Berberine is a chemical found in some plants like European barberry, goldenseal, goldthread, Oregon grape, phellodendron, and tree turmeric.

Berberine is a bitter-tasting and yellow-colored chemical. It might help strengthen the heartbeat, which could benefit people with certain heart conditions. It might also kill bacteria, help regulate how the body uses sugar in the blood, and help reduce swelling.

People most commonly use berberine for diabetes, high levels of cholesterol or other fats in the blood, and high blood pressure. It is also used for burns, canker sores, liver disease, and many other conditions but there is no good scientific evidence to support many of these uses.

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…

• Canker sores. Applying a gel containing berberine can reduce pain, redness, oozing, and the size of canker sores.
• Diabetes. Taking berberine by mouth seems to slightly reduce blood sugar levels in people with diabetes.
• High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Taking berberine by mouth, alone or with other ingredients, might help lower total cholesterol, low-density lipoprotein (LDL or “bad”) cholesterol, and triglyceride levels in people with high cholesterol.
• High blood pressure. Taking 0.9 grams of berberine by mouth daily along with the blood pressure-lowering drug amlodipine reduces blood pressure better than taking amlodipine alone in people with high blood pressure.
• A hormonal disorder that causes enlarged ovaries with cysts (polycystic ovary syndrome or PCOS). Taking berberine by mouth might lower blood sugar, improve cholesterol and triglyceride levels, reduce testosterone levels, and lower waist-to-hip ratio in people with PCOS.

There is interest in using berberine for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

When taken by mouth: Berberine is possibly safe for most adults. It’s been used safely in doses up to 1.5 grams daily for 6 months. Common side effects include diarrhea, constipation, gas, and upset stomach.

When applied to the skin: Berberine is possibly safe for most adults when used short-term.

Special precautions & warnings:

Pregnancy: It’s likely unsafe to take berberine by mouth if you are pregnant. 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.

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

Children: It’s likely 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. There isn’t enough reliable information to know if berberine is safe in older children.

High bilirubin levels in the blood in infants: Bilirubin is a chemical that is produced when 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.

Major

Do not take this combination.

Cyclosporine (Neoral, Sandimmune)

Berberine might decrease how quickly the body breaks down cyclosporine. This might increase the effects and side effects of cyclosporine.

Moderate

Be cautious with this combination.

Dextromethorphan (Robitussin DM, others)

Berberine might decrease how quickly the body breaks down dextromethorphan. This might increase the effects and side effects of dextromethorphan.

Losartan (Cozaar)

The liver activates losartan to make it work. Berberine might decrease how quickly the body activates it, which 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 change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Some medications are changed and broken down by the liver. Berberine might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Some medications are changed and broken down by the liver. Berberine might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications for diabetes (Antidiabetes drugs)

Berberine might lower blood sugar levels. Taking berberine along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Medications for high blood pressure (Antihypertensive drugs)

Berberine might lower blood pressure. Taking berberine along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Berberine might slow blood clotting. Taking berberine along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Metformin (Glucophage)

Berberine might increase the amount of metformin in the body. This may increase its effects and side effects. This interaction seems to occur when berberine is taken around 2 hours before metformin. Taking berberine and metformin at the same time doesn’t appear to increase the amount of metformin in the body.

Midazolam (Versed)

The body breaks down midazolam to get rid of it. Berberine can decrease how quickly the body breaks it down. This might increase the effects and side effects of midazolam.

Pentobarbital (Nembutal)

Pentobarbital is a medication that can cause sleepiness. Berberine might also cause sleepiness and drowsiness. Taking berberine with pentobarbital might cause too much sleepiness.

Sedative medications (CNS depressants)

Berberine might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking berberine with sedative medications might cause breathing problems and/or too much sleepiness.

Tacrolimus (Prograf)

Tacrolimus is removed from the body by the liver. Berberine might slow down the body’s ability to remove tacrolimus. This might increase the effects and side effects of tacrolimus.

Herbs and supplements that might lower blood pressure

Berberine might lower blood pressure. Taking it with other supplements that have the same effect might cause blood pressure to drop too much. Examples of supplements with this effect include andrographis, casein peptides, L-arginine, niacin, and stinging nettle.

Herbs and supplements that might lower blood sugar

Berberine might lower blood sugar. Taking it with other supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.

