Drug & supplement interaction

American Mistletoe + Guanabenz Acetate

Guanabenz Acetate brand name: Wytensin.

Major Interaction
The bottom line Major

American Mistletoe has a major interaction with Guanabenz Acetate. American mistletoe contains phoratoxin, a compound toxic to humans that induces smooth muscle contraction and vasoconstriction, potentially increasing blood pressure and heart rate.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Mistletoe and Guanabenz Acetate

Here is the interaction we found between these two, with the evidence behind it.

Major

Antihypertensive Drugs

Why this applies to Guanabenz Acetate

Guanabenz Acetate falls under Antihypertensive Drugs — the group American Mistletoe interacts with.

American mistletoe contains phoratoxin, a compound toxic to humans that induces smooth muscle contraction and vasoconstriction, potentially increasing blood pressure and heart rate. Case reports of cardiotoxicity have been documented with American mistletoe, and it should not be used with antihypertensive drugs or by individuals with cardiac conditions. American mistletoe is uncommon in dietary supplements, and formulations containing it are generally homeopathic. European mistletoe, which lacks phoratoxin, is more commonly used.
Severity Major Likelihood Probable Evidence C

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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: guanabenz (Wytensin) lowers your blood pressure by calming signals in your brain that relax your blood vessels and slow your heart rate. American mistletoe pulls in the opposite direction. Its toxin, phoratoxin, can tighten blood vessels and bump up blood pressure and heart rate, which works directly against what your medication is trying to do.

Put them together and you may end up fighting your own treatment, with blood pressure that's harder to control. There are also reports of this plant harming the heart, so it's a real concern, not just theory. The good news is American mistletoe is rarely found in supplements. Still, please don't use it while taking guanabenz, and check with your pharmacist or doctor if you're unsure what's in a product.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • 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.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

American Mistletoe Also Interacts With Other Medications

American Mistletoe has 189 major, known drug interactions in our database — the Guanabenz Acetate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against American Mistletoe

Covers the 2,830 medications we’ve checked against American Mistletoe. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Guanabenz Acetate

This page covers American Mistletoe only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guanabenz Acetate page lists 137 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Tyramine (major), Adrafinil (moderate) and Agmatine (moderate).

By severity: 4 major · 112 moderate · 21 minor.

From our pharmacist’s overview on the Guanabenz Acetate page

“Guanabenz acetate (Wytensin) is an older blood pressure medicine, and the 137 supplements on file call for genuine vigilance, beginning with the four rated major. Two are toxic plants that can strain the heart or swing pressure hard, one is tyramine, found in aged cheeses and cured meats, which fights the drug's effect, and one is acti…”

Reviewed by 2 · Jul 18, 2026

Open the Guanabenz Acetate interaction page

How much people look this up

Where American Mistletoe and Guanabenz Acetate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement American Mistletoe
Steady interest

#1,249 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Guanabenz Acetate
Steady interest

#2,053 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About American Mistletoe

What is American Mistletoe?

American Mistletoe
  • Traditional folk remedies
  • Digestive complaints
  • Decorative holiday plant

American mistletoe is a parasitic plant that is best known as a holiday decoration, not a proven medicine. It contains toxins that can harm the heart, gut, and blood vessels, and it has little reliable evidence to support any health use. We do not recommend taking it, and all parts should be kept away from children and pets.

Read the full American Mistletoe monograph & all interactions
Medication

About Guanabenz

What Is Guanabenz Used For?

Brand name: Wytensin

  • Guanabenz is used to treat high blood pressure. It is in a class of medications called centrally acting alpha2A-adrenergic receptor agonists. Guanabenz works by decreasing your heart rate and relaxing the blood vessels so that blood can flow more easily through the body.

  • High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

See full Guanabenz drug information
Keep checking

Other Drugs & American Mistletoe

Browse every other medication we’ve checked against American Mistletoe — both the ones with a known interaction and the ones without. Select any drug for the full detail.

189Major
0Moderate
0Minor
2,640No known interaction
Major

189 interactions

Showing 60 of 189 major interactions — see all 189 on the American Mistletoe page.

No interaction 2,640 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking American Mistletoe and Guanabenz Acetate Together: Common Questions

Can you take American Mistletoe with Guanabenz Acetate?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the American Mistletoe and Guanabenz Acetate interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Guanabenz Acetate and American Mistletoe?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.