Drug & supplement interaction

European Mandrake + Epoprostenol

Epoprostenol brand name: Flolan.

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

European Mandrake has a moderate interaction with Epoprostenol. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.

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

European Mandrake and Epoprostenol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ORAL DRUGS

Why this applies to Epoprostenol

Epoprostenol falls under ORAL DRUGS — the group European Mandrake interacts with.

Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.
Severity Moderate Likelihood Probable Evidence D

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

Let me start with the big picture: European mandrake is genuinely toxic, and I would never recommend taking it at all. So the safest answer here is simply to avoid it. Now, about the interaction on file. The concern is that mandrake's tropane alkaloids (like atropine and scopolamine) slow down how fast your gut moves, which could let some oral drugs sit longer and be absorbed more.

Here's the catch for epoprostenol (Flolan): it isn't an oral pill. It's given as a continuous infusion straight into a vein because it breaks down almost instantly in the body. That means this gut-absorption interaction really doesn't apply to it. The bigger worry is mandrake's own toxicity. Please talk with your doctor or pharmacist before using any herbal product alongside your therapy.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

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

European Mandrake Also Interacts With Other Medications

European Mandrake has 2,041 moderate known drug interactions in our database — the Epoprostenol one above is one of them. If you take anything else, check it against the full list below.

Moderate 2,041 No known interaction 789 (incl. Epoprostenol)
Taking anything else?

Check Another of Your Medications Against European Mandrake

Covers the 2,830 medications we’ve checked against European Mandrake. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Epoprostenol

This page covers European Mandrake only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epoprostenol page lists 136 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), Tyramine (major) and Adrafinil (moderate).

By severity: 4 major · 111 moderate · 21 minor.

From our pharmacist’s overview on the Epoprostenol page

“American hellebore tops my concerns for anyone on epoprostenol (Flolan), the continuous infusion that opens blood vessels in the lungs to treat pulmonary arterial hypertension. The herb lowers blood pressure even in small doses, and stacked on a medicine that already relaxes those vessels, the drop can be dangerous.”

Reviewed by 2 · Jul 18, 2026

Open the Epoprostenol interaction page

How much people look this up

Where European Mandrake and Epoprostenol 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 European Mandrake
Top 25%

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

29 days ago today
Medication Epoprostenol
Steady interest

#2,676 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 European Mandrake

What is European Mandrake?

European Mandrake
  • Insomnia (traditional)
  • Pain relief (historical)
  • Anxiety or depression (folk use)
  • Gout and aches (traditional)
  • Sedation or anesthesia (historical)

European mandrake is a highly toxic plant from the nightshade family that was used in ancient and medieval times as a sedative and pain reliever. It contains powerful poisons that can cause serious harm or death, and there is no proof it safely treats any condition. We strongly recommend you do not consume mandrake in any form.

Read the full European Mandrake monograph & all interactions
Medication

About Epoprostenol

What Is Epoprostenol Used For?

Brand name: Flolan

Epoprostenol (available as the brands Epoprostenol, Flolan, and Veletri) is used to treat pulmonary arterial hypertension (PAH) — WHO Group 1, a type of high blood pressure in the arteries of the lungs. The goal is to improve how much physical activity patients can handle.

The clinical studies that established its effectiveness included mainly patients with moderate-to-severe symptoms (NYHA Functional Class III–IV) whose PAH was idiopathic (no known cause), heritable (genetic), or related to connective tissue diseases such as scleroderma.

See full Epoprostenol drug information
Keep checking

Other Drugs & European Mandrake

Browse every other medication we’ve checked against European Mandrake — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
2,041Moderate
0Minor
788No known interaction
2,041 Moderate 788 No interaction
Moderate

2,041 interactions

Showing 60 of 2,041 moderate interactions — see all 2,041 on the European Mandrake page.

No interaction 788 drugs checked — show the list

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

Showing the 60 most looked-up of 788 medications checked with no known interaction — see the full European Mandrake list.

See the full European Mandrake interactions page
See every supplement checked against Epoprostenol, 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
European Mandrake monograph › Uses, safety, and every drug interaction in one place Epoprostenol supplement interactions › Every supplement checked against Epoprostenol, ranked by severity Epoprostenol 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 European Mandrake and Epoprostenol Together: Common Questions

Can you take European Mandrake with Epoprostenol?
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.
How serious is the European Mandrake and Epoprostenol 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

Still Have a Question About Epoprostenol and European Mandrake?

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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.