertolini S. Nutraceutical pill containing berberine versus ezetimibe on plasma lipid pattern in hypercholesterolemic subjects and its additive effect in patients with familial hypercholesterolemia on stable cholesterol-lowering treatment. Lipids Health Dis. 2012;11:123.22998978
50. Hu Y, Ehli EA, Kittelsrud J, et al. Lipid-lowering effect of berberine in human subjects and rats. Phytomedicine. 2012;19(10):861-867.22739410
51. Cianci A, Cicero AF, Colacurci N, Matarazzo MG, De Leo V. Activity of isoflavones and berberine on vasomotor symptoms and lipid profile in menopausal women. Gynecol Endocrinol. 2012;28(9):699-702.22313171
52. Yamaura K, Shimada M, Nakayama N, Ueno K. Protective effects of goldenseal (Hydrastis canadensis L.) on acetaminophen-induced hepatotoxicity through inhibition of CYP2E1 in rats. Pharmacognosy Res. 2011;3(4):250-255.22224048
53. Kim JS, Tanaka H, Shoyama Y. Immunoquantitative analysis for berberine and its related compounds using monoclonal antibodies in herbal medicines. Analyst. 2004;129(1):87-91.14737589
54. Misík V, Bezáková L, Máleková L, Kostálová D. Lipoxygenase inhibition and antioxidant properties of protoberberine and aporphine alkaloids isolated from Mahonia aquifolium. Planta Med. 1995;61(4):372-373.7480190
55. Periera da Silva A, Rocha R, Silva CM, Mira L, Duarte MF, Florêncio MH. Antioxidants in medicinal plant extracts. A research study of the antioxidant capacity of Crataegus, Hamamelis and Hydrastis. Phytother Res. 2000;14(8):612-616.11113998
56. Jiang XW, Zhang Y, Zhu YL, et al. Effects of berberine gelatin on recurrent aphthous stomatitis: a randomized, placebo-controlled, double-blind trial in a Chinese cohort. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(2):212-217.23246229
57. Kardos J, Blaskó G, Kerekes P, Kovács I, Simonyi M. Inhibition of [3H]GABA binding to rat brain synaptic membranes by bicuculline related alkaloids. Biochem Pharmacol. 1984;33(22):3537-3545.6095852
58. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos. 2003;31(11):1391-1397.14570772
59. Brinker FJ. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications; 1998.
60. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
61. Duke JA. Handbook of Medicinal Herbs, Second Edition. CRC Press; 2002.10.1201/9781420040463.Ch3
62. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate. 1993;63(4):201-208.8513024
63. Richard CL, Jurgens TM. Effects of natural health products on blood pressure. Ann Pharmacother. 2005;39(4):712-20.15741425
64. Ernst E. Cardiovascular adverse effects of herbal medicines: a systematic review of the recent literature. Can J Cardiol. 2003;19(7):818-27.12813616
65. Abilify (aripiprazole) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb; February 2011.
66. Kubo M, Koue T, Inaba A, et al. Influence of itraconazole co-administration and CYP2D6 genotype on the pharmacokinetics of the new antipsychotic aripiprazole. Drug Metab Pharmacokinet. 2005;20(1):55-64.15770075
67. Azuma J, Hasunuma T, Kubo M, et al. The relationship between clinical pharmacokinetics of aripiprazole and CYP2D6 genetic polymorphism: effects of CYP enzyme inhibition by coadministration of paroxetine or fluvoxamine. Eur J Clin Pharmacol. 2012;68(1):29-37.21739267
68. Hendset M, Molden E, Enoksen TB, Refsum H, Hermann M. The effect of coadministration of duloxetine on steady-state serum concentration of risperidone and aripiprazole: a study based on therapeutic drug monitoring data. Ther Drug Monit. 2010;32(6):787-790.21068650
69. Wu X, Li Q, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol. 2005;61 (8):567-572.16133554
70. Guo Y, Chen Y, Tan ZR, Klaassen CD, Zhou HH. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol. 2012;68 (2):213-217.21870106
71. Juxtapid (lomitapide) [prescribing information]. Cambridge, MA: Aegerion Pharmaceuticals, Inc; December 2012.
72. Gurley BJ, Swain A, Hartsfield F, et al. Supplementation with goldenseal (Hydrastis canadensis), but not kava kava (Piper methysticum), inhibits human CYP3A activity in vivo. Clin Pharmacol Ther. 2008;83(1):61-69.17495878
73. Desta Z, Kerbusch T, Flockhart DA. Effect of clarithromycin on the pharmacokinetics and pharmacodynamics of pimozide in healthy, poor, and extensive metabolizers of cytochrome P450 2D6 (CYP2D6). Clin Pharmacol Ther. 1999;65(1):10-20.9951426
74. Orap (pimozide) [prescribing information]. Sellersville, PA: Teva Pharmaceuticals USA; August 2011.
75. Flockhart DA, Richard E, Woosely RL, Pearle PL, Drici MD. A metabolic interaction between clarithromycin and pimozide may result in cardiac toxicity. Clin Pharmacol Ther. 1996;59:189.
76. Desta Z, Kerbusch T, Soukhova N, et al. Identification and characterization of human cytochrome P450 isoforms interacting with pimozide. J Pharmacol Exp Ther. 1998;285(2):428-437.9580580
77. Palanisamy A, Haller C, Olson KR. Photosensitivity reaction in a woman using an herbal supplement containing ginseng, goldenseal, and bee pollen. J Toxicol Clin Toxicol. 2003;41(6):865-867.14677798
78. Chen S, Wan L, Couch L, et al. Mechanism study of goldenseal-associated DNA damage. Toxicol Lett. 2013;221(1):64-72.23747414
79. Gorodetzky CW. Beating the urine test for heroin: ingestion of water and the herb, goldenseal (GS). Federation proceedings. 2012;36(3):4053. Accessed June 17, 2014.
80. McCarty CA, Berg RL, Rottscheit CM, Dart RA. The use of dietary supplements and their association with blood pressure in a large Midwestern cohort. BMC Complement Altern Med. 2013 Nov 28;13(1):339.24283381
81. Liu R, Tam TW, Mao J, Saleem A, Krantis A, Arnason JT, Foster BC. The effect of natural health products and traditional medicines on the activity of human hepatic microsomal-mediated metabolism of oseltamivir. J Pharm Pharm Sci. 2010;13(1):43-55.20456830


This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.