Drug & supplement interaction

Bishop's Weed + Vorapaxar

Vorapaxar brand name: Zontivity.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Vorapaxar falls into 2 drug categories that Bishop's Weed can interact with; the most serious is rated moderate. Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

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

Bishop's Weed and Vorapaxar

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

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Why this applies to Vorapaxar

Vorapaxar falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Bishop's Weed interacts with.

Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro. Theoretically, bishop's weed might inhibit elimination and increase blood levels of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include alprazolam (Xanax), amitriptyline (Elavil), amiodarone (Cordarone), buspirone (Buspar), cerivastatin (Baycol), citalopram (Celexa), felodipine (Plendil), fexofenadine (Allegra), itraconazole (Sporanox), ketoconazole (Nizoral), lansoprazole (Prevacid), losartan (Cozaar), lovastatin (Mevacor), ondansetron (Zofran), prednisone (Deltasone, Orasone), sertraline (Zoloft), sibutramine (Meridia), sildenafil (Viagra), simvastatin (Zocor), verapamil (Calan, Covera-HS, Isoptin), and many others.
Severity Moderate Likelihood Possible Evidence B

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 Vorapaxar (Zontivity). Your body clears this blood thinner mainly through a liver enzyme called CYP3A4. One of the compounds in Bishop's Weed (bergapten) has shown in lab tests that it can slow that enzyme down. If that slowdown happens in real life, vorapaxar could build up in your blood and hit harder than intended.

Since vorapaxar already keeps platelets from sticking together, higher levels could mean a greater bleeding risk (think easy bruising, nosebleeds, or harder-to-stop bleeding), especially since you're likely taking it alongside aspirin and clopidogrel. To be fair, this is mostly theoretical and based on lab work, not strong human studies. Still, with a bleeding medicine I wouldn't combine them without checking with your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther 2001;69:14-23. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

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Vorapaxar also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Bergapten, a constituent of bishop's weed, has antiplatelet activity. Theoretically, bishop's weed might have additive effects with anticoagulant or antiplatelet drugs and possibly increase the risk of bleeding.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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 basic idea with vorapaxar (Zontivity) and Bishop's Weed. Vorapaxar is a powerful antiplatelet drug that keeps your platelets from clumping together, so it already nudges you toward easier bleeding. One compound in Bishop's Weed, called bergapten, may have its own mild blood-thinning effect. Stack the two and, in theory, you could thin the blood a little more than intended.

I want to be honest about the evidence here: this is theoretical, based on how the chemicals behave, not on real patient reports. Still, vorapaxar is already used alongside aspirin and Plavix, so adding anything that touches bleeding deserves caution. Watch for easy bruising, nosebleeds, or bleeding gums, and check with your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Dr. Duke's Phytochemical and Ethnobotanical Databases. Available at: http://www.ars-grin.gov/duke/.

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

Bishop's Weed Also Interacts With Other Medications

Bishop's Weed has 953 moderate known drug interactions in our database — the Vorapaxar one above is among them. If you take anything else, check it against the full list below.

Moderate 953 No known interaction 1,877 (incl. Vorapaxar)
Taking anything else?

Check Another of Your Medications Against Bishop's Weed

Covers the 2,830 medications we’ve checked against Bishop's Weed. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Vorapaxar

This page covers Bishop's Weed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vorapaxar page lists 282 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 236 moderate · 41 minor.

From our pharmacist’s overview on the Vorapaxar page

“Vorapaxar (Zontivity) keeps platelets from clumping after a heart attack or clogged leg arteries, so it raises bleeding risk by design, and adding supplements calls for real caution. Of the 282 ingredients on file, 202 can thin the blood further, stacking their antiplatelet effects on the drug's.”

Reviewed by 2 · Jul 18, 2026

Open the Vorapaxar interaction page

One more smart check

Taking Bishop's Weed as Part of a Dietary Supplement Product? Check It for Interactions

We hold 83 real supplement products containing Bishop's Weed, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bishop's Weed. Your product may carry other ingredients that interact with Vorapaxar too, on top of Bishop's Weed — 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 Bishop's Weed and Vorapaxar 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 Bishop's Weed
Top half

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

29 days ago today
Medication Vorapaxar
Steady interest

#2,359 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 Bishop's Weed

What is Bishop's Weed?

Bishop's Weed
  • Vitiligo (loss of skin color)
  • Psoriasis
  • Digestive complaints
  • Asthma and breathing problems
  • Kidney stones
  • Diuretic (increasing urine)

Bishop's Weed (Ammi majus) is a flowering plant whose seeds contain natural light-sensitizing compounds called psoralens, which have been studied mainly for skin conditions like vitiligo and psoriasis when combined with light therapy. The plant is potentially toxic and can cause severe skin and eye reactions when exposed to sunlight, so it is not something to take on your own. If you are interested in psoralen-based treatments, work with a dermatologist rather than self-treating.

Read the full Bishop's Weed monograph & all interactions
Medication

About Vorapaxar

What Is Vorapaxar Used For?

Brand name: Zontivity

Zontivity (vorapaxar) is used to lower the risk of heart attack, stroke, cardiovascular death, and the need for urgent procedures to open blocked arteries. It is prescribed for people who have already had a heart attack or who have peripheral arterial disease (PAD) — a condition where arteries outside the heart become narrowed or blocked.

Zontivity is not used alone. It is given alongside aspirin and/or clopidogrel as part of a broader antiplatelet treatment plan.

See full Vorapaxar drug information
Keep checking

Other Drugs & Bishop's Weed

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

0Major
953Moderate
0Minor
1,876No known interaction
953 Moderate 1,876 No interaction
Moderate

953 interactions

Showing 60 of 953 moderate interactions — see all 953 on the Bishop's Weed page.

No interaction 1,876 drugs checked — show the list

We also checked Bishop's Weed against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,876 medications checked with no known interaction — see the full Bishop's Weed list.

See the full Bishop's Weed interactions page
See every supplement checked against Vorapaxar, ranked by severity
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

Keep exploring
Bishop's Weed monograph › Uses, safety, and every drug interaction in one place Vorapaxar supplement interactions › Every supplement checked against Vorapaxar, ranked by severity Vorapaxar drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Bishop's Weed and Vorapaxar Together: Common Questions

Can you take Bishop's Weed with Vorapaxar?
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 Bishop's Weed and Vorapaxar?
Vorapaxar belongs to more than one drug category, and Bishop's Weed 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 Bishop's Weed and Vorapaxar 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

Still Have a Question About Vorapaxar and Bishop's Weed?

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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.