Beetroot and dietary nitrate has 3 documented interactions in Magellan’s curated dataset, covering Nitrate vasodilators (nitroglycerin), PDE5 inhibitors (sildenafil, tadalafil), Blood pressure medications, Statins (cholesterol medications), Immunosuppressants, Sedatives and sleep medications and others. Each entry below gives the mechanism as the cited reference states it, the direction the risk runs, how serious that reference treats it, and what to actually do about it — which is, in every case, a conversation with the clinician or pharmacist who manages the prescription rather than a decision you make alone.
What it is. Beetroot (Beta vulgaris) is a root vegetable that is one of the richest dietary sources of inorganic nitrate; concentrated beetroot juice and 'shots' are widely used as nitrate supplements. After ingestion, nitrate is reduced to nitrite by bacteria on the tongue and is then converted in the body to nitric oxide, a signaling molecule that relaxes blood vessels (vasodilation) and increases blood flow.
Where it sits on the evidence. Magellan grades the supplement itself as Moderate evidence, with a typical studied dose of >=6 mmol (about 370 mg) nitrate/day gave the best exercise effects in an umbrella review. That grade is about whether it works, not about whether it is safe alongside your medication — the two questions are independent, and this page answers only the second.
Products this covers: Beetroot / Dietary Nitrate.
How the risks cluster. The entries split across 2 different mechanisms — additive; drug levels — and they are not managed the same way, so read each one rather than assuming a single rule covers all of them.
Safety and efficacy are separate questions, and this page only answers the first. For the second, the study Magellan’s coverage of Beetroot and dietary nitrate rests on is:
“Pivotal RCT in hypertensive patients (n=68, 4 weeks): daily nitrate-rich beetroot juice lowered clinic BP by 7.7/2.4 mmHg and 24-h ambulatory BP by 7.7/5.2 mmHg, improved endothelial function ~20%, with no tachyphylaxis.”
A strong result does not make a supplement safe alongside your prescription, and a documented interaction does not mean the supplement does not work. Magellan grades those two things separately, and neither grade moves for a commission.
Magellan’s Medication Safety Check runs entirely on your device — type the medicines you take and it flags every documented interaction in this dataset. Nothing you type is sent anywhere.
Open the Medication Safety Check →Dietary nitrate from beetroot is converted to nitric oxide in the body; combining nitric-oxide-raising intake with PDE5 inhibitors or nitrate medications produces additive vasodilation that can cause a dangerous drop in blood pressure, the same well-documented mechanism behind the pharmaceutical nitric-oxide-plus-sildenafil interaction.
Medicines in this group include: Nitroglycerin (Nitrostat, Nitro-dur), Isosorbide mononitrate (Imdur), Isosorbide dinitrate (Isordil), Sildenafil (Viagra, Revatio), Tadalafil (Cialis, Adcirca), Vardenafil (Levitra).
Beetroot/dietary nitrate itself has a blood-pressure-lowering effect; combined with antihypertensive medications it may cause additive blood pressure lowering, warranting monitoring, especially at supplement (vs. dietary) doses.
Medicines in this group include: Amlodipine (Norvasc), Diltiazem (Cardizem, Tiazac), Verapamil (Calan, Verelan), Nifedipine (Procardia, Adalat), Hydrochlorothiazide (Hctz, Microzide), Chlorthalidone (Thalitone), Indapamide (Lozol), Furosemide (Lasix) and 9 more.
Beet may alter how quickly the liver metabolizes CYP3A4-substrate drugs, potentially changing their effectiveness or side effects.
Medicines in this group include: Atorvastatin (Lipitor), Simvastatin (Zocor), Rosuvastatin (Crestor), Lovastatin (Mevacor, Altoprev), Pravastatin (Pravachol), Pitavastatin (Livalo), Fluvastatin (Lescol), Cyclosporine (Neoral, Sandimmune) and 20 more.
These are the warning signs that go with the medication classes on this page. They are general safety-netting, not a prediction that any supplement will cause them.
If something feels seriously wrong, do not wait for an appointment. Call 911 (US) or your local emergency number.
Severity describes the interaction as the cited reference frames it, not how a specific person will react. A “minor” entry in someone with kidney disease, on five other drugs, can matter more than a “major” one in someone on nothing else.
This is a curated set of interactions with citations — not an exhaustive pharmacology database. An interaction that is absent here has not been ruled out; it may simply not be documented in the references Magellan curates from. Supplements are also not batch-tested for identity or contamination the way prescription drugs are, so what is on the label is a claim rather than a guarantee. And most of these entries come from case reports and mechanistic work rather than randomized trials, which is exactly why the sensible response is a pharmacist review rather than either alarm or dismissal.
43 documented interactions across 24 supplements.
15 documented interactions across 14 supplements.
9 documented interactions across 9 supplements.
3 documented interactions · shares a drug class with Beetroot and dietary nitrate.
2 documented interactions · shares a drug class with Beetroot and dietary nitrate.
2 documented interactions · shares a drug class with Beetroot and dietary nitrate.
3 documented interactions · shares a drug class with Beetroot and dietary nitrate.
The mechanism and the research behind the compound itself.
The mechanism and the research behind the compound itself.
A–Z of every supplement and drug class in this dataset, plus how to read an interaction.
What the research actually shows, graded independently of affiliate commissions.
Not without checking with the prescriber or pharmacist first. Magellan's dataset grades this as a major interaction: Dietary nitrate from beetroot is converted to nitric oxide in the body; combining nitric-oxide-raising intake with PDE5 inhibitors or nitrate medications produces additive vasodilation that can cause a dangerous drop in blood pressure, the same well-documented mechanism behind the pharmaceutical nitric-oxide-plus-sildenafil interaction. (Source: Nitric Oxide and Viagra (Sildenafil) Drug Interactions.)
3 interactions are documented in Magellan's curated dataset: 1 major, 1 moderate, 1 minor. They cover Nitrate vasodilators (nitroglycerin), PDE5 inhibitors (sildenafil, tadalafil), Blood pressure medications, Statins (cholesterol medications), Immunosuppressants. Absence from this list is not proof of safety — it means no interaction is documented in the references we curate from.
Magellan lists the typical studied dose as: >=6 mmol (about 370 mg) nitrate/day gave the best exercise effects in an umbrella review. Dose matters for interactions — several of the entries on this page describe effects that only appear at supplemental rather than dietary intakes.