Aloe Vera Juice: Is It Safe to Take With Other Medications?

Although generally considered safe when used topically, aloe vera capsules or juice taken orally can react with certain drugs.

Aloe vera interactions with medications can reduce bioavailability, making drugs less effective or increase the response that may trigger negative reactions and side effects.

What Is Aloe Vera?

Aloe vera is a succulent plant grown in tropical and subtropical regions. Historically, it was used in ancient cultures, including Greece, Rome, and China, to treat skin conditions and promote wound healing, according to the National Center for Complementary and Integrative Health (NCCIH).

Many antibacterial and antimicrobial properties are associated with the pulp of the aloe leaves.

Aloe contains proteins, lipids, amino acids, vitamins, inorganic and small organic compounds, enzymes, and various carbohydrates. Due to its potential healing attributes, the pulp of the aloe has traditionally been used to make a clear gel for topical use, or a yellow latex oral form, as a remedy for a wide range of clinical uses.

Topically, aloe is used for skin conditions like burns, frostbite, psoriasis, and cold sores. As a dietary supplement or juice, aloe vera may be used to help reduce heartburn, relieve constipation, and boost vitamin and mineral intake, according to Cleveland Clinic.

Juice containing aloe vera may add variety to your beverage intake, but be aware that many of its beneficial health claims are unsubstantiated, NCCIH notes. Aloe vera juice is generally considered safe if not taken in high doses but can cause unhealthy outcomes if combined with some medications or other supplements.

Aloe Vera Interactions With Medications

Aloe vera juice is a potent laxative and is often used to cleanse the digestive system or relieve constipation. According to the National Institute of Environmental Health Sciences, the outer pulp of aloe leaves used to make juice is made up of an organic component known as latex, which contains anthraquinones. Anthraquinones, such as aloin, give the plant its laxative qualities.

Many drugs you take orally can become less effective when combined with aloe vera, according to Mayo Clinic. In some cases, aloe can reduce the bioavailability or block the action of the co-administered drug. In others, it can enhance the effect of the medication, triggering or worsening the drug's side effects.

Speak with your doctor if you intend to drink aloe vera juice and take any of the following drugs or supplements:

• Anticoagulants and antiplatelet medications: These types of drugs, herbs, and supplements reduce blood clotting, as may oral use of aloe. If you drink aloe vera juice with either of these types of medications, the result might be increased bleeding.
• Cardiac glycosides, such as digoxin (Lanoxin): Since aloe latex can decrease potassium levels, low potassium might increase the side effects of digoxin if you take aloe and digoxin together.
• Some anesthesias used during surgery, such as sevoflurane (Ultane): These drugs are used to slow blood clotting, but aloe vera taken orally might have a similar effect. If used in combination, excessive bleeding during surgery is possible.
• Stimulant laxatives: Due to the laxative effects of aloe vera, do not use in conjunction with other stimulant laxative medications. Overstimulation of your bowels can lead to dehydration.
• Warfarin (Coumadin, Jantoven): Aloe vera can cause diarrhea and increase the effects of warfarin, which is a blood-thinning drug. This combination could increase the risk of bleeding.
• Diuretics, also known as water pills: Drinking aloe vera juice while using diuretics might decrease potassium levels too much and create a deficiency.

In addition to the risk of aloe vera interactions with medications, the use of aloe vera preparations should be avoided if you have an allergy to plants of the Liliaceae family (garlic, onions, and tulips).

Possible Side Effects of Aloe Vera Juice

Aloe vera juice made from latex or whole-leaf extract is likely to be unsafe in high doses, as excessive intake for several days can cause acute kidney failure and can even be fatal, according to Mayo Clinic.

If you’re interested in trying aloe vera juice and have not had it before, start out with small doses (a couple of ounces) to see how your body reacts. You can gradually drink more, but do not exceed 1 cup per day, advises Cleveland Clinic.

Many people experience aloe vera side effects from using it as a laxative, which can include diarrhea and abdominal cramps. Mayo Clinic warns that oral laxatives may also lead to dehydration and the risk of an electrolyte imbalance, especially after prolonged use. Electrolytes — including calcium, chloride, potassium, magnesium, and sodium — regulate many bodily functions.

An electrolyte imbalance can cause weakness, confusion, abnormal heart rhythms, and seizures. Dangerously low levels of potassium can lead to fatigue, muscle weakness, and irregular heartbeats.

To avoid unwanted side effects and electrolyte imbalances, do not use aloe vera juice or any other laxative long term unless directed by a healthcare provider.