Drug & supplement interaction

Coleus + Treprostinil (Oral)

Treprostinil (Oral) brand names: Remodulin, Orenitram.

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

Treprostinil (Oral) falls into 2 drug categories that Coleus can interact with; the most serious is rated moderate. Theoretically, combining coleus with antihypertensive drugs might cause additive blood pressure lowering effects and increase the risk of hypotension.

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

Coleus and Treprostinil (Oral)

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. Treprostinil (Oral) 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

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Treprostinil (Oral)

Treprostinil (Oral) falls under ANTIHYPERTENSIVE DRUGS — the group Coleus interacts with.

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 gist: oral treprostinil already works partly by relaxing and widening your blood vessels, which lowers blood pressure. Coleus, through its compound forskolin, may push in the same direction. Stack the two and the blood-pressure-lowering effects could add up, leaving you more likely to feel dizzy, lightheaded, flushed, or faint, especially when you stand up quickly.

I want to be honest about the evidence, though. This concern comes mainly from animal studies and theory, not strong human data, so it's a 'be aware' situation rather than a sure thing. Since treprostinil is a serious medication for a serious condition, please don't add Coleus on your own. Check with your pharmacist or doctor first so they can weigh it for you.

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

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Treprostinil (Oral) 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 something worth knowing if you take oral treprostinil. This medication already works to relax and widen blood vessels in your lungs, and one of its known effects is that it can make platelets a little less sticky, which slightly raises your bleeding risk on its own. Coleus contains forskolin, and in lab and animal studies that compound also appears to keep platelets from clumping together.

Stack the two and, in theory, you might bruise more easily or notice things like nosebleeds, bleeding gums, or cuts that are slow to stop. I'll be honest though, this concern comes only from test tube and animal research, not real patient cases, so it's more a caution than a proven problem. Still, please run it by your doctor or pharmacist before adding Coleus.

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 Treprostinil (Oral) 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. Treprostinil (Oral))
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 Treprostinil (Oral)

This page covers Coleus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil (Oral) page lists 291 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), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Treprostinil (Oral) page

“With treprostinil (Orenitram), a medicine that opens narrowed lung arteries in pulmonary arterial hypertension, supplements deserve more scrutiny than usual. The drug widens blood vessels and dampens platelet clumping, and nearly everything on this list leans on one of those two levers.”

Reviewed by 2 · Jul 18, 2026

Open the Treprostinil (Oral) 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 Treprostinil (Oral) 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 Treprostinil (Oral) 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%

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

29 days ago today
Medication Treprostinil (Oral)
Top 25%

#615 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 Treprostinil

What Is Treprostinil Used For?

Brand names: Remodulin, Orenitram

Treprostinil treats pulmonary arterial hypertension (PAH; WHO Group 1) — high blood pressure in the arteries of the lungs. Depending on the product and route, it is used to improve exercise ability, delay disease progression, or reduce symptoms tied to physical activity. Remodulin and treprostinil injection products are also indicated for patients who need to transition away from another PAH medicine called epoprostenol.

Tyvaso, Tyvaso DPI, and Yutrepia (inhaled forms) are additionally approved to treat pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) — lung-pressure problems caused by scarring or inflammation in the lung tissue itself. Orenitram (extended-release oral tablet) is specifically indicated to delay disease progression and improve exercise capacity in PAH.

See full Treprostinil 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 Treprostinil (Oral), 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 Treprostinil (Oral) supplement interactions › Every supplement checked against Treprostinil (Oral), ranked by severity Treprostinil 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 Treprostinil (Oral) Together: Common Questions

Can you take Coleus with Treprostinil (Oral)?
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 Treprostinil (Oral)?
Treprostinil (Oral) 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 Treprostinil (Oral) 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.