Drug & supplement interaction

Ceylon Leadwort + Naproxen

Naproxen brand names: Naprosyn, Naprelan, Anaprox, Anaprox DS, Naproxyn, and others.

Moderate Interaction
The bottom line Moderate

Naproxen falls into 3 drug categories that Ceylon Leadwort can interact with; the most serious is rated moderate. Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 1A2 (CYP1A2) in vitro.

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

Ceylon Leadwort and Naproxen

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

Why Are There 3 Interactions?

Ceylon Leadwort interacts with whole categories of medication. Naproxen falls into 3 of those categories, so it can interact with Ceylon Leadwort 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 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Naproxen

Naproxen falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Ceylon Leadwort interacts with.

Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 1A2 (CYP1A2) in vitro. So far, this interaction has not been reported in humans. Theoretically, Ceylon leadwort might increase the levels of drugs metabolized by CYP1A2. Some substrates of CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), zileuton (Zyflo), zolmitriptan (Zomig), 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 short version: Ceylon Leadwort contains plumbagin, which in lab dishes slowed down a liver enzyme called CYP1A2. Naproxen does lean on CYP1A2 (along with another enzyme) to be broken down, so in theory this supplement could let naproxen build up a bit more than usual. Naproxen isn't a prodrug, so more drug hanging around means stronger effects, including the side effects we worry about with NSAIDs: stomach upset, heartburn, a higher risk of stomach bleeding or ulcers, and added strain on the kidneys.

That said, this is only a test-tube finding and has never been seen in real people, so I wouldn't lose sleep over it. Still, please run it past your pharmacist or doctor before combining the two, especially if you take naproxen regularly.

References
  1. Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

Naproxen also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 2C9 (CYP2C9) in vitro. So far, this interaction has not been reported in humans. Theoretically, Ceylon leadwort might increase the levels of drugs metabolized by CYP2C9. Drugs that are metabolized by CYP2C9 include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and S-warfarin (Coumadin).
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 naproxen and Ceylon Leadwort. Your body relies on a liver enzyme called CYP2C9 to break down naproxen and clear it out. A compound in this plant, plumbagin, has been shown to block that enzyme in lab dishes. In theory, that could slow how fast you clear naproxen, letting it build up a bit and lead to more of the usual side effects, things like stomach upset, heartburn, ulcers or bleeding, and added strain on your kidneys.

The important part: this is only based on test-tube research and hasn't been seen in real people, so I wouldn't lose sleep over it. Still, since naproxen already carries those stomach and kidney risks on its own, it's worth a quick chat with your pharmacist or doctor before combining the two.

References
  1. Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

3 of 3

Naproxen also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

There is some concern that Ceylon leadwort might potentiate the effects of anticoagulant and antiplatelet drugs and possibly increase the risk of bleeding. Ceylon leadwort root extract has been shown to decrease platelet adhesion and prolong bleeding in animals. However, this effect has not yet been demonstrated in humans. Until more is known, use cautiously in patients taking anticoagulant or antiplatelet drugs. Some of these 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 gist for naproxen, which is an NSAID you may know as Naprosyn or Aleve. On its own, naproxen already nudges up your bleeding risk a bit because it affects how platelets clump together and can be hard on the stomach lining. Ceylon Leadwort appears to do something similar, slowing platelets and lengthening bleeding time, so pairing the two could, in theory, stack those effects.

I want to be honest about the evidence though: this comes only from lab and animal studies, not from people, so it's more of a caution than a proven problem. Still, watch for things like easy bruising, nosebleeds, dark stools, or stomach pain. Please check with your pharmacist or doctor before combining them, especially if you take naproxen regularly.

References
  1. Vijayakumar R, Senthilvelan M, Ravindran R, Devi RS. Plumbago zeylanica action on blood coagulation profile with and without blood volume reduction. Vascul Pharmacol. 2006 Aug;45(2):86-90. 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

Ceylon Leadwort Also Interacts With Other Medications

Ceylon Leadwort has 1,096 moderate known drug interactions in our database — the Naproxen 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 Ceylon Leadwort

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

From our Q&A

Questions About Ceylon Leadwort or Naproxen

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ceylon Leadwort or Naproxen, 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 Naproxen

This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naproxen page lists 311 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

By severity: 7 major · 260 moderate · 44 minor.

Open the Naproxen interaction page

One more smart check

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

We hold 96 real supplement products containing Ceylon Leadwort, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ceylon Leadwort. Your product may carry other ingredients that interact with Naproxen too, on top of Ceylon Leadwort — 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 Ceylon Leadwort and Naproxen 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 Ceylon Leadwort
Top half

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

29 days ago today
Medication Naproxen
Top 5%

#56 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 Ceylon Leadwort

What is Ceylon Leadwort?

  • Digestive complaints and poor appetite
  • Skin conditions and wounds (applied to the skin)
  • Joint pain and swelling
  • Traditional 'metabolism-boosting' tonics
  • Antimicrobial folk remedy

Ceylon Leadwort (Plumbago zeylanica) is a plant long used in Ayurvedic and other traditional medicine systems, mainly for digestion, skin problems, and pain. Solid human studies are lacking, and the plant contains plumbagin, a compound that can irritate skin and tissues and may be unsafe in larger amounts. Talk to a pharmacist or doctor before using it, and avoid it in pregnancy.

Read the full Ceylon Leadwort monograph & all interactions
Medication

About Naproxen

What Is Naproxen Used For?

Brand names: Naprosyn, Naprelan, Anaprox, Anaprox DS, Naproxyn, Navalbine, Naproxen, Naprosyn EC, Napro-Na, Aleve, Arthroxen, Synflex, EC-Naprosyn

Naproxen tablets, naproxen sodium tablets, and naproxen oral suspension are used to relieve the signs and symptoms of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and polyarticular juvenile idiopathic arthritis. They are also used for tendonitis, bursitis, and acute gout, and for managing pain and primary dysmenorrhea (menstrual cramps).

Naproxen Sodium Controlled-Release Tablets are indicated for the same conditions plus the relief of mild to moderate pain. Several over-the-counter naproxen sodium products are indicated for the temporary relief of minor aches and pains from headache, backache, muscular aches, toothache, menstrual cramps, minor arthritis pain, and the common cold, and to temporarily reduce fever.

See full Naproxen drug information
Keep checking

Other Drugs & Ceylon Leadwort

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

0Major
1,096Moderate
0Minor
1,733No known interaction
Moderate

1,096 interactions

Showing 60 of 1,096 moderate interactions — see all 1,096 on the Ceylon Leadwort page.

No interaction 1,733 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 Ceylon Leadwort and Naproxen Together: Common Questions

Can you take Ceylon Leadwort with Naproxen?
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 Ceylon Leadwort and Naproxen?
Naproxen belongs to more than one drug category, and Ceylon Leadwort 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 Ceylon Leadwort and Naproxen 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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