Guggul - Zontivity (Vorapaxar) Interaction
Herbal: Guggul
Also Known As: Commiphora wightii, Devadhupa, Gomme Guggul, Guggal, Guggul Gum, Guggul Gum Resin, Guggul Lipids, Guggulipid, Guggulu, Guggulu Suddha, Guglipid, Gugulipid, Gum Guggal, Gum Guggulu, Indian Bdellium, Indian Bdellium-Tree, Indian Guggulipids, Koushika, Mukul Myrrh Tree, Palank
Drug: Vorapaxar
Brand names:
Zontivity
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Vorapaxar is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction 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
- Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35.
Interaction Details
Vorapaxar is classified as belonging to the following category: Anticoagulant/Antiplatelet Drugs
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research and preliminary clinical studies suggest that guggul might have antiplatelet and anticoagulant effects.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction 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
- Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8:659-64.
- Mester L, Mester M, Nityanand S. Inhibition of platelet aggregation by "guggulu" steroids. Planta Med 1979;37:367-9.
- Gaur SP, Garg RK, Kar AM, et al. Gugulipid, a new hypolipidaemic agent, in patients of acute ischaemic stroke: effect on clinical outcome, platelet function and serum lipids. Asia Pacif J Pharm 1997;12:65-69.
- Baldwa VS, Sharma RC, Ranka PC, et al. Effect of Commiphora mukul (guggul) on fibrinolytic activity and platelet aggregation in coronary artery disease. Rajas Med J 1980;19:84-86.
Guggul Overview
Guggal, also known as Commiphora mukul or Indian bdellium, is a species of tree native to India, Pakistan, and parts of the Middle East. It is known for producing a gum resin that has a long history of use in traditional Ayurvedic medicine.
Guggul is used for a variety of purposes, including for the treatment of joint pain, obesity, and high cholesterol. Many guggal preparations are often standardized to contain 2.5% to 5% guggulsterone.
Vorapaxar Overview
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Vorapaxar is used together with other medications, such as aspirin and clopidogrel (Plavix), to reduce the risk of serious or life-threatening heart or blood vessel problems such as heart attack and stroke in people who have already had a heart attack or have problems with the blood flow in their legs. Vorapaxar is in a class of medications called protease-activated receptor-1 (PAR-1) antagonists. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.
Guggul - More Interactions
Guggul interacts with 712 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.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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