What is the recommended dose of Berberine?

- **Most studied range:** 0.9 to 1.5 g/day was the most common dose across the 50 trials pooled in finding 1 (Wang 2024, PMID: 39640489). Individual trials on this page used 1.0 g/day in two divide...

Is Berberine safe to take daily?

Berberine is rated "Prescription Interactions" based on clinical evidence. - **Gastrointestinal effects are the common complaint.** Transient gastrointestinal adverse effects were reported in 20 patients (34.5%) in the Yin 2008 pilot study (PMID: 18442638). - **Pooled adverse event rates were not hi

Does Berberine interact with any medications?

Berberine has 4 known drug interactions, including interactions with CYP3A4/5 substrate drugs, CYP2D6 substrate drugs, Tacrolimus. Check with your doctor before combining with prescription medications.

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Ingredient Research

Graded against 173,636 supplements + 177 published clinical interactions, sourced from PubMed, FDA CAERS, openFDA, NIH DSLD

Berberine

MODERATE EVIDENCEBotanicalLast updated August 24, 2026

AVELOR SUMMARY

Berberine is a plant alkaloid studied mainly for glucose and lipid outcomes. This page draws on 3 randomized controlled trials and 7 systematic reviews or meta-analyses indexed in PubMed. Across those syntheses, berberine is associated in studies with lower fasting glucose, lower HbA1c, lower total cholesterol, and lower triglycerides in adults with type 2 diabetes, dyslipidaemia, or metabolic syndrome. It is a potent bioactive compound, not a casual supplement. The main safety consideration is drug interaction: in human liver microsomes berberine is a time-dependent inhibitor of CYP2D6 and CYP3A4/5, a plausible mechanism for the reported interaction with tacrolimus, which a review attributes to CYP450 and/or P-glycoprotein inhibition.

EVIDENCE GRADES

Blood Glucose (T2D)Consistent across large pooled datasets, trial quality limited

HbA1c (T2D)Consistent across large pooled datasets, trial quality limited

Total CholesterolConsistent direction, source syntheses flag high risk of bias

TriglyceridesModerate

LDL CholesterolModerate

Insulin ResistanceLimited, no dedicated pooled effect size in the sources below

Blood PressureInsufficient, the placebo-controlled synthesis and the dedicated review both found no reliable effect

OPTIMAL DOSAGE

Most studied range: 0.9 to 1.5 g/day was the most common dose across the 50 trials pooled in finding 1 (Wang 2024, PMID: 39640489). Individual trials on this page used 1.0 g/day in two divided doses (Zhao 2021) or 1.5 g/day in three divided doses (Yin 2008).
More is not better. Pooled subgroup analysis found the glucose association became unremarkable once the daily dose exceeded 2 g/day or treatment ran past 90 days (Liang 2019, PMID: 30393248).
Start low. Transient gastrointestinal effects were the dominant complaint in the cited trials (Yin 2008, PMID: 18442638).
Absorption: Berberine is described as a poorly absorbed alkaloid (Di Pierro 2023, PMID: 38074133). Enhanced absorption forms exist, and finding 10 used berberine phytosome at 550 mg twice daily. No source on this page quantifies how much any enhanced form raises absorption, so no multiplier is claimed here.

Scan a supplement containing Berberine

DRUG INTERACTIONS

CYP3A4/5 substrate drugsModerate

May increase drug levels

In vitro only. Discuss with a prescriber before combining.

CYP2D6 substrate drugsModerate

May increase drug levels

In vitro only. Discuss with a prescriber before combining.

TacrolimusSevere

Increased tacrolimus exposure

Do not combine without therapeutic drug monitoring.

Glucose-lowering drugsModerate

Additive glucose reduction

Monitor blood glucose.

SAFETY PROFILE

Side Effects

Gastrointestinal effects are the common complaint. Transient gastrointestinal adverse effects were reported in 20 patients (34.5%) in the Yin 2008 pilot study (PMID: 18442638).
Pooled adverse event rates were not higher than control. Total adverse events RR 0.73 (95% CI 0.55 to 0.97) in 37 trials (Xie W 2022, PMID: 36467075), adverse events RR 0.64 (95% CI 0.31 to 1.30) in 16 trials (Ju 2018, PMID: 30466986), and gastrointestinal adverse events versus placebo RR 1.01 (95% CI 0.76 to 1.35) in PCOS trials (Xie L 2019, PMID: 31915452).
Evidence on this page is insufficient to characterise the frequency of any non-gastrointestinal side effect.

