The short answer
An extra risk of low blood pressure or kidney injury from combining uva ursi with enalapril has not been established. Bearberry leaf medicines should still be avoided in people with kidney disorders, regardless of which blood-pressure medicine they take.
What this answer covers
Oral Arctostaphylos uva-ursi leaf preparations, including tea and extracts. Evidence does not cover other plant parts or every mixed urinary product.
- Supplement or preparation
- uva ursi (bearberry leaf)
- Medication ingredient
- enalapril
Has this combination been studied?
The reviewed sources did not identify a human study showing that bearberry leaf increases enalapril-related low blood pressure or kidney injury. The European monograph lists no reported medicine interactions. That is a gap in evidence, not proof that combining the products is safe.
Why does kidney health still matter?
Bearberry leaf medicines are contraindicated in people with kidney disorders. Enalapril also requires attention to kidney function, especially when a person becomes dehydrated. These separate precautions justify discussing the product with your prescriber, but do not show that bearberry directly damages the kidneys when added to enalapril.
Does research on urinary infections settle the question?
A 2025 European review included newer trials of bearberry leaf for urinary symptoms and antibiotic use. Those studies do not answer the enalapril interaction question. Do not use a urinary-symptom product as a reason to delay assessment of fever, blood in the urine or worsening symptoms.
What should I check before using it?
Show your pharmacist the plant part and full ingredient list. European bearberry leaf instructions limit use to one week and advise professional review if symptoms persist beyond four days. Report vomiting or lightheadedness while taking enalapril, because fluid loss itself can lower blood pressure further. There is no established enalapril-specific dose-spacing rule for this herb.
Evidence and practical considerations
Side effects & toxicity
No qualifying evidence was found that oral bearberry leaf specifically increases hypotension or kidney injury during enalapril treatment.
- Exact scope
- Oral Arctostaphylos uva-ursi leaf preparations, including tea and extracts. Evidence does not cover other plant parts or every mixed urinary product. with Enalapril, exact RxCUI 3827, inventory name enalapril, TTY IN. The inspected enalapril maleate label explicitly identifies the maleate salt of enalapril and its hydrolysis to enalaprilat. This is the salt-to-IN bridge for oral tablets and solution. The solution label also includes tablet clinical data. Do not transfer these conclusions to injected enalaprilat, combination products, or other ACE inhibitors without a separate rationale.
- Medication form and route
- oral
- Timing or duration
- No pair-specific duration threshold established.
What remains uncertain
- Absence of located evidence does not prove absence of an interaction. Available urinary-symptom trials did not test this pair.
Factors that may matter: exact leaf preparation; limited direct human evidence.
Read the supporting source summaries
Source 1: regulatory herbal assessment
ema.europa.eu · Source check Sep 10, 2026
Population: Adult women using specified bearberry leaf preparations for mild recurrent lower urinary tract symptoms after serious conditions are excluded.
Kidney disorders are a contraindication. The interaction section records none reported. Nausea, vomiting and stomach ache are reported; frequency is unknown.
How this applies: Exact Arctostaphylos uva-ursi species; explicit leaf-only boundary. The kidney-disease restriction matters independently of enalapril, while a pair-specific kidney-injury claim remains unproven.
A traditional-use monograph is not an enalapril coadministration study. None reported does not mean interactions have been ruled out. Applies to leaf preparations, not every part or mixed product.
Source 2: regulatory herbal assessment
ema.europa.eu · Source check Sep 10, 2026
Population: Review of 2016-2024 literature and pharmacovigilance, including adult women with uncomplicated urinary tract infection.
Identified 20 new adverse events, including expected gastrointestinal symptoms, without a changed safety profile. New urinary-tract trials exist, correcting the older summary that no single-ingredient clinical trials were available.
How this applies: Current context for leaf preparations only. Neither this review nor the targeted search establishes extra hypotension or kidney injury caused by the exact enalapril pair.
Trials addressed urinary symptoms or antibiotic use, not enalapril exposure or blood-pressure interactions. Surveillance lacks a denominator and cannot establish absence of rare harm.
Research assessment: · Open full citations ↗
Timing & monitoring
Bearberry leaf has a kidney-disorder contraindication; enalapril users with renal disease or fluid loss need clinician review before use.
- Exact scope
- Oral Arctostaphylos uva-ursi leaf preparations, including tea and extracts. Evidence does not cover other plant parts or every mixed urinary product. with Enalapril, exact RxCUI 3827, inventory name enalapril, TTY IN. The inspected enalapril maleate label explicitly identifies the maleate salt of enalapril and its hydrolysis to enalaprilat. This is the salt-to-IN bridge for oral tablets and solution. The solution label also includes tablet clinical data. Do not transfer these conclusions to injected enalaprilat, combination products, or other ACE inhibitors without a separate rationale.
- Medication form and route
- oral
- Timing or duration
- EMA leaf preparations are restricted to short use, no more than one week.
What remains uncertain
- This is a disease and volume-status precaution, not evidence of additive botanical nephrotoxicity.
Factors that may matter: kidney disorder; vomiting or dehydration.
Read the supporting source summaries
Source 1: regulatory herbal assessment
ema.europa.eu · Source check Sep 10, 2026
Population: Adult women using specified bearberry leaf preparations for mild recurrent lower urinary tract symptoms after serious conditions are excluded.
Kidney disorders are a contraindication. The interaction section records none reported. Nausea, vomiting and stomach ache are reported; frequency is unknown.
How this applies: Exact Arctostaphylos uva-ursi species; explicit leaf-only boundary. The kidney-disease restriction matters independently of enalapril, while a pair-specific kidney-injury claim remains unproven.
A traditional-use monograph is not an enalapril coadministration study. None reported does not mean interactions have been ruled out. Applies to leaf preparations, not every part or mixed product.
Source 2: regulatory prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed oral enalapril for hypertension, heart failure or asymptomatic left ventricular dysfunction.
Warns that volume or salt depletion can produce excessive hypotension and renal consequences. Serum potassium should be monitored. Potassium supplements can cause hyperkalemia. Describes the maleate salt and conversion to enalaprilat.
How this applies: Applies to oral enalapril through the explicit maleate-to-enalapril bridge. Physiologic susceptibility is relevant when a botanical causes fluid loss or opposes blood-pressure control; this is an explicit clinical inference.
No named botanical interaction is measured. These medication-specific warnings establish susceptibility and monitoring context, not the incidence or magnitude of any botanical interaction.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Original evidence and current official source documents inspected. Article distinguishes measured findings, preparation limits and remaining uncertainty. | |
| Research summary published |
Article revision: 04882d6b407cf80d
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.