Aloe Vera Juice Drug Interactions

In our latest question and answer, the pharmacist discusses whether or not aloe vera juice has any drug interactions.

Mar 29, 2018

Queenel asked

Could my husband drink aloe Vera juice while taking omeprazole? He is also taking losartan, rosuvastatin, aspirin, levothyroxine and a multi vitamin. Thank you

Answer

Aloe is a popular over the counter supplement/topical product that is used for a wide range of conditions including:

  • Burns
  • Acne
  • Inflammation
  • Constipation
  • Gastritis
  • High cholesterol
  • High blood sugar

Aloe products are generally extracted from the leaf of the cactus like plant and contain many different active constituents. Aloe gel specifically is obtained from the 'mucilaginous' plant cells in the center of the leaf.


Oral aloe products are generally obtained from a different part of the aloe plant leaf than the aloe gel. These aloe extracts are generally referred to as 'aloe latex'. Aloe latex, like aloe gel, contains the numerous active components.

Aloe Vera Drug Interactions

In regard to drug interactions with oral aloe products, there isn't much data to indicate any major interactions.

However, taking aloe vera by mouth is known to have significant stimulant laxative effects, which could potentially alter how oral drugs taken at the same time are absorbed.

The anthraquinones contained in aloe vera products are the constituents thought to have the laxative effects in individuals. They irritate mucous membranes, which increases GI secretions and induces peristalsis, which increases how fast contents move through the GI tract. 

As aloe vera can increase how quickly things move through the GI tract, it generally isn't recommended to take at the same time as other oral medications. Doing so could potentiality cause an overall decrease in the absorption of oral medication.

As a general recommendation with laxatives, oral medications should be:

  • Dosed at least 30 to 60 minutes before oral aloe products or 2 to 4 hours after aloe vera juice.
  • If taking extended release medications, oral aloe products aren't recommended.

Below are some other potential drug interactions based on studies and case reports:

  • Anticoagulant Drugs: Aloe vera may decrease certain clotting factors, increasing the risk of bleeding when used with anticoagulant/anti-platelet drugs. 
  • Anti-diabetic Drugs: Aloe very may decrease blood sugar, potentiality leading to hypoglycemia in those taking other anti-diabetic drugs.
  • Digoxin: Due to potential electrolyte depletion (e.g. potassium) from the laxative effects of aloe vera, there are potential interactions with drugs like digoxin.

The evidence behind the above interactions are lacking and more evidence is needed to make a better determination of aloe vera drug interactions. As with all over the counter supplements, it is important to let your doctor know if you plan on taking them so you can be appropriately monitored.

Summary

  • In terms of drug interactions, oral aloe vera has a stimulant laxative effect and can increase the speed at which medications and food move through the GI tract. Therefore, aloe vera should ideally not be taken at the same time as oral medications.
  • Aloe vera may also interact with other medications such as anticoagulant and anti-diabetic medication but more information is needed.

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