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Berberine

What is it?

Berberine is a chemical found in several plants including European barberry, goldenseal, goldthread, Oregon grape, phellodendron, and tree tumeric.

People take berberine for heart failure.

Some people apply berberine directly to the skin to treat burns and to the eye to treat trachoma, a bacterial infection that frequently causes blindness.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for BERBERINE are as follows:

Possibly effective for...

  • Diabetes. Berberine seems to slightly reduce blood sugar levels in people with diabetes. Also, some early research suggests that taking 500 mg of berberine 2-3 times daily for up to 3 months might control blood sugar as effectively as metformin or rosiglitazone.
  • High cholesterol. There is early evidence that berberine can help lower cholesterol levels in people with high cholesterol. Taking 500 mg of berberine twice daily for 3 months seems to reduce total cholesterol, low-density lipoprotein (LDL or “bad”) cholesterol, and triglyceride levels in people with high cholesterol.

Insufficient evidence to rate effectiveness for...

  • Burns. Early research suggests that applying an ointment that contains berberine and beta-sitosterol can treat second-degree burns as effectively as conventional treatment with silver sulfadiazine.
  • Congestive heart failure (CHF). Early research suggests that berberine can reduce some of the symptoms and lower the death rate in some people with congestive heart failure.
  • Diarrhea. Some early research suggests that berberine sulfate can decrease diarrhea in people with certain bacterial infections. Also, berberine hydrochloride seems to speed up recovery time for people with diarrhea when added to some standard treatments. However, berberine does not seem to enhance the effects of tetracycline in treating diarrhea related to cholera infection.
  • Glaucoma. Early research suggests that using eye drops containing berberine and tetrahydrozoline for 3 days does not reduce eye pressure in people with glaucoma better than eye drops containing tetrahydrozoline alone.
  • Stomach ulcers caused by Helicobacter pylori (H pylori) infection. Early research suggests that taking berberine three times daily for 6 weeks is more effective than the drug ranitidine at eliminating H. pylori infection, but less effective at healing ulcers in people with stomach ulcers due to H. pylori.
  • Hepatitis. Early research suggests that taking berberine daily for 2 months decreases blood sugar, triglycerides, and markers of liver damage in people with diabetes and hepatitis B or C.
  • Liver disease. Early research suggests that taking berberine for 12 weeks reduces fat in the blood and markers of liver damage in people with liver disease and diabetes.
  • Menopausal symptoms. Early research suggests that taking berberine and soy isoflavones can reduce menopausal symptoms.
  • Metabolic syndrome. Taking a combination product (Armolipid Plus) containing berberine, policosanol, and red yeast rice might improve blood pressure and blood flow in people with metabolic syndrome.
  • Obesity. Early research suggests that taking berberine for 12 weeks can reduce weight in obese people by about 5 pounds.
  • Osteoporosis. Early research suggests that taking berberine together with vitamin D3, vitamin K, and a chemical found in hops for 14 weeks can decrease bone loss in postmenopausal women with osteoporosis.
  • An ovary disorder known as polycystic ovary syndrome (PCOS). Early research suggests that berberine can reduce blood sugar, cholesterol, triglycerides, testosterone, and waist-to-hip ratio in women with PCOS.
  • Injuries caused by radiation. Some early research suggests that taking berberine during radiation therapy can reduce the occurrence and severity of some injuries caused by radiation in patients being treated for cancer.
  • Low blood platelet counts (thrombocytopenia). Blood platelets are important for blood clotting. Early research suggests that taking berberine for 15 days, either alone or with prednisolone, can increase the number of blood platelets in people with low blood platelet counts.
  • Trachoma. There is some evidence that eye drops containing berberine might be useful for treating trachoma, a common cause of blindness in developing countries.
  • Other conditions.
More evidence is needed to rate the effectiveness of berberine for these uses.

How does it work?

Berberine might cause stronger heartbeats. It also might also be able to kill bacteria.

Are there safety concerns?

Berberine is POSSIBLY SAFE for most adults for short-term use when taken by mouth or applied to the skin.

Special precautions & warnings:

Children: It’s UNSAFE to give berberine to newborns. It can cause kernicterus, a rare type of brain damage that can occur in newborns who have severe jaundice. Jaundice is yellowing of the skin caused by too much bilirubin in the blood. Bilirubin is a chemical that is produced when the old red cells break down. It is normally removed by the liver. Berberine may keep the liver from removing bilirubin fast enough.

Pregnancy and breast-feeding: It’s UNSAFE to take berberine by mouth if you are pregnant. Researchers believe berberine can cross the placenta and might cause harm to the fetus. Kernicterus, a type of brain damage, has developed in newborn infants exposed to berberine.

It’s also UNSAFE to take berberine if you are breast-feeding. Berberine can be transferred to the infant through breast milk, and it might cause harm.

Diabetes: Berberine can lower blood sugar. Theoretically, berberine may cause blood sugar to become too low if taken by diabetics who are controlling their blood sugar with insulin or medications. Use with caution in people with diabetes.

