Cat's Claw - Adempas (Riociguat) Interaction

Interaction Details

Riociguat is classified as belonging to the following category: Antihypertensive Drugs

Theoretically, taking cat's claw with antihypertensive drugs might increase the risk of hypotension.
Cat's claw contains rhynchophylline. In vitro and animal research suggests that rhynchophylline can lower blood pressure. This interaction has not been reported in humans.

Interaction Rating

Likelihood of Occurrence

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.

References

• Zhou, J. and Zhou, S. Antihypertensive and neuroprotective activities of rhynchophylline: the role of rhynchophylline in neurotransmission and ion channel activity. J.Ethnopharmacol. 10-28-2010;132(1):15-27.
• Zhou, J. Y. and Zhou, S. W. Isorhynchophylline: A plant alkaloid with therapeutic potential for cardiovascular and central nervous system diseases. Fitoterapia 2012;83(4):617-626.
• Hemingway, S. R. and Phillipson, J. D. Proceedings: Alkaloids from S. American species of Uncaria (Rubiaceae). J.Pharm.Pharmacol. 1974;26 Suppl:113P.

Interaction Details

Riociguat is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, cat's claw might increase the levels and adverse effects of drugs metabolized by CYP3A4.
In vitro research shows that cat's claw can inhibit CYP3A4 enzymes. In one case report, a patient taking cat's claw (at an unspecified dose) experienced increased serum levels of atazanavir, ritonavir, and saquinavir, all of which are CYP3A4 substrates. Levels returned to normal 15 days after discontinuation of the cat's claw supplement, suggesting inhibition of CYP3A4 by cat's claw.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

• Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82.
• Müller AC, Kanfer I. Potential pharmacokinetic interactions between antiretrovirals and medicinal plants used as complementary and African traditional medicines. Biopharm Drug Dispos. 2011;32(8):458-70.

Riociguat Overview

• Riociguat is used to treat pulmonary arterial hypertension (PAH; high blood pressure in the vessels that carry blood to the lungs). Riociguat is also used to treat chronic thromboembolic pulmonary hypertension (CTEPH; high blood pressure in the lung arteries caused by blood clots that narrow or block blood flow) in adults who cannot have surgery or for those treated with surgery who continue to have high lung blood pressure levels after surgery. Riociguat may improve the ability to exercise in people with PAH and CTEPH and may slow the worsening of symptoms in people with PAH. Riociguat is in a class of medications called soluble guanylate cyclase (sGC) stimulators. It works by relaxing the blood vessels in the lungs to allow blood to flow easily.

Cat's Claw - More Interactions

Cat's Claw interacts with 911 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.