Herbs and supplements that might slow blood clotting

Berberine might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

Herbs and supplements with sedative properties

Berberine might cause sleepiness and slowed breathing. Taking it along with other supplements with similar effects might cause too much sleepiness and/or slowed breathing in some people. Examples of supplements with this effect include hops, kava, L-tryptophan, melatonin, and valerian.

Probiotics

Probiotics are living organisms. Berberine might kill certain probiotics. If taken together, berberine might reduce how well probiotic supplements work.

There are no known interactions with foods.

Berberine has most often been used by adults in doses of 0.4-1.5 grams by mouth daily for up to 2 years. Berberine has also been used in eye drops and gels. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

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

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

1. Asbaghi O, Ghanbari N, Shekari M, et al. The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: a systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN 2020;38:43-9. View abstract.
2. Chen YX, Gao QY, Zou TH, et al. Berberine versus placebo for the prevention of recurrence of colorectal adenoma: a multicentre, double-blinded, randomised controlled study. Lancet Gastroenterol Hepatol. 2020;5:267-75. View abstract.
3. Beba M, Djafarian K, Shab-Bidar S. Effect of Berberine on C-reactive protein: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2019;46:81-6. View abstract.
4. Lyu Y, Zhang Y, Yang M, et al. Pharmacokinetic interactions between metformin and berberine in rats: Role of oral administration sequences and microbiota. Life Sci. 2019;235:116818. View abstract.
5. Xu L, Zhang Y, Xue X, et al. A phase I trial of berberine in Chinese with ulcerative colitis. Cancer Prev Res (Phila). 2020;13:117-26. View abstract.
6. Zhang LS, Zhang JH, Feng R, et al. Efficacy and safety of berberine alone or combined with statins for the treatment of hyperlipidemia: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Chin Med 2019;47:751-67. View abstract.
7. Qing Y, Dong X, Hongli L, Yanhui L. Berberine promoted myocardial protection of postoperative patients through regulating myocardial autophagy. Biomed Pharmacother. 2018;105:1050-1053. View abstract.
8. Ju J, Li J, Lin Q, Xu H. Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials. Phytomedicine. 2018;50:25-34. View abstract.
9. Li G, Zhao M, Qiu F, Sun Y, Zhao L. Pharmacokinetic interactions and tolerability of berberine chloride with simvastatin and fenofibrate: an open-label, randomized, parallel study in healthy Chinese subjects. Drug Des Devel Ther. 2018;13:129-139. View abstract.
10. Yan HM, Xia MF, Wang Y, Chang XX, Yao XZ, Rao SX, et al. Efficacy of berberine in patients with non-alcoholic fatty liver disease. PLoS One. 2015 Aug 7;10:e0134172. doi: 10.1371/journal.pone.0134172. View abstract.
11. Chen C, Tao C, Liu Z, Lu M, Pan Q, Zheng L, et al. A randomized clinical trial of berberine hydrochloride in patients with diarrhea-predominant irritable bowel syndrome. Phytother Res. 2015 Nov;29:1822-7. doi: 10.1002/ptr.5475. View abstract.
12. Wu XK, Wang YY, Liu JP, Liang RN, Xue HY, Ma HX, et al. Randomized controlled trial of letrozole, berberine, or a combination for infertility in the polycystic ovary syndrome. Fertil Steril. 2016;106:757-765.e1. doi: 10.1016/j.fertnstert.2016.05.022. View abstract.
13. Zhang D, Ke L, Ni Z, Chen Y, Zhang LH, Zhu SH, et al. Berberine containing quadruple therapy for initial Helicobacter pylori eradication: An open-label randomized phase IV trial. Medicine (Baltimore). 2017;96:e7697. doi: 10.1097/MD.0000000000007697. View abstract.
14. Marazzi G, Campolongo G, Pelliccia F, Quattrino S, Vitale C, Cacciotti L, et al. Comparison of low-dose statin versus low-dose statin + Armolipid plus in high-intensity statin-intolerant patients with a previous coronary event and percutaneous coronary intervention (ADHERENCE trial). Am J Cardiol. 2017 Sep 15;120:893-897. doi: 10.1016/j.amjcard.2017.06.015. View abstract.
