Avoid in individuals with a known allergy or hypersensitivity to lotus (Nelumbo nucifera).

Few adverse effects in humans have been reported for lotus. Lotus may cause flatulence (gas), constipation and other gastrointestinal irritation. Avoid in patients with constipation and stomach distension (swelling).

Theoretically, lotus may lower blood pressure and have antiarrhythmic (treats abnormal heart beat) and contraceptive activity. Lotus may also increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking agents that may increase the risk of bleeding. Dosing adjustments may be necessary.

Lotus is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Although not well studied in humans, Nelumbo nucifera seed may have antifertility activity.

There is no proven safe or effective dose for lotus in adults, and use is not recommended.

There is no proven safe or effective dose for lotus in children, and use is not recommended.

Alkaloids isolated from lotus have been noted to have anti-arrhythmic activity and may interact with anti-arrhythmic drugs. Patients taking medications aimed at maintaining sinus rhythm and suppressing atrial fibrillation should use lotus cautiously as the effects may be additive.

Neferine from Nelumbo nucifera may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Theoretically, lotus may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Although not well studied in humans, lotus may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.

Theoretically, lotus may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Lotus may lower blood sugar levels. Caution is advised in patients with diabetes (high blood sugar) or hypoglycemia (low blood sugar), and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Alkaloids isolated from Nelumbo nucifera, including liensinine, daurisoline and neferine, have been noted to have anti-arrhythmic activity (treats irregular heartbeat). Patients taking herbs and supplements aimed at maintaining sinus rhythm and suppressing atrial fibrillation should use lotus cautiously as the effects may be additive.

Lotus may cause low blood pressure. Caution is advised in patients taking herbs or supplements that may lower blood pressure.