Drug & supplement interaction

Bupleurum + Riociguat

Riociguat brand name: Adempas.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Bupleurum and Riociguat in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Bupleurum and Riociguat

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Riociguat and Bupleurum in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Bupleurum safety at a glance

Bupleurum overall Use caution Generally used short-term in formulas, but it has been linked to rare lung and liver problems and quality varies.
Pregnancy Avoid Not enough safety information, so it is best avoided during pregnancy.
Breastfeeding Avoid Not enough safety information, so it is best avoided while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Riociguat and Bupleurum? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Riociguat

Interactions in our licensed database are recorded against drug classes, not just single drug names. Riociguat is filed under 4 classifications — including antihypertensive drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Bupleurum has documented interactions with 3 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and immunosuppressants (moderate) — and none of Riociguat’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Bupleurum Does Interact With Other Medications

Bupleurum has 327 moderate known drug interactions in our database — Riociguat isn’t one of them. If you take anything else, check it against the full list below.

Moderate 327 No known interaction 2,503 (incl. Riociguat)
Taking anything else?

Check Another of Your Medications Against Bupleurum

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

What to actually watch for

No Interaction Found — But Data Suggests Bupleurum and Riociguat May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Swelling Additional detail

    Bupleurum

    “Orally, combination products containing bupleurum have been reported to cause eosinophilic pneumonia, pulmonary edema, and multiple cases of pneumonitis. A specific combination product (sho-saiko-to), used in combination with interferon-alpha in patients with chronic active hepatitis, has also been associated with multiple cases of pneumonitis.”

    Bupleurum · Natural Medicines adverse-effect record, reported in hepatitis.

    6 sources cited
    1. 354. Kobashi Y, Nakajima M, Niki Y, Matsushima T. [A case of acute eosinophilic pneumonia due to Sho-saiko-to]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:1372-7.
    2. 361. Miyazaki E, Ando M, Ih K, et al. [Pulmonary edema associated with the Chinese medicine shosaikoto]. Nihon Kokyuki Gakkai Zasshi 1998;36:776-80.
    3. 355. Wada Y, Kubo M. [Acute lymphoblastic leukemia complicated by type C hepatitis during treatment and further by acute interstitial pneumonia due to sho-saiko-to in 7-year-old]. Arerugi 1997;46:1148-55.
    4. 356. Sato A, Toyoshima M, Kondo A, et al. [Pneumonitis induced by the herbal medicine Sho-saiko-to in Japan]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:391-5.
    5. 357. Daibo A, Yoshida Y, Kitazawa S, et al. [A case of pneumonitis and hepatic injury caused by a herbal drug (sho-saiko-to)]. Nippon Kyobu Shikkan Gakkai Zasshi 1992;30:1583-8.
    6. 37404. Sugiyama H, Nagai M, Kotajima F, and et al. [A case of interstitial pneumonia with chronic hepatitis C following interferon-alfa and sho-saiko-to therapy]. Arerugi 1995;44(7):711-714.

    Riociguat

    Listed in the ADVERSE REACTIONS section of the FDA label for Riociguat. Read the label on DailyMed ›

  • Nausea Additional detail

    Bupleurum

    “Orally, a specific bupleurum-containing combination product (sho-saiko-to) has been reported to cause nausea, anorexia, and abdominal fullness. It is unclear if these adverse effects are due to bupleurum, other ingredients, or the combination.”

    Bupleurum · Natural Medicines adverse-effect record, reported in anorexia.

    1 source cited
    1. 37391. Hirayama, C., Okumura, M., Tanikawa, K., and et al. A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. Gastroenterol Jpn 1989;24(6):715-719. PubMed

    Riociguat

    Listed in the ADVERSE REACTIONS section of the FDA label for Riociguat. Read the label on DailyMed ›

Reported for Bupleurum but not commonly for Riociguat: numbness or tingling, liver problems, a higher chance of infection and reduced appetite.

Effects for Riociguat come from the ADVERSE REACTIONS section of its FDA label; effects for Bupleurum come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Riociguat

This page covers Bupleurum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Riociguat page lists 230 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), Grapefruit (major) and St. John's Wort (major).

By severity: 6 major · 187 moderate · 37 minor.

From our pharmacist’s overview on the Riociguat page

“Riociguat (Adempas) works by relaxing the blood vessels in your lungs, which also lowers blood pressure, so I read this list of 230 supplements and herbs with real concern, and the six rated major are what to understand first. Grapefruit can push riociguat levels up and intensify its effect, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Riociguat interaction page

One more smart check

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

We hold 89 real supplement products containing Bupleurum, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bupleurum. Even though Bupleurum itself has no known interaction with Riociguat, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bupleurum and Riociguat 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 Bupleurum
Top 25%

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

29 days ago today
Medication Riociguat
Steady interest

#2,260 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Bupleurum reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Bupleurum and Riociguat records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Bupleurum

What is Bupleurum?

Bupleurum
  • Liver and digestive support
  • Cold, flu, and fever
  • Inflammation
  • Stress and mood
  • Immune support

Bupleurum (Chai Hu) is a root used in traditional Chinese medicine, usually as part of multi-herb formulas, for liver, digestive, and fever-related complaints. High-quality human evidence for its benefits is limited, and it has been linked to lung and liver problems in some reports, so use it cautiously and only under professional guidance.

Bupleurum chinense · Apiaceae · Root · Capsules, tablets, dried root, teas, tinctures, and traditional Chinese herbal formulas

An interaction check asks whether these two react with each other — it does not ask whether Bupleurum is a good idea for someone in your situation. Here is what our Bupleurum record says about it on its own.

Bupleurum: dosing

There is no well-established standard dose of Bupleurum. Do not exceed the recommended amount, and avoid long-term use without professional guidance.

