Drug & supplement interaction

Coleus + Amlodipine Besylate

Amlodipine Besylate brand name: Norvasc.

Major Interaction
The bottom line Major

Amlodipine Besylate falls into 3 drug categories that Coleus can interact with; the most serious is rated major. Theoretically, combining coleus with calcium channel blockers might increase the coronary vasodilatory effects.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Coleus and Amlodipine Besylate

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

Why Are There 3 Interactions?

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

Major

CALCIUM CHANNEL BLOCKERS

1 of 3

Why this applies to Amlodipine Besylate

Amlodipine Besylate falls under CALCIUM CHANNEL BLOCKERS — the group Coleus interacts with.

Theoretically, combining coleus with calcium channel blockers might increase the coronary vasodilatory effects.
Forskolin, a constituent of coleus, and calcium channel blockers both cause coronary vasodilatory effects.
Severity Major Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: both amlodipine (Norvasc) and the forskolin in Coleus can relax and widen your blood vessels. Amlodipine already does this on purpose to lower your blood pressure and ease chest pain. Adding Coleus may pile on a similar effect, so the two together could push your blood pressure lower than intended.

In real life that might show up as feeling dizzy or lightheaded, flushing, headache, swollen ankles, or feeling faint when you stand up quickly. Worth knowing: this concern is largely theoretical and based on how forskolin behaves, not on strong human studies. Amlodipine is not a prodrug, so this isn't about activation. Still, please check with your pharmacist or doctor before pairing them, especially if your blood pressure already runs low.

References
  1. Baumann G, Felix S, Sattelberger U, Klein G. Cardiovascular effects of forskolin (HL-362) in patients with idiopathic congestiv cardiomyopathy. A comparative study with dobutamine and sodium nitroprusside. J Cardiovasc Pharmacol 1990;16:93-100.
  2. Kramer W, Thormann J, Kindler M, Schlepper M. Effects of forskolin on left ventricular function in dilated cardiomyopathy. Arzneimittelforschung 1987;37:364-7.
Moderate

ANTIHYPERTENSIVE DRUGS

2 of 3

Amlodipine Besylate also falls under ANTIHYPERTENSIVE DRUGS.

Theoretically, combining coleus with antihypertensive drugs might cause additive blood pressure lowering effects and increase the risk of hypotension.
Animal research shows that forskolin, a constituent of coleus, may lower blood pressure.
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: amlodipine (Norvasc) already relaxes your blood vessels to bring your blood pressure down. Coleus contains forskolin, which in animal studies also seems to lower blood pressure. So the worry isn't that one changes how the other is broken down. Instead, the two could add together and push your pressure lower than you want.

If that happened, you might feel dizzy, lightheaded, tired, or a bit faint when you stand up. I want to be honest, though: this concern is theoretical and based mostly on lab and animal data, not strong human studies. It's not a reason to panic. Still, since both affect blood pressure, please check with your pharmacist or doctor before adding Coleus, and don't change your amlodipine on your own.

References
  1. Baumann G, Felix S, Sattelberger U, Klein G. Cardiovascular effects of forskolin (HL-362) in patients with idiopathic congestiv cardiomyopathy. A comparative study with dobutamine and sodium nitroprusside. J Cardiovasc Pharmacol 1990;16:93-100.
  2. Kramer W, Thormann J, Kindler M, Schlepper M. Effects of forskolin on left ventricular function in dilated cardiomyopathy. Arzneimittelforschung 1987;37:364-7.
  3. Schlepper, M., Thormann, J., and Mitrovic, V. Cardiovascular effects of forskolin and phosphodiesterase-III inhibitors. Basic Res Cardiol 1989;84 Suppl 1:197-212. PubMed
  4. Lindner, E., Dohadwalla, A. N., and Bhattacharya, B. K. Positive inotropic and blood pressure lowering activity of a diterpene derivative isolated from Coleus forskohli: Forskolin. Arzneimittelforschung 1978;28(2):284-289.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

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

Theoretically, taking coleus might decrease serum levels of drugs metabolized by CYP3A4.
In vitro research shows that coleus can activate the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of coleus and other drugs affected by these enzymes.
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 for amlodipine (Norvasc): your body clears this blood pressure pill using a liver enzyme called CYP3A4. Lab studies hint that Coleus (forskolin) may rev up that enzyme, which could make your body break amlodipine down a little faster. In theory, that means slightly less drug working in your system, so your blood pressure or chest pain might not be controlled quite as well.

I want to be honest about the strength of this: it comes only from test-tube and animal research, not real patients, so we genuinely don't know if it matters in people. Amlodipine isn't a prodrug, so this points toward weaker effect, not stronger. Before adding a Coleus supplement, run it by your pharmacist or doctor, especially since both can affect blood pressure.

References
  1. Ding, X. and Staudinger, J. L. Induction of drug metabolism by forskolin: the role of the pregnane X receptor and the protein kinase a signal transduction pathway. J Pharmacol Exp Ther 2005;312(2):849-856. PubMed
  2. Staudinger, J. L., Ding, X., and Lichti, K. Pregnane X receptor and natural products: beyond drug-drug interactions. Expert.Opin Drug Metab Toxicol 2006;2(6):847-857. 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

Coleus Also Interacts With Other Medications

Coleus has 28 major, 886 moderate known drug interactions in our database — the Amlodipine Besylate 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 Coleus

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

From our Q&A

Questions About Coleus or Amlodipine Besylate

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

This page covers Coleus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amlodipine Besylate page lists 232 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).

Open the Amlodipine Besylate interaction page

One more smart check

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

We hold 803 real supplement products containing Coleus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Coleus. Your product may carry other ingredients that interact with Amlodipine Besylate too, on top of Coleus — 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 Coleus and Amlodipine Besylate 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 Coleus
Top 25%

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

29 days ago today
Medication Amlodipine Besylate
Top 5%

#61 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 Coleus

What is Coleus?

Coleus
  • Weight management
  • Asthma and breathing
  • High blood pressure
  • Heart conditions
  • Glaucoma (eye pressure)
  • Exercise and body composition

Coleus is a plant from the mint family whose root contains a compound called forskolin, often marketed for weight loss, asthma, and heart health. While early lab and small human studies are interesting, solid proof that Coleus supplements help any of these conditions is limited. Talk to your pharmacist or doctor before using it, especially if you have heart problems or low blood pressure.

Read the full Coleus monograph & all interactions
Medication

About Amlodipine

What Is Amlodipine Used For?

Brand name: Norvasc

Amlodipine treats high blood pressure (hypertension) in adults and children aged 6–17 years. Lowering blood pressure reduces the risk of strokes and heart attacks. Sdamlo (oral solution) is specifically indicated for hypertension in adults and pediatric patients 6 years of age and older.

Amlodipine also treats coronary artery disease in adults, including chronic stable angina (chest pain with exertion), vasospastic angina (Prinzmetal's or variant angina, caused by coronary artery spasms), and documented coronary artery disease in patients without heart failure or significantly reduced heart pumping function.

See full Amlodipine drug information
Keep checking

Other Drugs & Coleus

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

28Major
886Moderate
0Minor
1,915No known interaction
Major

28 interactions

Moderate

886 interactions

Showing 60 of 886 moderate interactions — see all 886 on the Coleus page.

No interaction 1,915 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 Coleus and Amlodipine Besylate Together: Common Questions

Can you take Coleus with Amlodipine Besylate?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Coleus and Amlodipine Besylate?
Amlodipine Besylate belongs to more than one drug category, and Coleus 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 Coleus and Amlodipine Besylate interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

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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.