Drug & supplement interaction

Bulbine Natalensis + Effient

Effient brand name: Prasugrel.

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

Effient falls into 3 drug categories that Bulbine Natalensis can interact with; the most serious is rated moderate. Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP2C9 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bulbine Natalensis and Effient

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Bulbine Natalensis interacts with whole categories of medication. Effient falls into 3 of those categories, so it can interact with Bulbine Natalensis in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 3

Why this applies to Effient

Effient falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Bulbine Natalensis interacts with.

Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Bulbine natalensis stem extract induces CYP2C9 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP2C9 substrates; however, this has not been studied in humans.
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 thing about Effient (prasugrel): it's a prodrug, meaning your body has to convert it into its active form before it can do its job of keeping platelets from clumping and forming clots. Lab studies suggest Bulbine natalensis may speed up an enzyme called CYP2C9. In theory, revving up that enzyme could shift how Effient is processed.

Honestly, this is very theoretical. It comes only from test-tube and animal work, not from people, so we can't say for sure it matters in real life. Still, because Effient protects you after a heart attack or stent, anything that might weaken it is worth taking seriously. Please check with your pharmacist or doctor before adding this supplement, and don't change your Effient on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Dale OR, Manda V, et al. Bulbine natalensis (currently Bulbine latifolia) and select bulbine knipholones modulate the activity of AhR, CYP1A2, CYP2B6, and P-gp. Planta Med 2022;88(12):975-984. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Effient also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Bulbine natalensis stem extract induces CYP3A4 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP3A4 substrates, but this has not been studied in humans.
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 wrinkle with Effient (prasugrel): it's a prodrug. That means you swallow an inactive form, and your body has to switch it on before it can thin your blood and prevent clots. Enzymes like CYP3A4 help with that activation step.

Lab studies suggest Bulbine natalensis may speed up CYP3A4. With most drugs that would clear them out faster, but because Effient needs activating, the theoretical concern runs the other way: you could end up with a bit more active drug, which might mean a higher bleeding risk (easy bruising, nosebleeds, blood in urine or stool). Honestly though, this is only test-tube evidence, never proven in people. Since Effient is serious heart-protection medicine, please run any supplement past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Dale OR, Manda V, et al. Bulbine natalensis (currently Bulbine latifolia) and select bulbine knipholones modulate the activity of AhR, CYP1A2, CYP2B6, and P-gp. Planta Med 2022;88(12):975-984. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

3 of 3

Effient also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, combining Bulbine natalensis leaf with drugs that have anticoagulant or antiplatelet activity might increase the risk of bruising and bleeding.
In vitro research shows that Bulbine natalensis ground leaf extract inhibits platelet aggregation.
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 simple version. Effient (prasugrel) already works hard to keep your platelets from sticking together and forming clots, which is exactly why it protects your heart after a stent or heart attack. The concern with Bulbine natalensis is that lab studies suggest it may also slow platelets down. Stack the two, and in theory you could tip toward easier bruising and bleeding, things like nosebleeds, bleeding gums, or cuts that take longer to stop.

I want to be honest about the strength of this: it's theoretical, based only on test-tube work, not real patients. Still, since you're already on Effient plus aspirin, the bleeding stakes are higher than usual. Please loop in your pharmacist or doctor before adding this supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mosa RA, Lazarus GG, Gwala PE, Oyedeji AO, Opoku AR. In Vitro Anti-platelet Aggregation, Antioxidant and Cytotoxic Activity of Extracts of Some Zulu Medicinal Plants. J Nat Prod. 2011;4(2011):136-146.

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

Bulbine Natalensis Also Interacts With Other Medications

Bulbine Natalensis has 918 moderate known drug interactions in our database — the Effient one above is among them. If you take anything else, check it against the full list below.

Moderate 918 No known interaction 1,912 (incl. Effient)
Taking anything else?

Check Another of Your Medications Against Bulbine Natalensis

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

From our Q&A

Questions About Bulbine Natalensis or Effient

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bulbine Natalensis or Effient, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Effient

This page covers Bulbine Natalensis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Effient page lists 295 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 · 248 moderate · 42 minor.

From our pharmacist’s overview on the Effient page

“Effient (prasugrel) keeps platelets from forming clots, usually after a stent or a heart attack, and I would not pair supplements with it casually. Roughly 200 ingredients on this list can thin the blood further and raise bleeding risk, including two of the five rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Effient interaction page

One more smart check

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

We hold 51 real supplement products containing Bulbine Natalensis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bulbine Natalensis. Your product may carry other ingredients that interact with Effient too, on top of Bulbine Natalensis — 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 Bulbine Natalensis and Effient 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 Bulbine Natalensis
Steady interest

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

29 days ago today
Medication Effient
Top half

#785 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 Bulbine Natalensis

What is Bulbine Natalensis?

  • Boosting testosterone
  • Improving libido
  • Muscle building and athletic performance
  • General male vitality

Bulbine natalensis is a South African plant marketed mainly as a testosterone-boosting and libido supplement, but the human evidence is essentially absent and most claims come from animal studies. Animal research has also raised concerns about possible liver and kidney harm at higher doses, so caution is warranted. Talk to your pharmacist or doctor before trying it.

Read the full Bulbine Natalensis monograph & all interactions
Medication

About Prasugrel

What Is Prasugrel Used For?

Brand name: Prasugrel

Prasugrel tablets (brand names Effient and Prasugrel) are used to lower the risk of dangerous blood clots — including clots that can block a stent — in people with acute coronary syndrome (ACS), which includes unstable angina (chest pain at rest) and heart attacks (both NSTEMI and STEMI types). It is used specifically in patients who are being treated with a procedure called percutaneous coronary intervention (PCI), in which a catheter is used to open a blocked coronary artery, often with a stent.

Effient has been shown to reduce the combined rate of cardiovascular death, nonfatal heart attack, or nonfatal stroke compared to clopidogrel — with the benefit driven mainly by fewer heart attacks.

See full Prasugrel drug information
Keep checking

Other Drugs & Bulbine Natalensis

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

0Major
918Moderate
0Minor
1,911No known interaction
918 Moderate 1,911 No interaction
Moderate

918 interactions

Showing 60 of 918 moderate interactions — see all 918 on the Bulbine Natalensis page.

No interaction 1,911 drugs checked — show the list

We also checked Bulbine Natalensis against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,911 medications checked with no known interaction — see the full Bulbine Natalensis list.

See the full Bulbine Natalensis interactions page
See every supplement checked against Effient, 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
Bulbine Natalensis monograph › Uses, safety, and every drug interaction in one place Effient supplement interactions › Every supplement checked against Effient, ranked by severity Prasugrel 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 Bulbine Natalensis and Effient Together: Common Questions

Can you take Bulbine Natalensis with Effient?
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 3 interactions listed for Bulbine Natalensis and Effient?
Effient belongs to more than one drug category, and Bulbine Natalensis 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 Bulbine Natalensis and Effient 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 Effient and Bulbine Natalensis?

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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.