MODERATE — Monitor Closely
🟡 CAUTION — Licorice root causes pseudoaldosteronism (sodium retention, potassium wasting, blood pressure elevation) that directly opposes Ramipril. Avoid licorice root if taking antihypertensive medications, or use DGL (deglycyrrhizinated licorice) which lacks this effect.
Evidence level: STRONG
Licorice root acts like a steroid hormone in your body, causing sodium and water retention that pushes blood pressure up. Ramipril lowers blood pressure by reducing angiotensin II production. When licorice overrides this through a completely separate pathway (mineralocorticoid receptor activation), Ramipril cannot compensate.
Glycyrrhizin in licorice root inhibits 11-beta-hydroxysteroid dehydrogenase type 2, causing cortisol to activate mineralocorticoid receptors (pseudoaldosteronism). This causes sodium retention, potassium wasting, and blood pressure elevation — directly opposing the antihypertensive action of Ramipril.
Discontinue licorice root while on Ramipril. This is especially critical if you take Ramipril post-heart attack for cardiac protection — uncontrolled blood pressure undermines the cardiovascular benefits your doctor prescribed it for. Check ingredient labels on herbal teas, as many contain licorice root. DGL licorice is the safe alternative.
Take Ramipril at a consistent time daily. Licorice Root — be mindful of potassium-rich foods (bananas, potatoes, tomatoes, avocados). ACE inhibitors raise potassium levels, and excessive dietary potassium on top of this can cause dangerous hyperkalemia. Moderate intake is fine.
Higher risk for: those with renal impairment, hyperkalemia risk, concurrent potassium-sparing diuretics or potassium supplements, elderly, dehydrated patients, or those with bilateral renal artery stenosis.
Rising blood pressure despite medication, headache, swelling in legs/ankles, muscle weakness or cramps, irregular heartbeat (from low potassium).
No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.
ACE inhibitor interactions often involve potassium levels or blood pressure effects. Ask your doctor about ARBs as alternatives, or adjust the timing of the interacting substance. Monitor potassium levels and blood pressure regularly.
Licorice root acts like a steroid hormone in your body, causing sodium and water retention that pushes blood pressure up. Ramipril lowers blood pressure by reducing angiotensin II production. When licorice overrides this through a completely separate pathway (mineralocorticoid receptor activation), Ramipril cannot compensate.
Take Ramipril at a consistent time daily. Licorice Root — be mindful of potassium-rich foods (bananas, potatoes, tomatoes, avocados). ACE inhibitors raise potassium levels, and excessive dietary potassium on top of this can cause dangerous hyperkalemia. Moderate intake is fine.
Rising blood pressure despite medication, headache, swelling in legs/ankles, muscle weakness or cramps, irregular heartbeat (from low potassium).
ACE inhibitor interactions often involve potassium levels or blood pressure effects. Ask your doctor about ARBs as alternatives, or adjust the timing of the interacting substance. Monitor potassium levels and blood pressure regularly.
No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.
Or browse the full interaction database (121,000+ pairs).