Drug & supplement interaction

Docosahexaenoic Acid (dha) + Treprostinil

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

Treprostinil falls into 2 drug categories that Docosahexaenoic Acid (dha) can interact with; the most serious is rated moderate. Theoretically, taking DHA with antihypertensive drugs might increase the risk of hypotension.

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

Docosahexaenoic Acid (dha) and Treprostinil

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

Why Are There 2 Interactions?

Docosahexaenoic Acid (dha) interacts with whole categories of medication. Treprostinil falls into 2 of those categories, so it can interact with Docosahexaenoic Acid (dha) 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

Treprostinil falls under ANTIHYPERTENSIVE DRUGS — the group Docosahexaenoic Acid (dha) interacts with.

Theoretically, taking DHA with antihypertensive drugs might increase the risk of hypotension.
Fish oils containing DHA can lower blood pressure and might have additive effects in patients treated with antihypertensives; use with caution.
Severity Moderate 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 simple version: treprostinil (Orenitram) widens your blood vessels to ease the workload on your heart and lungs, and one of its known effects is lowering blood pressure. DHA from fish oil can nudge blood pressure down a little too. So when you take them together, those effects may stack up, and you could feel more lightheaded, dizzy, or flushed, especially when you stand up quickly.

This is mostly a theoretical, additive concern, and the supporting evidence is on the weaker side, so don't panic. Treprostinil already needs careful dose adjusting, so even small added effects are worth watching. Please don't start, stop, or change either one on your own. Just check in with your pharmacist or doctor first, and let them know if you feel unusually dizzy.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12.
  2. Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8.
  3. Sacks FM, Hebert P, Appel LJ, et al. Short report: the effect of fish oil on blood pressure and high-density lipoprotein-cholesterol levels in phase I of the trials of hypertension prevention. J Hypertens 1994;12:209-13.
  4. Vandongen R, Mori TA, Burke V, et al. Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease. Hypertension 1993;22:371-9. PubMed
  5. Mori, T. A., Bao, D. Q., Burke, V., Puddey, I. B., and Beilin, L. J. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension 1999;34(2):253-260. PubMed
  6. Nestel, P., Shige, H., Pomeroy, S., Cehun, M., Abbey, M., and Raederstorff, D. The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am.J.Clin.Nutr. 2002;76(2):326-330. PubMed
  7. Woodman, R. J., Mori, T. A., Burke, V., Puddey, I. B., Barden, A., Watts, G. F., and Beilin, L. J. Effects of purified eicosapentaenoic acid and docosahexaenoic acid on platelet, fibrinolytic and vascular function in hypertensive type 2 diabetic patients PubMed
  8. Theobald, H. E., Goodall, A. H., Sattar, N., Talbot, D. C., Chowienczyk, P. J., and Sanders, T. A. Low-dose docosahexaenoic acid lowers diastolic blood pressure in middle-aged men and women. J Nutr 2007;137(4):973-978.
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Treprostinil also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Although some clinical evidence suggests that DHA might reduce collagen-stimulated platelet aggregation and thromboxane release, most clinical evidence suggests that DHA alone does not affect blood clotting. However, theoretically, when given in combination with EPA as fish oil, concomitant use with anticoagulant or antiplatelet drugs (including aspirin) might increase risk of bleeding.
Severity Moderate Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the thing about treprostinil (Orenitram): besides relaxing blood vessels in your lungs, it also makes platelets a little less sticky, which slightly nudges up bleeding risk on its own. DHA can do something similar by mildly affecting how platelets clump together. So in theory, stacking the two could add up to a touch more bruising, nosebleeds, or bleeding that's slow to stop.

That said, this is mostly theoretical. Most studies show DHA by itself doesn't meaningfully change clotting, and the worry climbs only with higher fish oil doses (DHA plus EPA). Eating fish is unlikely to matter. Before adding a concentrated supplement, just run it by your pharmacist or doctor, and watch for any unusual bleeding.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Leng GC, Smith FB, Fowkes FG, et al. Relationship between plasma essential fatty acids and smoking, serum lipids, blood pressure and haemostatic and rheological factors. Prostaglandins Leukot Essent Fatty Acids 1994;51:101-8. PubMed
  2. Nelson GJ, Schmidt PS, Bartolini GL, et al. The effect of dietary docosahexaenoic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans. Lipids 1997;32:1129-36. PubMed
  3. Woodman, R. J., Mori, T. A., Burke, V., Puddey, I. B., Barden, A., Watts, G. F., and Beilin, L. J. Effects of purified eicosapentaenoic acid and docosahexaenoic acid on platelet, fibrinolytic and vascular function in hypertensive type 2 diabetic patients 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

Docosahexaenoic Acid (dha) Also Interacts With Other Medications

Docosahexaenoic Acid (dha) has 374 moderate known drug interactions in our database — the Treprostinil one above is among them. If you take anything else, check it against the full list below.

Moderate 374 No known interaction 2,456 (incl. Treprostinil)
Taking anything else?

Check Another of Your Medications Against Docosahexaenoic Acid (dha)

Covers the 2,830 medications we’ve checked against Docosahexaenoic Acid (dha). Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Treprostinil

This page covers Docosahexaenoic Acid (dha) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil 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.

Open the Treprostinil interaction page

How much people look this up

Where Docosahexaenoic Acid (dha) and Treprostinil 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 Docosahexaenoic Acid (dha)
Top half

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

29 days ago today
Medication Treprostinil
Steady interest

#2,033 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 Docosahexaenoic Acid (dha)

What is Docosahexaenoic Acid (dha)?

Docosahexaenoic Acid (dha)
  • Brain and cognitive health
  • Eye and vision health
  • Fetal and infant development
  • Heart and triglyceride support
  • General omega-3 supplementation

DHA is an omega-3 fatty acid found in fatty fish and algae that is a building block for the brain, nervous system, and eyes. It is widely used and generally well tolerated, with the strongest support for fetal/infant development and lowering triglycerides; evidence for many other uses is mixed. Talk with your pharmacist or doctor before starting, especially if you are pregnant, have a bleeding risk, or take blood thinners.

Read the full Docosahexaenoic Acid (dha) monograph & all interactions
Medication

About Treprostinil

What Is Treprostinil Used For?

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 & Docosahexaenoic Acid (dha)

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

0Major
374Moderate
0Minor
2,455No known interaction
374 Moderate 2,455 No interaction
Moderate

374 interactions

Showing 60 of 374 moderate interactions — see all 374 on the Docosahexaenoic Acid (dha) page.

No interaction 2,455 drugs checked — show the list

We also checked Docosahexaenoic Acid (dha) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,455 medications checked with no known interaction — see the full Docosahexaenoic Acid (dha) list.

See the full Docosahexaenoic Acid (dha) interactions page
See every supplement checked against Treprostinil, 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
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Pharmacist Counseling Corner

Taking Docosahexaenoic Acid (dha) and Treprostinil Together: Common Questions

Can you take Docosahexaenoic Acid (dha) with Treprostinil?
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 Docosahexaenoic Acid (dha) and Treprostinil?
Treprostinil belongs to more than one drug category, and Docosahexaenoic Acid (dha) 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 Docosahexaenoic Acid (dha) and Treprostinil 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.