From our Bupleurum monograph — the full record covers uses, side effects and every documented interaction.

Read the full Bupleurum monograph & all interactions
Medication

About Riociguat

What Is Riociguat Used For?

Brand name: Adempas

Riociguat tablets — sold as Adempas and under the generic name Riociguat — are used to treat adults with two types of pulmonary hypertension (high blood pressure in the lungs).

The first is chronic thromboembolic pulmonary hypertension (CTEPH), a condition caused by blood clots in the lung arteries, either after surgery or when surgery is not an option. The second is pulmonary arterial hypertension (PAH), where the arteries carrying blood to the lungs are narrowed or blocked. In both conditions, riociguat helps improve exercise ability and functional status, and in PAH it also helps slow the disease from getting worse.

Most-Reported Side Effects for Riociguat

From FAERS, the FDA’s public side-effect reporting system (32,415 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 5,718 reports
Headache 4,513 reports
Nausea 3,769 reports
Diarrhea 3,533 reports
Dizziness 3,522 reports
See full Riociguat drug information
Keep checking

Other Drugs & Bupleurum

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

0Major
327Moderate
0Minor
2,502No known interaction
327 Moderate 2,502 No interaction
Moderate

327 interactions

Showing 60 of 327 moderate interactions — see all 327 on the Bupleurum page.

No interaction 2,502 drugs checked — show the list

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

Showing the 60 most looked-up of 2,502 medications checked with no known interaction — see the full Bupleurum list.

See the full Bupleurum interactions page
See every supplement checked against Riociguat, ranked by severity
Evidence & sources

Bupleurum References

The 17 references that drive our Bupleurum monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Kobashi Y, Nakajima M, Niki Y, Matsushima T. [A case of acute eosinophilic pneumonia due to Sho-saiko-to]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:1372-7.
  2. Wada Y, Kubo M. [Acute lymphoblastic leukemia complicated by type C hepatitis during treatment and further by acute interstitial pneumonia due to sho-saiko-to in 7-year-old]. Arerugi 1997;46:1148-55.
  3. Sato A, Toyoshima M, Kondo A, et al. [Pneumonitis induced by the herbal medicine Sho-saiko-to in Japan]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:391-5.
  4. Daibo A, Yoshida Y, Kitazawa S, et al. [A case of pneumonitis and hepatic injury caused by a herbal drug (sho-saiko-to)]. Nippon Kyobu Shikkan Gakkai Zasshi 1992;30:1583-8.
  5. Sugiyama H, Nagai M, Kotajima F, et al. [A case of interstitial pneumonia with chronic hepatitis C following interferon-alfa and sho-saiko-to therapy]. Arerugi 1995;44:711-4.
  6. Ishizaki T, Sasaki F, Ameshima S, et al. Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. Eur Respir J 1996;9:2691-6. PubMed
  7. Nakagawa A, Yamaguchi T, Takao T, Amano H. [Five cases of drug induced pneumonitis due to Sho-saiko-to or interferon-alpha or both]. Nippon Kyobu Shikkan Gakkai Zasshi 1995;33:1361-6.
  8. Miyazaki E, Ando M, Ih K, et al. [Pulmonary edema associated with the Chinese medicine shosaikoto]. Nihon Kokyuki Gakkai Zasshi 1998;36:776-80.
  9. Matsumoto T, Yamada H. Regulation of immune complexes binding of macrophages by pectic polysaccharide from Bupleurum falcatum L.: pharmacological evidence for the requirement of intracellular calcium/calmodulin on Fc receptor up-regulation by bupleuran 2
  10. Hattori T, Ito M, Suzuki Y. [Studies on antinephritic effects of plant components in rats (1). Effects of saikosaponins original-type anti-GBM nephritis in rats and its mechanisms]. Nippon Yakurigaku Zasshi 1991;97:13-21. PubMed
  11. Chang WC, Hsu FL. Inhibition of platelet activation and endothelial cell injury by flavan-3-ol and saikosaponin compounds. Prostaglandins Leukot Essent Fatty Acids 1991;44:51-6. PubMed
  12. Kato M, Pu MY, Isobe K, et al. Characterization of the immunoregulatory action of saikosaponin-d. Cell Immunol 1994;159:15-25. PubMed
  13. Ushio Y, Oda Y, Abe H. Effect of saikosaponin on the immune responses in mice. Int J Immunopharmacol 1991;13:501-8. PubMed
  14. Hirayama, C., Okumura, M., Tanikawa, K., and et al. A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. Gastroenterol Jpn 1989;24(6):715-719. PubMed
  15. Hiai S, Yokoyama H, Nagasawa T, and et al. Stimulation of the pituitary-adrenocortical axis by saikosaponin of Bupleuri radix. Chemical and Pharmaceutical Bulletin (Tokyo) 1981;29(2):495-499. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Bupleurum and Riociguat Together: Common Questions

Is it safe to take Bupleurum with Riociguat?
We do not list a known interaction between Bupleurum and Riociguat. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Bupleurum and Riociguat have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Bupleurum and Riociguat combination checked?
Interactions in our licensed database are recorded against drug classes. Riociguat is filed under 4 classifications, and Bupleurum has documented interactions with 3 drug classes — none of Riociguat's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Bupleurum interact with any other medications?
Yes. Bupleurum has 327 documented drug interactions in our database — Riociguat is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Riociguat interact with any supplements?
Yes. Riociguat has documented interactions with 230 supplements in our database — Bupleurum is not one of them. The Riociguat interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Bupleurum monograph Uses, safety profile, and every drug interaction in one place Riociguat drug information The full plain-English guide to this medication Riociguat supplement interactions Every supplement checked against Riociguat, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 17 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Riociguat and Bupleurum?

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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.