Drug & supplement interaction

Coleus + Naproxen, Pseudoephedrine

Naproxen, Pseudoephedrine brand name: Aleve Cold and Sinus.

Moderate Interaction
The bottom line Moderate

Naproxen, Pseudoephedrine falls into 2 drug categories that Coleus can interact with; the most serious is rated moderate. Theoretically, taking coleus may affect drugs metabolized by CYP2C9 and increase the risk of adverse effects or reduce the effectiveness.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Coleus and Naproxen, Pseudoephedrine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Coleus interacts with whole categories of medication. Naproxen, Pseudoephedrine falls into 2 of those categories, so it can interact with Coleus in 2 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 2

Why this applies to Naproxen, Pseudoephedrine

Naproxen, Pseudoephedrine falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Coleus interacts with.

Theoretically, taking coleus may affect drugs metabolized by CYP2C9 and increase the risk of adverse effects or reduce the effectiveness.
Research on the effect of coleus on CYP2C9 is conflicting. Some animal research shows that coleus extract can induce CYP2C9, while in vitro research shows that coleus can inhibit CYP2C9. Until more is known, advise patients that taking coleus might increase or decrease levels of drugs metabolized by CYP2C9.
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 deal with Aleve Cold and Sinus, which combines naproxen (the pain and inflammation reliever) and pseudoephedrine (the decongestant). The naproxen part is cleared by a liver enzyme called CYP2C9. Coleus, through its active compound forskolin, may nudge that enzyme one way or the other. The catch is that the research pulls in opposite directions: lab studies hint that coleus might block CYP2C9 (which could let naproxen build up, raising the odds of stomach upset, heartburn, or ulcers), while animal studies suggest it might speed up the enzyme (making naproxen less effective).

Honestly, this is theoretical and based only on lab and animal work, so I wouldn't lose sleep over it. Still, since pseudoephedrine can already raise blood pressure and heart rate, and coleus may affect those too, it's worth a quick chat with your pharmacist or doctor before combining them.

References
  1. Yokotani K, Chiba T, Sato Y, et al. Hepatic cytochrome P450 mediates interaction between warfarin and Coleus forskohlii extract in vivo and in vitro. J Pharm Pharmacol. 2012;64(12):1793-801.
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Naproxen, Pseudoephedrine also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, concomitant use of coleus and anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro and animal research shows that forskolin, a constituent of coleus, can inhibit platelet aggregation and adhesion.
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 with Aleve Cold and Sinus, which pairs naproxen (an anti-inflammatory pain reliever) with pseudoephedrine (a decongestant). Naproxen on its own can already thin the blood a little and irritate the stomach lining. Lab and animal studies suggest forskolin, the active piece of Coleus, may make platelets less sticky. Put those two together and you could, in theory, see a bit more bruising, nosebleeds, or stomach upset and bleeding.

I want to be honest: this is theoretical and based only on test-tube and animal data, so I wouldn't lose sleep over it. Still, pseudoephedrine can also raise blood pressure, and Coleus may lower it, so the mix gets unpredictable. Please check with your pharmacist or doctor before combining them, especially if you have heart concerns.

References
  1. Christenson JT, Thulesius O, Nazzal MM. The effect of forskolin on blood flow, platelet metabolism, aggregation and ATP release. Vasa 1995;24:56-61.
  2. Agarwal KC, Zielinski BA, Maitra RS. Significance of plasma adenosine in the antiplatelet activity of forskolin: potentiation by dipyridamole and dilazep. Thromb Haemost 1989;61:106-10. DOI
  3. Agarwal KC, Parks RE. Forskolin: a potential antimetastatic agent. Int J Cancer 1983;32:801-4. 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 29 major, 885 moderate known drug interactions in our database — the Naproxen, Pseudoephedrine 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.

Everything else you take

See Every Supplement That Interacts With Naproxen, Pseudoephedrine

This page covers Coleus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naproxen, Pseudoephedrine page lists 334 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 Ephedra (major).

By severity: 11 major · 279 moderate · 44 minor.

From our pharmacist’s overview on the Naproxen, Pseudoephedrine page

“Aleve Cold and Sinus pairs naproxen, an anti-inflammatory painkiller, with pseudoephedrine, a decongestant that acts as a mild stimulant, and that combination is why its supplement list runs to 334 entries and deserves real vigilance. The two biggest themes mirror the two drugs.”

Reviewed by 2 · Jul 18, 2026

Open the Naproxen, Pseudoephedrine 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 Naproxen, Pseudoephedrine 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 Naproxen, Pseudoephedrine 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%

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

29 days ago today
Medication Naproxen, Pseudoephedrine
Steady interest

#1,831 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
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.

29Major
885Moderate
0Minor
1,915No known interaction
Major

29 interactions

Moderate

885 interactions

Showing 60 of 885 moderate interactions — see all 885 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 Naproxen, Pseudoephedrine Together: Common Questions

Can you take Coleus with Naproxen, Pseudoephedrine?
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 2 interactions listed for Coleus and Naproxen, Pseudoephedrine?
Naproxen, Pseudoephedrine 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 Naproxen, Pseudoephedrine 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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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.