Significant Interactions

Because controlled studies are not available, interactions are currently speculative and based on evidence of pharmacological activity. No drug interactions have been reported; however, an extract of goldenseal has demonstrated inhibition of cytochrome P450 in vitro (Budzinski et al 2000). Theoretically these findings suggests that any drugs metabolised using this pathway may be affected. The clinical relevance of this possible interaction is unknown. CYCLOSPORIN A

Berberine increased the blood concentration of cyclosporin A in renal transplant patients in a RCT (Wu et al 2005): 52 patients received 0.2 g of berberine orally three times daily for 3 months. The final blood concentration in the berberine/cyclosporin A group was 29.3% higher than the group given cyclosporin A only. The relevance of this to oral ingestion of goldenseal is unknown — caution advised.

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