High bilirubin levels in the blood in infants: Bilirubin is a chemical that is produced when the old red blood cells break down. It is normally removed by the liver. Berberine may keep the liver from removing bilirubin fast enough. This can cause brain problems, especially in infants with high levels of bilirubin in the blood. Avoid using.

Low blood pressure: Berberine might lower blood pressure. Use with caution in people with low blood pressure.

Are there interactions with medications?

Major
Do not take this combination.
Cyclosporine (Neoral, Sandimmune)
The body breaks down cyclosporine (Neoral, Sandimmune) to get rid of it. Berberine might decrease how fast the body breaks down cyclosporine (Neoral, Sandimmune). Cyclosporine (Neoral, Sandimmune) might build up in the body and could possible cause side effects.
Medications for diabetes (Antidiabetes drugs)
Berberine might lower blood sugar. Diabetes medications are also used to lower blood sugar. Taking berberine along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (Diabeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
Moderate
Be cautious with this combination.
Dextromethorphan (Robitussin DM, and others)
The body breaks down dextromethorphan (Robitussin DM, others) to get rid of it. Berberine might decrease how quickly the body breaks down dextromethorphan (Robitussin DM, others). Taking berberine while taking dextromethorphan (Robitussin DM, others) might increase the effects and side effects of dextromethorphan (Robitussin DM, others).
Losartan (Cozaar)
The liver activates losartan (Cozaar) to make it work. Berberine might decrease how quickly the body breaks down losartan (Cozaar). Taking berberine while taking losartan (Cozaar) might decrease the effects of losartan.
Medications changed by the liver (Cytochrome P450 2C9 [CYP2C9] substrates)
Some medications are changed and broken down by the liver. Berberine might decrease how quickly the liver breaks down some medications. Taking berberine along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking berberine, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and S-warfarin (Coumadin).
Medications changed by the liver (Cytochrome P450 2D6 [CYP2D6] substrates)
Some medications are changed and broken down by the liver. Berberine might decrease how quickly the liver breaks down some medications. Taking berberine along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking berberine, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.
Medications changed by the liver (Cytochrome P450 3A4 [CYP3A4] substrates)
Some medications are changed and broken down by the liver. Berberine might decrease how quickly the liver breaks down some medications. Taking berberine along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking berberine, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include cyclosporin (Neoral, Sandimmune), lovastatin (Mevacor), clarithromycin (Biaxin), indinavir (Crixivan), sildenafil (Viagra), triazolam (Halcion), and many others.
Medications for high blood pressure (Antihypertensive drugs)
Berberine might decrease blood pressure in some people. Taking berberine along with medications used for lowering high blood pressure might cause your blood pressure to go too low. However, it's not known if this is a big concern. Do not take too much berberine if you are taking medications for high blood pressure.

Some medications for high blood pressure include include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Berberine might slow blood clotting. Taking berberine along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), and others.
Midazolam (Versed)
The body breaks down midazolam (Versed) to get rid of it. Berberine can decrease how quickly the body breaks down midazolam (Versed). Taking berberine along with midazolam (Versed) might increase the effects and side effects of midazolam (Versed).
Sedative medications (CNS depressants)
Berberine might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking berberine along with sedative medications might cause too much sleepiness.

Some sedative medications include benzodiazepines, pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), thiopental (Pentothal), fentanyl (Duragesic, Sublimaze), morphine, propofol (Diprivan), and others.

Are there interactions with herbs and supplements?

Herbs and supplements that might lower blood pressure
Berberine might lower blood pressure. Using it along with other herbs and supplements that have this same effect might increase the risk of blood pressure dropping too low in some people. Some of these products include andrographis, casein peptides, cat's claw, coenzyme Q-10, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.
Herbs and supplements that might lower blood sugar
Berberine might lower blood sugar. Using it along with other herbs and supplements that have the same effect might cause blood sugar to drop too low in some people. Some of these products include alpha-lipoic acid, bitter melon, chromium, devil's claw, fenugreek, garlic, guar gum, horse chestnut seed, Panax ginseng, psyllium, Siberian ginseng, and others.
Herbs and supplements that might slow blood clotting
Berberine might slow blood clotting. Taking berberine along with other herbs that might slow blood clotting might increase the chances of bruising and bleeding. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and others.
Herbs and supplements with sedative properties
Berberine can cause sleepiness or drowsiness. Using it along with other herbs and supplements that have the same effect might make you overly drowsy. Some of these herbs and supplements include calamus, California poppy, catnip, hops, Jamaican dogwood, kava, L-tryptophan, melatonin, sage, SAMe, St. John's wort, sassafras, skullcap, and others.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The appropriate dose of berberine depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for berberine. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Other names

Alcaloïde de Berbérine, Berberina, Berbérine, Berberine Alkaloid, Berberine Complex, Berberine Sulfate, Sulfate de Berbérine.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

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Last reviewed - 02/13/2015