Butea Superba + Macitentan, Tadalafil
Macitentan, Tadalafil brand name: Opsynvi.
Butea Superba has a moderate interaction with Macitentan, Tadalafil. Butea superba is thought to inhibit phosphodiesterase and cause vasodilation.
Read the full interaction reportButea Superba and Macitentan, Tadalafil
Here is the interaction we found between these two, with the evidence behind it.
PHOSPHODIESTERASE-5 INHIBITORS
Why this applies to Macitentan, Tadalafil
Macitentan, Tadalafil falls under PHOSPHODIESTERASE-5 INHIBITORS — the group Butea Superba interacts with.
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.
Opsynvi combines two blood-vessel relaxers: tadalafil (the same active ingredient as Cialis) and macitentan. Both are designed to widen blood vessels and lower pressure in the lungs. Here's the concern with Butea superba: lab work suggests this Thai herb may work in a similar way to tadalafil, blocking the same PDE-5 enzyme and relaxing blood vessels. Stacking two things that do the same job could add up.
In plain terms, taking them together might push your blood pressure lower than intended. Watch for dizziness, lightheadedness, headache, flushing, or feeling faint when you stand up. To be fair, this is a theoretical worry based on how the herb behaves in the lab, not proven in people. Still, since Opsynvi already affects your blood pressure, please check with your pharmacist or doctor before adding Butea superba.
- Cherdshewasart W, Nimsakul N. Clinical trial of Butea superba, an alternative herbal treatment for erectile dysfunction. Asian J Androl 2003;5:243-6.
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Butea Superba Also Interacts With Other Medications
Butea Superba has 6 moderate known drug interactions in our database — the Macitentan, Tadalafil one above is one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Butea Superba
We haven’t checked that one against Butea Superba yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Butea Superba. Pick one to open its full report.
See Every Supplement That Interacts With Macitentan, Tadalafil
This page covers Butea Superba only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Macitentan, Tadalafil page lists 264 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), Beer (major) and Grapefruit (major).
By severity: 10 major · 215 moderate · 39 minor.
From our pharmacist’s overview on the Macitentan, Tadalafil page
“Opsynvi pairs macitentan and tadalafil to lower pressure in the lung arteries, so anything that drops blood pressure further or shifts how the body handles these drugs deserves genuine respect, and I would read this list carefully. Ten of the 264 ingredients rate major, and most of the rest fall into two camps: additive blood-pressure-…”
Reviewed by 2 · Jul 18, 2026
Taking Butea Superba as Part of a Dietary Supplement Product? Check It for Interactions
We hold 23 real supplement products containing Butea Superba, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Butea Superba. Your product may carry other ingredients that interact with Macitentan, Tadalafil too, on top of Butea Superba — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Butea Superba and Macitentan, Tadalafil 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.
#1,145 of 1,452 supplements looked up here in the last 7 days
#1,441 of 2,830 medications looked up here in the last 7 days
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.
About Butea Superba
What is Butea Superba?
- Erectile dysfunction
- Low libido
- Male sexual performance
- General vitality and energy
- Traditional tonic
Butea superba is a Thai herb traditionally used to support male sexual health, but the human evidence is very limited and mostly small or low-quality. Its safety has not been well studied, so caution is advised, and you should talk with a pharmacist or doctor before trying it—especially if you have a medical condition or take other medicines.
Other Drugs & Butea Superba
Browse every other medication we’ve checked against Butea Superba — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
6 interactions
No interaction 2,823 drugs checked — show the list
We also checked Butea Superba against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Warfarin ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Ivermectin ›
- Metoprolol ›
- Aspirin ›
- Rivaroxaban ›
- Rosuvastatin ›
- Acetaminophen ›
- Escitalopram ›
- Clopidogrel ›
- Abemaciclib ›
- Atorvastatin ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Ibuprofen ›
- Methamphetamine ›
- Sumatriptan ›
- Tirzepatide ›
- Semaglutide ›
- Warfarin Sodium ›
- Prednisone ›
- Propranolol ›
- Lisdexamfetamine ›
- Metformin ›
- Bupropion ›
- Amoxicillin ›
- Lisinopril ›
- Bendamustine ›
- Acyclovir ›
- Amitriptyline ›
- Methotrexate ›
- Doxycycline ›
- Fluoxetine ›
- Amphetamine ›
- Acetaminophen, Codeine ›
- Lamotrigine ›
- Pregabalin ›
- Azithromycin ›
- Gabapentin ›
- Dextroamphetamine ›
- Isotretinoin ›
- Clonazepam ›
- Methylene Blue ›
- Omeprazole ›
- Amlodipine Besylate ›
- Quetiapine ›
- Duloxetine ›
- Letrozole ›
- Buspirone ›
- Naproxen ›
- Citalopram ›
- Ciprofloxacin ›
- Bisoprolol ›
Showing the 60 most looked-up of 2,823 medications checked with no known interaction — see the full Butea Superba list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Macitentan, Tadalafil Is Linked to Lower Levels of One Nutrient
Natural Medicines records Macitentan, Tadalafil as a medicine that can lower these. This is not an interaction with Butea Superba — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Macitentan, Tadalafil nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Butea Superba and Macitentan, Tadalafil Together: Common Questions
Can you take Butea Superba with Macitentan, Tadalafil?
How serious is the Butea Superba and Macitentan, Tadalafil interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Macitentan, Tadalafil and Butea Superba?
Our pharmacists answer your medication & supplement questions — free.
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.