Drug Interactions

Claims about berberine and CYP2C9, and about berberine and bleeding risk with antiplatelet or anticoagulant drugs, were removed from this table. In the microsomal study above, CYP2C9 inhibition was attributed to a different goldenseal alkaloid, (-)-beta-hydrastine, not to berberine. No source located for this page evaluates bleeding risk with berberine plus antiplatelet drugs. Evidence is insufficient in both cases.

Precautions

Pregnancy and breastfeeding: avoid. Berberine displaced bilirubin from albumin in vitro at roughly tenfold the potency of phenylbutazone, and chronic dosing in rats lowered bilirubin protein binding and raised unbound and total serum bilirubin. The authors advise that berberine-rich herbs are best avoided in jaundiced neonates and in pregnant women (Chan 1993, PMID: 8513024). Note that this is in vitro and animal evidence. The earlier claim on this page that berberine initiates uterine contractions was unsourced and has been removed.
On glucose-lowering medication: monitor closely, since the pooled data show additive glucose reduction.
Enhanced absorption formulations: the one trial here using a phytosome form (finding 10) does not establish equivalence with standard berberine HCl in either effect or interaction risk. Treat them as different exposures.
Nothing on this page is a substitute for medical care. Talk to a prescriber before combining berberine with any medication.

Quality Concerns

Analysis of 15 berberine dietary supplements bought from US vendors found average berberine content of 75% ± 25% of the label claim, with product potency ranging from 33% to 100%. Nine of the 15 products (60%) failed the 90% to 110% potency standard commonly applied to pharmaceutical preparations, and measured potency showed no association with product cost (Funk 2018, PMID: 28792254). Third-party testing is worth looking for. The previous claim on this page about testing in France was unsourced and has been removed.

WADA Status

Not Prohibited.

WHO SHOULD BE CAREFUL

QUALITY CONCERNS

HOW AVELOR SCORES THIS

Present at 900 to 1,500 mg/day:Green flag for metabolic support. This is the range where the pooled evidence is strongest.

Present above 2,000 mg/day:Yellow flag. Pooled subgroup data show no added glucose benefit above 2 g/day (Liang 2019).

In someone on glucose-lowering medication:Yellow flag. Additive glucose lowering, needs monitoring.

In someone on tacrolimus or other narrow-therapeutic-index CYP3A4 or CYP2D6 substrates:Red flag. Documented pharmacokinetic interaction with tacrolimus, plus in vitro CYP3A4/5 and CYP2D6 inhibition.

During pregnancy or breastfeeding:Red flag. Bilirubin displacement data, and the source authors advise avoidance in pregnancy.

Marketed for blood pressure support:Red flag. Two independent syntheses on this page found no reliable blood pressure effect.

RELATED RESEARCH

Apigenin Extended, See apigenin.md

ApigeninChamomile extract

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ArjunaArjuna bark

Scan Your Berberine Supplement Browse all ingredients

Independently graded against 173,636 indexed supplements with 177 published clinical interactions, sourced from PubMed, FDA CAERS, openFDA, and NIH DSLD | Last updated: August 24, 2026

Not medical advice. Based on published clinical research and systematic reviews.

Berberine · interaction landscape

7 flagged

Dangerous

Moderate

Timing

Pre-op

Safety

Berberine: Drug Interactions

Discuss with prescriber

Clinically significant interactions per published research. Talk to your prescriber or pharmacist before using this supplement if you take any of these.

Metformin
Berberine and metformin lower blood glucose via similar pathways.
RiskSevere hypoglycemia.
ActionStart at 500mg berberine. Monitor glucose closely. Metformin dose may need to be reduced.
SourcePMID: 37439907
Cyclosporine
Berberine inhibits CYP3A4 and P-glycoprotein, dramatically increasing cyclosporine levels.
RiskCyclosporine toxicity (nephrotoxic).
ActionNever combine without transplant team supervision.
SourceClinical pharmacology

Use with caution

Moderate interactions. Monitoring, timing separation, or dose adjustment may be required.

