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Hibiscus (Hibiscus spp.)



Interactions

Hibiscus/Drug Interactions:
  • AntibioticsAntibiotics: In laboratory research, various Hibiscus species have exhibited antimicrobial activity against Escherichia coli O157:H7, Proteus mirabilis, Bacillus subtilis, Listeria monocytogenes, Staphylococcus aureus, Enterobacter aerogenes, Bacillus cereus,Salmonella enterica, Salmonella typhimurium DT104 and Shigella flexneri (42; 43; 44; 45; 46).
  • Antidiabetic agentsAntidiabetic agents: In human research, H. sabdariffa extract powder (HSEP) significantly reduced glucose (31).
  • AntihypertensivesAntihypertensives: In human research, hibiscus extracts reduced systolic and diastolic pressure (3; 4; 31).
  • Anti-inflammatoriesAnti-inflammatories: Based on a pharmacokinetic study, zobo drink (made from hibiscus) may cause significant changes (p<0.05) in K-beta and t1/2beta of acetaminophen when given 90 minutes beforehand (47). In laboratory research, constituents of Hibiscus exhibited anti-inflammatory properties (48) and Hibiscus sabdariffa aqueous extract facilitated in the production of inflammatory cytokines, including IL-6 and IL-8 (49).
  • AntilipemicsAntilipemics: In human research, Hibiscus sabdariffa extract increased and decreased total cholesterol, LDL-C, triglycerides, TAB/HDL-C ratio, and VLDL-C, phospholipids, and atherogenic index, as well as increased and decreased HDL-C (29; 31).
  • AntimalarialsAntimalarials: Based on a pharmacokinetic study, 500mg karkadi beverage (Hibiscus sabdarifa) may reduce antimalarial (quinine) efficacy (50).
  • AntineoplasticsAntineoplastics: Hibiscus has shown anticancer effects in laboratory and animal studies (12; 13; 14; 10).
  • AntiviralsAntivirals: Antiviral effects have been observed in preliminary laboratory study (10).
  • Cardiovascular agentsCardiovascular agents: In human research, H. sabdariffa extract reduced systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure (31; 4; 3; 37; 38).
  • Chloroquine, Chloroquine: Based on a pharmacokinetic study, reduced effectiveness of chloroquine is possible (50).
  • Fertility agentsFertility agents: According to review, Hibiscus rosa-sinensis has exhibited antifertility activity (16) and various hibiscus plant alkaloids have been studied for their male antifertility effects (51).
  • Gastrointestinal agentsGastrointestinal agents: In human research, nausea (29) and mild gastrointestinal symptoms, including abdominal distention, gas, and epigastric pain (30) have been reported following administration of Hibiscus sabadariffa extract.
  • Genitourinary tract agentsGenitourinary tract agents: In human research, dysuria and difficulty urinating have been reported following administration of H. sabadariffa extract (29).
  • Hormonal agentsHormonal agents: According to review, Hibiscus rosa-sinensis may have estrogenic activity, although the clinical significance is unclear (52).
  • HydrochlorothiazideHydrochlorothiazide: In animal research, Hibiscus sabdariffa L. extract in combination with hydrochlorothiazide (HCTZ) significantly increased urine volume, increased and prolonged HCTZ plasma concentration, mean area under the curve, and volume of distribution, decreased urine pH, and sodium, bicarbonate, and chloride ion concentrations , and dose-dependently decreased HCTZ plasma clearance and elimination rate constant (53).
  • ImmunostimulantsImmunostimulants: In laboratory research, Hibiscus sabdariffa extract exhibited imunoprotective effects (54).
  • ImmunosuppressantsImmunosuppressants: In laboratory research, Hibiscus sabdariffa extract exhibited imunoprotective effects (54).
  • Neurologic agentsNeurologic agents: In human research, tremor and headache have been reported following administration H. sabadariffa extract (29).
  • Otic agentsOtic agents: In human research, tinnitus has been reported following administration of H. sabdariffa extract (29).
  • PhotosensitizersPhotosensitizers: In vitro, Hibiscus cannabinus was identified as a photosensitizer (41).
  • Renal agentsRenal agents: In healthy men, consumption of H. sabdariffa has resulted in significant decreases in the urinary concentrations of creatinine, uric acid, citrate, tartrate, calcium, sodium, potassium, and phosphate, but not oxalate (6). Another study in healthy men showed that the urine after consumption of roselle juice showed a decrease of creatinine, uric acid, citrate, tartrate, calcium, sodium, potassium, and phosphate, but not oxalate in urinary excretion (21).

