Supplements and Heart Medications: Which Combinations Need Care?

Updated 2026-10-08 · HarmoHealth Editorial Team

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If you take medicine for your heart, blood pressure or cholesterol, the supplement aisle carries real risks. Some herbs change how drugs are absorbed or broken down; others add to a drug's effect or push in the opposite direction. NCCIH explains that these interactions can make a medicine less effective or increase its side effects.

This guide covers the combinations most relevant to heart-health supplements. It is not a complete list, and your pharmacist is the best person to check your exact medicines against a specific label.

Why do supplements interact with heart medicines?

Supplements and drugs can interact in several ways:

• Changing drug levels. Some ingredients speed up or slow down how the body processes a medicine, so blood levels rise or fall.
• Adding to an effect. Two things that each thin the blood or lower blood sugar can add up.
• Opposing an effect. An ingredient that raises blood pressure works against a blood pressure drug.

Heart medicines often have narrow safety margins, which is why small changes can matter.

Which supplements interact with statins?

• Green tea extract: NCCIH reports that green tea extract can reduce blood levels of atorvastatin. Green tea extract appears in CardioShield and green tea leaf extract in Chocotide.
• Red yeast rice: some products contain monacolin K, which NCCIH describes as structurally identical to lovastatin. Taking it with a statin could mean doubling up on a statin-like compound.
• Bergamot: a 2020 review noted a possible additive effect with statins. Your doctor should know so lipid tests can be interpreted correctly. See Bergamot Plus.
• Grapefruit: not a supplement, but the FDA warns that grapefruit juice can interact with some cholesterol-lowering drugs. Check your medication leaflet.

Which supplements increase bleeding risk with blood thinners?

If you take warfarin, a newer anticoagulant, clopidogrel or daily aspirin, watch for these:

Also tell your surgeon or dentist about any of these before a procedure. MedlinePlus has a general overview of blood thinners.

Which supplements can raise blood pressure or counteract blood pressure drugs?

According to NCCIH, bitter orange, ephedra, ginseng and licorice root may raise blood pressure. Specific points:

• Licorice: NCCIH warns that glycyrrhizin can cause serious effects such as irregular heartbeat, and that even small amounts have been linked to severe effects in people with hypertension or heart or kidney conditions. Licorice extract is listed in ColestZen.
• Green tea: NCCIH says high doses can reduce blood levels of the beta-blocker nadolol, and green tea extract may increase blood pressure.
• Caffeine sources such as guarana can cause temporary rises. See our caffeine guide.

Can hawthorn interact with heart medicines?

Possibly. NCCIH notes a study in which one hawthorn preparation may have been linked to early progression of heart failure, and one suggested explanation was an interaction with patients' drugs. Hawthorn's long-term safety is not established. If you take heart failure medicines, digoxin or beta-blockers, ask your cardiologist before using a hawthorn product.

Do blood-sugar herbs matter if I take heart medicine?

They matter if you also have diabetes, which is common in people with heart disease. Cinnamon, chromium, bitter melon and gymnema are discussed for lowering blood sugar (NCCIH), and CoQ10 may interact with insulin. Combining them with insulin or other diabetes drugs may raise the risk of low blood sugar. ColestZen contains several of these ingredients.

Are calming herbs safe with blood pressure medicine?

Calming herbs such as passionflower can cause drowsiness and dizziness (NCCIH). Blood pressure medicines can also cause dizziness, especially when standing up. The combination could make that worse. Passion flower is listed in Arteris Plus.

What about potassium supplements?

Potassium matters for blood pressure, but supplements can be risky for people taking ACE inhibitors, ARBs or potassium-sparing diuretics, or for those with kidney disease, because potassium levels can climb too high. The ODS potassium fact sheet covers this. Get potassium from food unless your doctor advises otherwise.

Are "natural" products less likely to interact?

No. "Natural" describes where an ingredient comes from, not how it behaves in your body. Many prescription drugs were originally derived from plants, and herbs such as licorice and St. John's wort have well-documented interactions. NCCIH notes that St. John's wort can interact in dangerous, sometimes life-threatening ways with a variety of medicines. Treat every supplement as an active substance.

How do I check a supplement against my medicines?

1. Write down every medicine, including over-the-counter drugs and aspirin.
2. Photograph the full Supplement Facts panel of the product you are considering.
3. Ask your pharmacist to review both; it is quick and usually free.
4. Start only one new product at a time.
5. Tell your doctor before any blood test so results are interpreted correctly.
6. Stop the supplement and seek care if you notice bleeding, bruising, fainting, a racing heart or swelling.

Quick reference: heart supplements on this site and their main interaction flags

Review the Bergamot Plus label with your pharmacist

Sources consulted: nccih.nih.gov, pubmed.ncbi.nlm.nih.gov, fda.gov, ods.od.nih.gov, medlineplus.gov.