CYP2D6 substrates (codeine, tramadol, many antidepressants)
Berberine inhibits CYP2D6.
RiskIncreased drug levels.
ActionMonitor for side effects.
SourcePMID: 38928095
CYP3A4 substrates (statins, calcium channel blockers)
Berberine inhibits CYP3A4.
RiskIncreased drug levels and potential toxicity.
ActionUse caution with narrow-therapeutic-index drugs.
SourcePMID: 37439907
Sulfonylureas (glipizide, glyburide)
Additive glucose lowering.
RiskHypoglycemia.
ActionMonitor blood sugar closely.
SourceClinical consensus
Blood pressure medications
Berberine may lower BP.
RiskHypotension.
ActionMonitor BP.
SourceClinical consensus
Anticoagulants
Berberine may have antiplatelet effects.
RiskBleeding risk.
ActionMonitor if combining.
SourceLimited evidence

Educational information only. This is not medical advice. These statements have not been evaluated by the FDA. Talk to your prescriber before starting, stopping, or combining any supplement with prescription medication.

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Ingredient Research

Graded against 173,636 supplements + 177 published clinical interactions, sourced from PubMed, FDA CAERS, openFDA, NIH DSLD

Berberine

MODERATE EVIDENCEBotanicalLast updated August 24, 2026

AVELOR SUMMARY

EVIDENCE GRADES

Blood Glucose (T2D)Consistent across large pooled datasets, trial quality limited

HbA1c (T2D)Consistent across large pooled datasets, trial quality limited

Total CholesterolConsistent direction, source syntheses flag high risk of bias

TriglyceridesModerate

LDL CholesterolModerate

Insulin ResistanceLimited, no dedicated pooled effect size in the sources below

Blood PressureInsufficient, the placebo-controlled synthesis and the dedicated review both found no reliable effect

OPTIMAL DOSAGE

Most studied range: 0.9 to 1.5 g/day was the most common dose across the 50 trials pooled in finding 1 (Wang 2024, PMID: 39640489). Individual trials on this page used 1.0 g/day in two divided doses (Zhao 2021) or 1.5 g/day in three divided doses (Yin 2008).
More is not better. Pooled subgroup analysis found the glucose association became unremarkable once the daily dose exceeded 2 g/day or treatment ran past 90 days (Liang 2019, PMID: 30393248).
Start low. Transient gastrointestinal effects were the dominant complaint in the cited trials (Yin 2008, PMID: 18442638).
Absorption: Berberine is described as a poorly absorbed alkaloid (Di Pierro 2023, PMID: 38074133). Enhanced absorption forms exist, and finding 10 used berberine phytosome at 550 mg twice daily. No source on this page quantifies how much any enhanced form raises absorption, so no multiplier is claimed here.

Scan a supplement containing Berberine

DRUG INTERACTIONS

CYP3A4/5 substrate drugsModerate

May increase drug levels

In vitro only. Discuss with a prescriber before combining.

CYP2D6 substrate drugsModerate

May increase drug levels

In vitro only. Discuss with a prescriber before combining.

TacrolimusSevere

Increased tacrolimus exposure

Do not combine without therapeutic drug monitoring.

Glucose-lowering drugsModerate

Additive glucose reduction

Monitor blood glucose.

SAFETY PROFILE

Side Effects

Gastrointestinal effects are the common complaint. Transient gastrointestinal adverse effects were reported in 20 patients (34.5%) in the Yin 2008 pilot study (PMID: 18442638).
Pooled adverse event rates were not higher than control. Total adverse events RR 0.73 (95% CI 0.55 to 0.97) in 37 trials (Xie W 2022, PMID: 36467075), adverse events RR 0.64 (95% CI 0.31 to 1.30) in 16 trials (Ju 2018, PMID: 30466986), and gastrointestinal adverse events versus placebo RR 1.01 (95% CI 0.76 to 1.35) in PCOS trials (Xie L 2019, PMID: 31915452).
Evidence on this page is insufficient to characterise the frequency of any non-gastrointestinal side effect.

