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People who have known allergies to salicylates, such as aspirin, should not use willow bark. According to some researchers, willow bark should not be recommended to people with asthma, diabetes, gout, gastritis, hemophilia, and stomach ulcers. If you have any of these conditions, or if you're taking blood-thinning medications or NSAID's regularly, be sure to check with your doctor before taking willow bark.
The drug interactions associated with salicylates may apply to products that contain willow bark. You should not use willow bark with alcohol, barbiturates, sedatives, and other products that have salicylates because this may worsen irritant effects and adverse reactions. Willow may also interact with oral anticoagulants, seizure medications and other drugs such as methotrexate.
The side effects of willow bark are usually mild. Common side effects include: gastrointestinal discomfort such as nausea and stomach ache, dizziness and rash. Allergic reaction to willow bark has also been reported. Overdoses of willow bark may cause skin rash, stomach irritation, nausea, vomiting, kidney inflammation, and tinnitus or ringing in the ears.