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Because physical exercise increases the demand on the weakened heart, measures of exercise tolerance are frequently used to monitor the severity of heart failure

It is widely used in medicine, used as a nutritional supplement

Important safety considerations when using these supplements together include: Drug interactions : Berberine may potentially interact with numerous medications, including antidiabetic drugs (increasing hypoglycaemia risk), anticoagulants, and medications metabolised by CYP450 enzymes (such as ciclosporin and certain statins)

Am J Physiol Heart Circ Physiol

References (1) Flanagan JL, et al

Results from another uncontrolled intervention in 21 HIV-positive patients suggested that long-term (two to four years) oral ALCAR supplementation (1.5 g/day) may be a beneficial adjunct to antiretroviral therapy to improve neuropathic symptoms in some HIV-infected individuals (80, 81)