Drug Interactions

Precautions

Pregnancy and breastfeeding: avoid. Berberine displaced bilirubin from albumin in vitro at roughly tenfold the potency of phenylbutazone, and chronic dosing in rats lowered bilirubin protein binding and raised unbound and total serum bilirubin. The authors advise that berberine-rich herbs are best avoided in jaundiced neonates and in pregnant women (Chan 1993, PMID: 8513024). Note that this is in vitro and animal evidence. The earlier claim on this page that berberine initiates uterine contractions was unsourced and has been removed.
On glucose-lowering medication: monitor closely, since the pooled data show additive glucose reduction.
Enhanced absorption formulations: the one trial here using a phytosome form (finding 10) does not establish equivalence with standard berberine HCl in either effect or interaction risk. Treat them as different exposures.
Nothing on this page is a substitute for medical care. Talk to a prescriber before combining berberine with any medication.

Quality Concerns

WADA Status

Not Prohibited.

WHO SHOULD BE CAREFUL

QUALITY CONCERNS

HOW AVELOR SCORES THIS

Present at 900 to 1,500 mg/day:Green flag for metabolic support. This is the range where the pooled evidence is strongest.

Present above 2,000 mg/day:Yellow flag. Pooled subgroup data show no added glucose benefit above 2 g/day (Liang 2019).

In someone on glucose-lowering medication:Yellow flag. Additive glucose lowering, needs monitoring.

In someone on tacrolimus or other narrow-therapeutic-index CYP3A4 or CYP2D6 substrates:Red flag. Documented pharmacokinetic interaction with tacrolimus, plus in vitro CYP3A4/5 and CYP2D6 inhibition.

During pregnancy or breastfeeding:Red flag. Bilirubin displacement data, and the source authors advise avoidance in pregnancy.

Marketed for blood pressure support:Red flag. Two independent syntheses on this page found no reliable blood pressure effect.

RELATED RESEARCH

Apigenin Extended, See apigenin.md

ApigeninChamomile extract

Apocynum Venetum

ArjunaArjuna bark

Scan Your Berberine Supplement Browse all ingredients

Independently graded against 173,636 indexed supplements with 177 published clinical interactions, sourced from PubMed, FDA CAERS, openFDA, and NIH DSLD | Last updated: August 24, 2026

Not medical advice. Based on published clinical research and systematic reviews.

Berberine · interaction landscape

7 flagged

Dangerous

Moderate

Timing

Pre-op

Safety

Berberine: Drug Interactions

Discuss with prescriber

Clinically significant interactions per published research. Talk to your prescriber or pharmacist before using this supplement if you take any of these.

Metformin
Berberine and metformin lower blood glucose via similar pathways.
RiskSevere hypoglycemia.
ActionStart at 500mg berberine. Monitor glucose closely. Metformin dose may need to be reduced.
SourcePMID: 37439907
Cyclosporine
Berberine inhibits CYP3A4 and P-glycoprotein, dramatically increasing cyclosporine levels.
RiskCyclosporine toxicity (nephrotoxic).
ActionNever combine without transplant team supervision.
SourceClinical pharmacology

Use with caution

Moderate interactions. Monitoring, timing separation, or dose adjustment may be required.

CYP2D6 substrates (codeine, tramadol, many antidepressants)
Berberine inhibits CYP2D6.
RiskIncreased drug levels.
ActionMonitor for side effects.
SourcePMID: 38928095
CYP3A4 substrates (statins, calcium channel blockers)
Berberine inhibits CYP3A4.
RiskIncreased drug levels and potential toxicity.
ActionUse caution with narrow-therapeutic-index drugs.
SourcePMID: 37439907
Sulfonylureas (glipizide, glyburide)
Additive glucose lowering.
RiskHypoglycemia.
ActionMonitor blood sugar closely.
SourceClinical consensus
Blood pressure medications
Berberine may lower BP.
RiskHypotension.
ActionMonitor BP.
SourceClinical consensus
Anticoagulants
Berberine may have antiplatelet effects.
RiskBleeding risk.
ActionMonitor if combining.
SourceLimited evidence

Discover More

Helps With

Blood Sugar Diabetes Weight Loss Gut Health

Related Ingredients

Chromium Alpha Lipoic Acid Cinnamon

Explore

Browse All 834 Ingredients Browse All 20 Conditions