Drug & supplement interaction

Coleus + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Nintedanib Esylate falls into 2 drug categories that Coleus can interact with; the most serious is rated moderate. Theoretically, taking coleus might decrease serum levels of drugs metabolized by CYP3A4.

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

Coleus and Nintedanib Esylate

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. Nintedanib Esylate 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 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Nintedanib Esylate

Nintedanib Esylate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Coleus interacts with.

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 with Ofev (nintedanib) and Coleus. Your body partly clears nintedanib using a liver enzyme called CYP3A4. Lab studies suggest the forskolin in Coleus may rev up that enzyme, which in theory could clear nintedanib a little faster and leave less of it in your system. Since nintedanib is the active drug (not a prodrug that needs switching on), that would mean a weaker effect, and the whole point of Ofev is to slow lung scarring.

I want to be honest, though: this is only test-tube evidence, so we don't really know if it matters in real life. Please don't stop or change anything on your own. Just loop in your pharmacist or doctor before adding Coleus so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
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
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Nintedanib Esylate 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 connection to keep in mind with Ofev (nintedanib). This medication can carry a bleeding risk on its own, and Coleus may add to that. The active compound in Coleus, forskolin, has been shown in lab and animal studies to make platelets (the cells that help blood clot) stickier and slower to clump together. Stacking the two could, in theory, make bruising or bleeding a little more likely.

I want to be honest that this is theoretical and based only on test-tube and animal research, not human studies, so the real-world risk isn't well proven. Still, watch for things like easy bruising, nosebleeds, bleeding gums, or blood in your stool. Please check with your doctor or pharmacist before adding Coleus while you're on Ofev.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Nintedanib Esylate one above is among them. If you take anything else, check it against the full list below.

Major 29 Moderate 885 No known interaction 1,916 (incl. Nintedanib Esylate)
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 Nintedanib Esylate

This page covers Coleus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate 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 Nintedanib Esylate 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 Nintedanib Esylate 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%

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

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,963 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 Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib 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.

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

We also checked Coleus against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,915 medications checked with no known interaction — see the full Coleus list.

See the full Coleus interactions page
See every supplement checked against Nintedanib Esylate, ranked by severity
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

Keep exploring
Coleus monograph › Uses, safety, and every drug interaction in one place Nintedanib Esylate supplement interactions › Every supplement checked against Nintedanib Esylate, ranked by severity Nintedanib drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Coleus and Nintedanib Esylate Together: Common Questions

Can you take Coleus with Nintedanib Esylate?
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 Nintedanib Esylate?
Nintedanib Esylate 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 Nintedanib Esylate 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.