The short answer
Licorice containing glycyrrhizin can raise blood pressure and lower potassium. Have it reviewed before use with oral hydrocortisone, which can also affect fluid and electrolytes.
What this answer covers
Oral hydrocortisone with glycyrrhizin-containing Glycyrrhiza glabra root/stolon preparations. Deglycyrrhizinated products and uncharacterized extracts differ.
- Supplement or preparation
- Glycyrrhiza glabra
- Medication ingredient
- hydrocortisone
Which treatment this applies to
This review concerns oral hydrocortisone tablets such as CORTEF. Hormone replacement and higher-dose anti-inflammatory treatment have different exposure and monitoring needs. Findings are not automatically applicable to skin creams, injections or the different medicine cortisone acetate.
The concern is fluid and electrolytes
The current European licorice assessment advises against use with corticosteroids when electrolyte imbalance could worsen. Licorice can cause fluid retention, BP elevation and potassium loss. The exact hydrocortisone label also describes these effects, with risk depending on dose and clinical context.
Preparation and exposure matter
A trial in healthy adults found higher home systolic BP with licorice containing quantified glycyrrhizic acid. It did not test hydrocortisone. Root extracts, teas, food products and deglycyrrhizinated preparations should not be assumed interchangeable, and a product’s total weight does not establish glycyrrhizin exposure.
Arrange review rather than self-correction
Share the product label and daily amount before adding licorice. Report new swelling, rising BP, weakness or palpitations; clinicians may check electrolytes. Do not add potassium, change hydrocortisone or rely on a few hours of separation to counter the potential problem.
Evidence and practical considerations
Side effects & toxicity
Defined glycyrrhizin-containing licorice warrants an electrolyte/BP precaution with hydrocortisone; this is not a measured exact-pair event rate or universal metabolism effect.
- Exact scope
- Oral hydrocortisone with glycyrrhizin-containing Glycyrrhiza glabra root/stolon preparations. Deglycyrrhizinated products and uncharacterized extracts differ. with Exact RxNorm 5492 IN hydrocortisone, also called cortisol; CORTEF plain oral tablets. Cortisone acetate is a different administered drug, and injectable esters or topical products are not equivalent exposure.
- Medication form and route
- Oral
What remains uncertain
- Exact-drug label plus preparation-specific class precaution and supplement trial, not a controlled exact-pair study. The bundled QT/arrhythmia claim is not established as an intrinsic pair effect; low potassium is a separate risk pathway.
Factors that may matter: Exact oral preparation and dose; Treatment duration and indication; Blood pressure and electrolyte status; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed CORTEF hydrocortisone oral tablets.
Describes dose-related salt/water retention, potassium loss, calcium excretion and systemic corticosteroid precautions; replacement requirements and tapering depend on indication.
How this applies: Exact ingredient and specified formulation. Exact RxNorm 5492 IN hydrocortisone, also called cortisol; CORTEF plain oral tablets. Cortisone acetate is a different administered drug, and injectable esters or topical products are not equivalent exposure.
Physiologic replacement is not equated with higher anti-inflammatory doses. Cortisone acetate studies and endogenous cortisol measurements are not direct tablet PK trials.
Source 2: Final regulatory assessment
ema.europa.eu · Source check Sep 10, 2026
Population: Users of defined G.glabra, G.inflata or G.uralensis root/stolon preparations.
BP elevation, fluid retention and potassium loss; precaution against corticosteroid co-use that could aggravate electrolyte imbalance. Explicitly rejects assuming inhibition of every corticosteroid and notes dexamethasone counterevidence.
How this applies: Preparation-limited electrolyte/BP precaution; steroid-specific counterevidence retained.
Not an exact hydrocortisone combination incidence or universal PK effect. Deglycyrrhizinated products and processed Gan cao preparations differ.
Source 3: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 28 healthy young adults in a randomized crossover.
Home systolic BP increased and renin/aldosterone were suppressed.
How this applies: Applicable only to the stated preparation, route and endpoints; other-drug evidence is indirect.
Abstract-only; no hydrocortisone co-use or universal safe amount. Trial changes of 3.1 versus -0.3 mm Hg are not a 3.1 mm Hg between-treatment estimate.
Source 4: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
hydrocortisone is IN.
How this applies: Exact ingredient.
Not clinical evidence.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Sources checked and article drafted. | |
| Research summary published |
Article revision: 4975a580fb29db7b
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.