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In large doses, barberry may cause vomiting, diarrhea, convulsions, and dangerous drops in blood pressure, heart rate, and breathing. Do not take barberry without discussing it first with your physician especially if you take anticoagulants (blood thinners), blood pressure medication, diabetes medication, diuretics (water pills), antibiotics, and antihistamines. Barberry may decrease or increase the effectiveness of these and other drugs. For example, one study published in the European Journal of Pharmacology found that berberine elevated the amount of the drug cyclosporin A in kidney transplant patients.
An overdose of barberry can result in kidney irritation. Symptoms of kidney problems are bloody urine, pain when urinating, low back or stomach pain, and fever. Seek medical attention immediately.
Barberry should not be used to replace conventional treatment. In particular, it shouldn't be used as a home remedy for UTIs. If the bacteria aren't fully eradicated, the infection may spread to the kidneys, even though symptoms, such as difficult or painful urination, may disappear.
Pregnant women should not use barberry because it may stimulate uterine contractions and cause miscarriage. The safety of barberry in nursing women and children is unknown and should be avoided. *
Contraindications
Caution is warranted in the presence of cardiac arrhythmia. Use in children has not been validated.
Pregnancy/Lactation
Avoid use. There are documented adverse effects, including uterine stimulant effects.
Interactions
Case reports are lacking; however, barberry exhibits anti-cytochrome P450 3A4 (CYP3A4) activity similar to that of grapefruit. Caution is warranted with coadministration of potentially toxic medicines such as cyclosporine.
Adverse Reactions
GI symptoms (eg, nausea, vomiting, diarrhea), dizziness, and fainting have been reported. Effects on the cardiovascular system (eg, hypotension, decreased heart rate) and decreased respiration may occur with high dosages. The German Commission E reports that lower doses of berberine are well tolerated. Hypersensitivity has been documented.
Toxicology
Symptoms of poisoning are characterized by lethargy, stupor and daze, vomiting and diarrhea, and nephritis. A median lethal dose (LD50) for berberine was noted as 27.5 mg/kg in humans. Berberine showed mutagenicity in yeast cells and Ames test, while a phototoxic reaction between berberine alkaloid and ultraviolet A (UVA) light has been described.
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