Drug & supplement interaction

Banaba + Bosentan

Bosentan brand name: Tracleer.

Moderate Interaction
The bottom line Moderate

Bosentan falls into 2 drug categories that Banaba can interact with; the most serious is rated moderate. Theoretically, concomitant use of banaba and antihypertensive drugs might cause additive effects.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Banaba and Bosentan

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Banaba interacts with whole categories of medication. Bosentan falls into 2 of those categories, so it can interact with Banaba in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Bosentan

Bosentan falls under ANTIHYPERTENSIVE DRUGS — the group Banaba interacts with.

Theoretically, concomitant use of banaba and antihypertensive drugs might cause additive effects.
Human and animal research suggests that banaba can lower blood pressure.
Severity Moderate Likelihood Probable Evidence B

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. Bosentan relaxes blood vessels in your lungs to ease the strain of pulmonary arterial hypertension, and it can nudge your overall blood pressure down a bit too. Banaba, which folks usually take for blood sugar, may also lower blood pressure based on some early human and animal studies. Put them together and those two effects could stack up.

So the worry isn't that banaba breaks down your bosentan or makes it stop working. It's that your blood pressure might dip a little more than expected, leaving you dizzy, lightheaded, or tired, especially when you stand up. The evidence here is fairly limited, so don't panic. Just loop in your pharmacist or doctor before adding banaba, and mention any dizzy spells.

References
  1. Yamaguchi, Y., Yamada, K., Yoshikawa, N., Nakamura, K., Haginaka, J., and Kunitomo, M. Corosolic acid prevents oxidative stress, inflammation and hypertension in SHR/NDmcr-cp rats, a model of metabolic syndrome. Life Sci 11-25-2006;79(26):2474-2479. PubMed
  2. Manaf A, Tjandrawinata RR, Malinda D. Insulin sensitizer in prediabetes: a clinical study with DLBS3233, a combined bioactive fraction of Cinnamomum burmanii and Lagerstroemia speciosa. Drug Des Devel Ther. 2016;10:1279-89. PubMed
  3. Tjokroprawiro A, Murtiwi S, Tjandrawinata RR. DLBS3233, a combined bioactive fraction of Cinnamomum burmanii and Lagerstroemia speciosa, in type-2 diabetes mellitus patients inadequately controlled by metformin and other oral antidiabetic agents. J Comple
Moderate

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

2 of 2

Bosentan also falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP).

Theoretically, concomitant use of banaba with substrates of OATP might reduce the bioavailability of the OATP substrate.
In vitro research shows that banaba inhibits OATP, particularly OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the absorption of drugs and other compounds.
Severity Moderate Likelihood Possible Evidence D

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.

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

Here's the gist for bosentan (Tracleer). Your body relies on transporter proteins called OATPs to help pull bosentan into the gut wall and liver. Lab studies suggest banaba may block one of these transporters (OATP2B1). In theory, that could mean less bosentan getting absorbed, which might leave you with weaker treatment for your pulmonary hypertension. That matters, because bosentan helps keep the blood vessels in your lungs open and your breathing and exercise tolerance steady.

I want to be honest, though: this concern comes only from test-tube research, not from people, so we don't really know if it plays out in real life. Bosentan is an important medicine you don't want to underdose, so please loop in your pharmacist or doctor before adding banaba rather than starting it on your own.

References
  1. Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed

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

Banaba Also Interacts With Other Medications

Banaba has 298 moderate known drug interactions in our database — the Bosentan one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Banaba

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

Everything else you take

See Every Supplement That Interacts With Bosentan

This page covers Banaba only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bosentan page lists 266 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Apple (major) and Beer (major).

By severity: 11 major · 216 moderate · 39 minor.

Open the Bosentan interaction page

One more smart check

Taking Banaba as Part of a Dietary Supplement Product? Check It for Interactions

We hold 573 real supplement products containing Banaba, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Banaba. Your product may carry other ingredients that interact with Bosentan too, on top of Banaba — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Banaba and Bosentan 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 Banaba
Top 25%

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

29 days ago today
Medication Bosentan
Steady interest

#1,620 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 Banaba

What is Banaba?

Banaba
  • Blood sugar support
  • Type 2 diabetes
  • Weight management
  • High blood pressure
  • Cholesterol support

Banaba is a leaf extract most often used to help support healthy blood sugar, and small early studies suggest its active compound corosolic acid may modestly lower glucose. The overall evidence is limited and short-term, so it should not replace prescribed diabetes care. Talk to your pharmacist or doctor before trying it, especially if you take blood sugar medicine.

Read the full Banaba monograph & all interactions
Medication

About Bosentan

What Is Bosentan Used For?

Brand name: Tracleer

Bosentan is used to treat pulmonary arterial hypertension (PAH) — high blood pressure in the arteries of the lungs. In adults, it helps improve the ability to exercise and slows how quickly the disease gets worse.

In children aged 3 years and older with idiopathic (no known cause) or congenital (present from birth) PAH, bosentan is used to lower resistance in the lung blood vessels, which is expected to improve exercise ability. Tracleer is one brand approved for both adults and pediatric patients with PAH.

See full Bosentan drug information
Keep checking

Other Drugs & Banaba

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

0Major
298Moderate
0Minor
2,531No known interaction
Moderate

298 interactions

Showing 60 of 298 moderate interactions — see all 298 on the Banaba page.

No interaction 2,531 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 Banaba and Bosentan Together: Common Questions

Can you take Banaba with Bosentan?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Banaba and Bosentan?
Bosentan belongs to more than one drug category, and Banaba interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Banaba and Bosentan interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

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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.