The short answer
Goldenseal may alter diazepam exposure by inhibiting drug metabolism, but this exact combination has not been measured in a human study. The concern is not proven increased intestinal absorption.
What this answer covers
Hydrastis canadensis extracts; not isolated berberine or all root preparations.
- Supplement or preparation
- Hydrastis canadensis
- Medication ingredient
- diazepam
The clinical enzyme evidence used another drug
Goldenseal increased oral midazolam exposure in a human study. That supports CYP3A inhibition but does not supply a numerical change for diazepam.
Diazepam has its own metabolic pathways
Diazepam uses CYP3A4 and CYP2C19 and produces active metabolites. A midazolam result cannot fully predict its parent/metabolite balance or duration of sedation.
Absorption is not the established endpoint
The available evidence raises a metabolic-exposure possibility. It does not prove increased intestinal uptake, identify an exact risk rate or establish that every goldenseal extract behaves similarly.
Review before starting or stopping the product
Tell the prescriber the preparation and dose. Do not change diazepam yourself or assume a short gap prevents systemic enzyme effects. Seek advice for unexpected sedation or a change in therapeutic response.
Evidence and practical considerations
Absorption & effectiveness
Conditional metabolic-exposure concern based on human goldenseal CYP3A probe evidence plus diazepam label; exact-pair concentrations, intestinal uptake and active-metabolite outcome unknown.
- Exact scope
- Hydrastis canadensis extracts; not isolated berberine or all root preparations. with Diazepam3322 IN; oral, IV/IM and intranasal formulations, active metabolites and study-route limits.
- Medication form and route
- oral medication; intravenous medication; intramuscular medication; intranasal medication; oral supplement
What remains uncertain
- No unmeasured pair incidence, blanket class transfer or arbitrary spacing interval.
Factors that may matter: Preparation; Dose; Other medicines; Organ function.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed diazepam
CNS-depressant risk; CYP3A4/2C19 formation of active metabolites with prolonged elimination.
How this applies: Exact diazepam RxCUI 3322 IN, with stated salt/formulation/route bridge.
Not midazolam metabolism or proof of exact botanical risk.
Source 2: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed diazepam
Sedation and respiratory precautions with other CNS depressants.
How this applies: Exact diazepam RxCUI 3322 IN, with stated salt/formulation/route bridge.
Bypasses intestinal absorption; oral juice exposure magnitude cannot be transferred.
Source 3: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed diazepam
CNS-depressant and metabolism-related interaction precautions; exact rescue dosing directions.
How this applies: Exact diazepam RxCUI 3322 IN, with stated salt/formulation/route bridge.
Not oral-study dosing or a basis to delay prescribed rescue treatment; rectal preparations not directly studied here.
Source 4: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 16 healthy volunteers.
Goldenseal increased midazolam exposure; kava did not significantly alter its disposition.
How this applies: Original source interpreted for diazepam only within the stated preparation and endpoint limits.
Human goldenseal plus oral midazolam study, not diazepam, its active metabolites or CYP2C19-specific disposition.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Prepared exact diazepam article with formulation-specific evidence and uncertainty. |
Article revision: f9c169096c3de5b4
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?
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Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.