Drug & supplement interaction

Eurycoma Longifolia + Propranolol Hydrochloride

Propranolol Hydrochloride brand name: Hemangeol.

Moderate Interaction
The bottom line Moderate

Propranolol Hydrochloride falls into 3 drug categories that Eurycoma Longifolia can interact with; the most serious is rated moderate. Eurycoma longifolia can reduce the levels and clinical effects of propranolol.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions3
EvidenceA
What do Severity, Likelihood & Evidence mean?
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Interaction report

Eurycoma Longifolia and Propranolol Hydrochloride

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Eurycoma Longifolia interacts with whole categories of medication. Propranolol Hydrochloride falls into 3 of those categories, so it can interact with Eurycoma Longifolia in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

PROPRANOLOL (Inderal)

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Eurycoma longifolia can reduce the levels and clinical effects of propranolol.
A small clinical study in healthy persons shows that taking a single dose of a water-based Eurycoma longifolia extract 200 mg, in combination with a single dose of propranolol 80 mg, reduces the propranolol area under the curve (AUC) by 29%, reduces the peak concentration by 42%, and increases time to peak concentration by 86% when compared with control. Since the elimination half-life of propranolol did not change, it seems that Eurycoma longifolia alters the kinetics of propranolol by decreasing its absorption in the gut, and not by altering its metabolism. It is not known if separating administration will prevent this interaction.
Severity Moderate Likelihood Probable Evidence A

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 gist: tongkat ali (Eurycoma longifolia) seems to get in the way of how well your body absorbs propranolol from the gut. In a good-quality study in healthy adults, taking the herb alongside propranolol lowered the amount that reached the bloodstream by roughly a third and cut the peak level by about 42%. So this is about less propranolol working, not more.

For an infant treated for hemangioma, propranolol is dosed carefully to shrink those growths and keep blood vessels in check. If the herb blunts how much is absorbed, the medicine may simply work less well. Honestly, tongkat ali isn't something you'd give a baby anyway, but if anyone in the home is considering this combo, please check with your pharmacist or doctor first rather than changing anything on your own.

References
  1. Salman SA, Amrah S, Wahab MS, et al. Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract. J Clin Pharm Ther 2010;35:691-6. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

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Why this applies to Propranolol Hydrochloride

Propranolol Hydrochloride falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Eurycoma Longifolia interacts with.

Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP1A2 enzymes. This effect has not been reported in humans.
Severity Minor 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 tongkat ali and propranolol. Your liver uses an enzyme called CYP1A2 to help clear propranolol from the body. In a test-tube study, an extract of this herb was shown to mildly block that enzyme. If that happened in a real person, propranolol could clear a little slower and build up slightly, which in theory might mean more of its usual effects, like a slower heart rate, lower blood pressure, tiredness, or cool hands and feet.

The important part: this was only seen in a lab dish, never in actual people, and the effect was weak. So this is more of a theoretical concern than a proven one. Since this version of propranolol is given to infants for hemangioma, please loop in the prescriber or pharmacist before adding any supplement.

References
  1. Han YM, Kim IS, Rehman SU, Choe K, Yoo HH. In vitro evaluation of the effects of Eurycoma longifolia extract on CYP-mediated drug metabolism. Evid Based Complement Alternat Med 2015;2015:631329.
Minor

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

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Propranolol Hydrochloride also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2C19 enzymes. This effect has not been reported in humans.
Severity Minor 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 tongkat ali and propranolol. The concern on file is that this herb might mildly block an enzyme called CYP2C19, which is one of the pathways your body uses to clear propranolol. If that enzyme slows down, propranolol could build up a bit, which in theory could nudge its effects stronger. With propranolol that might look like a slower heart rate, lower blood pressure, tiredness, or cold hands and feet. In the infant solution (Hemangeol), parents would want to watch for sluggishness, poor feeding, or unusually low heart rate.

That said, this is theoretical and comes only from lab (test tube) studies, never shown in real people, and it's rated minor. So don't panic, but do run it by your pharmacist or doctor first before combining them.

References
  1. Han YM, Kim IS, Rehman SU, Choe K, Yoo HH. In vitro evaluation of the effects of Eurycoma longifolia extract on CYP-mediated drug metabolism. Evid Based Complement Alternat Med 2015;2015:631329.

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

Eurycoma Longifolia Also Interacts With Other Medications

Eurycoma Longifolia has 2 moderate, 245 minor known drug interactions in our database — the Propranolol Hydrochloride 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 Eurycoma Longifolia

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

Everything else you take

See Every Supplement That Interacts With Propranolol Hydrochloride

This page covers Eurycoma Longifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Propranolol Hydrochloride page lists 236 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), Indian Snakeroot (major) and Tyramine (major).

Open the Propranolol Hydrochloride interaction page

One more smart check

Taking Eurycoma Longifolia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,122 real supplement products containing Eurycoma Longifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eurycoma Longifolia. Your product may carry other ingredients that interact with Propranolol Hydrochloride too, on top of Eurycoma Longifolia — 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 Eurycoma Longifolia and Propranolol Hydrochloride 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 Eurycoma Longifolia
Top 25%

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

29 days ago today
Medication Propranolol Hydrochloride
Steady interest

#1,803 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 Eurycoma Longifolia

What is Eurycoma Longifolia?

Eurycoma Longifolia
  • Low testosterone or low libido in men
  • Male fertility support
  • Athletic performance and muscle strength
  • Energy and fatigue
  • Stress and mood
  • General male enhancement

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits. However, the overall evidence is still limited and product quality varies widely, so talk with your pharmacist or doctor before using it, and avoid it if you are pregnant or breastfeeding.

Read the full Eurycoma Longifolia monograph & all interactions
Medication

About Propranolol (Infantile Hemangioma)

What Is Propranolol (Infantile Hemangioma) Used For?

Brand name: Hemangeol

This intravenous (IV) form of propranolol is used in hospital settings to treat serious, life-threatening heart rhythm problems. It works on several types of abnormal rhythms, including those that happen during anesthesia or are caused by drug toxicity.

Specific uses include fast heart rhythms coming from the upper chambers of the heart (supraventricular tachycardia), dangerous rhythms caused by too much digitalis in the body, and certain fast rhythms triggered by excess stress hormones (catecholamines) during surgery.

See full Propranolol (Infantile Hemangioma) drug information
Keep checking

Other Drugs & Eurycoma Longifolia

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

0Major
2Moderate
245Minor
2,582No known interaction
Moderate

2 interactions

Minor

245 interactions

Showing 60 of 245 minor interactions — see all 245 on the Eurycoma Longifolia page.

No interaction 2,582 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 Eurycoma Longifolia and Propranolol Hydrochloride Together: Common Questions

Can you take Eurycoma Longifolia with Propranolol Hydrochloride?
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 3 interactions listed for Eurycoma Longifolia and Propranolol Hydrochloride?
Propranolol Hydrochloride belongs to more than one drug category, and Eurycoma Longifolia 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 Eurycoma Longifolia and Propranolol Hydrochloride 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.