15. Marazzi G, Pelliccia F, Campolongo G, Quattrino S, Cacciotti L, Volterrani M, et al. Usefulness of nutraceuticals (Armolipid Plus) versus ezetimibe and combination in statin-intolerant patients with dyslipidemia with coronary heart disease. Am J Cardiol. 2015 Dec 15;116:1798-801. doi: 10.1016/j.amjcard.2015.09.023. View abstract.
16. Wen C, Wu L, Fu L, Zhang X, Zhou H. Berberine enhances the anti tumor activity of tamoxifen in drug sensitive MCF 7 and drug resistant MCF 7/TAM cells. Mol Med Rep. 2016;14:2250-6. View abstract.
17. Millán J, Cicero AF, Torres F, Anguera A. Effects of a nutraceutical combination containing berberine (BRB), policosanol, and red yeast rice (RYR), on lipid profile in hypercholesterolemic patients: A meta-analysis of randomized controlled trials. Clin Investig Arterioscler. 2016;28:178-87. View abstract.
18. Pérez-Rubio KG, González-Ortiz M, Martínez-Abundis E, Robles-Cervantes JA, Espinel-Bermúdez MC. Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion. Metab Syndr Relat Disord 2013;11:366-9. View abstract.
19. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. View abstract.
20. 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;115:212-7. View abstract.
21. Hou Q, Han W, Fu X. Pharmacokinetic interaction between tacrolimus and berberine in a child with idiopathic nephrotic syndrome. Eur J Clin Pharmacol 2013;69:1861-2. View abstract.
22. Dong H, Zhao Y, Zhao L, Lu F. The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta Med 2013;79:437-46. View abstract.
23. An Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol (Oxf) 2014;80:425-31. View abstract.
24. Abascal K, Yarnell E. Recent clinical advances with berberine. Altern Complement Ther 2010;16:281-7.
25. Huang CG, Chu ZL, Wei SJ, Jiang H, Jiao BH. Effect of berberine on arachidonic acid metabolism in rabbit platelets and endothelial cells. Thromb Res 2002;106(4-5):223-7. View abstract.
26. Garber AJ. Long-acting glucagon-like peptide 1 receptor agonists: a review of their efficacy and tolerability. Diabetes Care 2011;34 Suppl 2:S279-84. View abstract.
27. Coughlan KA, Valentine RJ, Ruderman NB, Saha AK. AMPK activation: a therapeutic target for type 2 diabetes? Diabetes Metab Syndr Obes 2014;7:241-53. View abstract.
28. Butcher NJ, Minchin RF. Arylamine N-acetyltransferase 1: a novel drug target in cancer development. Pharmacol Rev 2012;64:147-65. View abstract.
29. Ruscica M, Gomaraschi M, Mombelli G, Macchi C, Bosisio R, Pazzucconi F, Pavanello C, Calabresi L, Arnoldi A, Sirtori CR, Magni P. Nutraceutical approach to moderate cardiometabolic risk: results of a randomized, double-blind and crossover study with Armolipid Plus. J Clin Lipidol. 2014;8:61-8. View abstract.
30. Rabbani G. Mechanism and treatment of diarrhoea due to Vibrio cholerae and Escherichia coli: roles of drugs and prostaglandins. Danish Medical Bulletin 1996;43:173-185.
31. Kaneda Y, Torii M, Tanaka T, and et al. In vitro effects of berberine sulphate on the growth and structure of Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. Annals of Tropical Medicine and Parasitology 1991;85:417-425.
32. Saksena HC, Tomar VN, and Soangra MR. Efficacy of a new salt of Berberine Uni-Berberine in oriental sore. Current Medical Practice 1970;14:247-252.
33. Purohit SK, Kochar DK, Lal BB, and et al. Cultivation of Leishmania tropica from untreated and treated cases of oriental sore. Indian Journal of Public Health 1982;26:34-37.
34. Sharma R, Joshi CK, and Goyal RK. Berberine tannate in acute diarrhoea. Indian Pediatrics 1970;7:496-501.
35. Li XB. [Controlled clinical trial in infants and children comparing Lacteol Fort sachets with two antidiarrhoeal reference drugs]. Ann Pediatr 1995;42:396-401.
36. Lahiri S and Dutta NK. Berberine and chloramphenicol in the treatment of cholera and severe diarrhoea. Journal of the Indian Medical Association 1967;48:1-11.
37. Kamat SA. Clinical trials with berberine hydrochloride for the control of diarrhea in acute gastroenteritis. J Assoc Physicians India 1967;15:525-529.
38. Dutta NK and Panse MV. Usefulness of berberine (an alkaloid from Berberis aristata) in the treatment of cholera (experimental). Indian J Med Res 1962;50:732-736.
39. Wu, S. N., Yu, H. S., Jan, C. R., Li, H. F., and Yu, C. L. Inhibitory effects of berberine on voltage- and calcium-activated potassium curre