Drug & supplement interaction

Coleus + Nicardipine

Nicardipine brand names: Cardene, Cardene SR, Cardene IV.

Major Interaction
The bottom line Major

Nicardipine 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 Nicardipine

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. Nicardipine 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 Nicardipine

Nicardipine 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 thing to know if you're thinking about adding Coleus while on nicardipine. Nicardipine already works by relaxing and widening your blood vessels to lower blood pressure and ease chest pain. Coleus contains forskolin, which in lab and small studies also seems to relax blood vessels through a separate pathway. So the worry is that the two could stack on top of each other and push your blood pressure too low.

If that happens, you might feel dizzy, lightheaded, unusually tired, flushed, or notice your heart racing, especially when you stand up quickly. This is a theoretical concern more than a proven one, but since it could add up, please don't start Coleus without checking with your pharmacist or doctor first. They can review your blood pressure and your full medication list.

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

Nicardipine 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. Nicardipine already does one main job: it relaxes and widens your blood vessels to bring your blood pressure down. Coleus contains forskolin, which in animal studies can also nudge blood pressure lower. So if you take both together, the worry is that their effects stack up and your pressure drops too far.

If that happened, you might feel dizzy or lightheaded, get a headache, notice flushing, or feel like your heart is racing, especially when you stand up quickly. To be fair, this is a theoretical concern based mostly on lab and animal work, not strong human proof. Still, since both can lower pressure, it's worth a quick chat with your pharmacist or doctor before combining them, particularly if your readings already run 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.
  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

Nicardipine 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 gist for Nicardipine: your liver clears it using an enzyme called CYP3A4. Lab research suggests Coleus may nudge your body into making more of that enzyme, which could speed up how fast Nicardipine is broken down. Nicardipine isn't a prodrug, so faster breakdown means less of it sticking around to do its job.

In plain terms, your blood pressure or chest pain might not be as well controlled if levels drop. I'll be honest though, this is only based on test-tube studies, so we really don't know if it matters in real people. Before adding Coleus, check with your pharmacist or doctor so they can keep an eye on your readings.

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 Nicardipine 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 Nicardipine

This page covers Coleus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nicardipine page lists 243 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), Arsenic (major) and Cesium (major).

By severity: 11 major · 191 moderate · 41 minor.

From our pharmacist’s overview on the Nicardipine page

“Nicardipine (Cardene) works by relaxing blood vessels to bring blood pressure down, so a supplement that shifts how much of the drug reaches your blood, or that moves blood pressure on its own, is worth genuine care rather than a shrug. Grapefruit can raise nicardipine levels enough to intensify its effects, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Nicardipine 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 Nicardipine 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 Nicardipine 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 Nicardipine
Steady interest

#1,878 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 Nicardipine

What Is Nicardipine Used For?

Brand names: Cardene, Cardene SR, Cardene IV

Nicardipine Hydrochloride capsules are used to treat high blood pressure (hypertension) and chronic stable angina (chest pain that comes on with physical effort). The capsules can be used alone or combined with other blood pressure or heart medications.

Intravenous (IV) nicardipine products — including Cardene I.V., Nicardipine Hydrochloride Injection, and Nicardipine Hydrochloride in Sodium Chloride — are used for the short-term treatment of high blood pressure in hospital settings when a patient cannot take oral medication. Once stable, patients are switched to oral therapy.

See full Nicardipine 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 Nicardipine Together: Common Questions

Can you take Coleus with Nicardipine?
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 Nicardipine?
Nicardipine 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 Nicardipine 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.