Hibiscus/Herb/Supplement Interactions:
  • AntibacterialsAntibacterials: In laboratory research, various Hibiscus species have have exhibited antimicrobial activity against Escherichia coli O157:H7, Proteus mirabilis, Bacillus subtilis, Listeria monocytogenes, Staphylococcus aureus, Enterobacter aerogenes, Bacillus cereus,Salmonella enterica, Salmonella typhimurium DT104 and Shigella flexneri (42; 43; 44; 45; 46).
  • Anti-inflammatoriesAnti-inflammatories: Based on a pharmacokinetic study, zobo drink (made from hibiscus) may cause significant changes (p<0.05) in K-beta and t1/2beta of acetaminophen when given 90 minutes beforehand (47). In laboratory research, constituents of Hibiscus exhibited anti-inflammatory properties (48) and Hibiscus sabdariffa aqueous extract facilitated in the production of inflammatory cytokines, including IL-6 and IL-8 (49).
  • AntilipemicsAntilipemics: In human research, Hibiscus sabdariffa extract increased and decreased total cholesterol, LDL-C, triglycerides, TAB/HDL-C ratio, and VLDL-C, phospholipids, and atherogenic index, as well as increased and decreased HDL-C (29; 31).
  • AntimalarialsAntimalarials: Based on a pharmacokinetic study, 500mg karkadi beverage (Hibiscus sabdarifa) may reduce the efficacy of antimalarial herbs and supplements (50).
  • AntineoplasticsAntineoplastics: Hibiscus has shown anticancer effects in laboratory and animal studies (12; 13; 14; 10).
  • AntioxidantsAntioxidants: In human and animal research, various species of Hibiscus reduced oxidative stress (34), protected against oxidative damage (20), exhibited antioxidant activity (55; 56).
  • AntiviralsAntivirals: Antiviral effects have been observed in preliminary laboratory study (10).
  • Cardiovascular agentsCardiovascular agents: In human research, H. sabdariffa extract reduced systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure (31; 4; 3; 37; 38).
  • Fertility agentsFertility agents: According to review, Hibiscus rosa-sinensis has exhibited antifertility activity (16) and various hibiscus plant alkaloids have been studied for their male antifertility effects (51).
  • Gastrointestinal agentsGastrointestinal agents: In human research, nausea (29) and mild gastrointestinal symptoms, including abdominal distention, gas, and epigastric pain (30) have been reported following administration of Hibiscus sabadariffa extract.
  • Hormonal agentsHormonal agents: Based on a review of the literature, Hibiscus rosa-sinensis may have estrogenic activity, although the clinical significance is unclear (52).
  • HypoglycemicsHypoglycemics: In human research, H. sabdariffa extract powder (HSEP) significantly reduced glucose (31).
  • HypotensivesHypotensives: In human research, hibiscus extracts reduced systolic and diastolic pressure (3; 4; 31).
  • KavaKava: In laboratory research, concomitant kava and Hibiscus tiliaceus use cause skin inflammations (57).
  • ImmunomodulatorsImmunomodulators: In laboratory research, Hibiscus sabdariffa extract exhibited imunoprotective effects (54).
  • Neurologic agentsNeurologic agents: In human research, tremor and headache have been reported following administration H. sabadariffa extract (29).
  • PhotosensitizersPhotosensitizers: In vitro, Hibiscus cannabinus was identified as a photosensitizer (41).
  • Renally eliminated agentsRenally eliminated agents: In healthy men, consumption of H. sabdariffa has resulted in significant decreases in the urinary concentrations of creatinine, uric acid, citrate, tartrate, calcium, sodium, potassium, and phosphate, but not oxalate (6). Another study in healthy men showed that the urine after consumption of roselle juice showed a decrease of creatinine, uric acid, citrate, tartrate, calcium, sodium, potassium, and phosphate, but not oxalate in urinary excretion (21).

Hibiscus/Food Interactions:
  • Insufficient available evidence.

Hibiscus/Lab Interactions:
  • Ascorbic acidAscorbic acid: In human research, HSE slightly changed ascorbic acid plasma concentrations over time, although significant between-group differences were lacking (34).
  • Blood pressureBlood pressure: In human research, hibiscus extracts reduced systolic and diastolic pressure (3; 4; 31).
  • GlucoseGlucose: In human research, H. sabdariffa extract powder reduced glucose (31).
  • Lipid levelsLipid levels: In human research, Hibiscus sabdariffa extract increased and decreased total cholesterol, LDL-C, triglycerides (TAG), TAG/HDL-C ratio, and VLDL-C, phospholipids, and atherogenic index, as well as increased and decreased HDL-C (29; 31; 36).
  • Liver enzymesLiver enzymes: In human research, H. sabdariffa extract powder decreased AST (31).
  • Uric acidUric acid: In human research, HSE slightly changed uric acid plasma concentrations over time, although significant between-group differences were lacking (34).
  • Urinary concentrationsUrinary concentrations: In healthy men, consumption of Hibiscussabdariffa has resulted in significant decreases in the urinary concentrations of creatinine, uric acid, citrate, tartrate, calcium, sodium, potassium, and phosphate, but not oxalate (6).

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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