Drug & supplement interaction

Fenugreek + Macitentan

Macitentan brand name: Opsumit.

Minor Interaction
Medically reviewed by · Updated March 2023
The bottom line Minor

Fenugreek has a minor interaction with Macitentan. Fenugreek may also have an additive effect on blood pressure-lowering medications.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fenugreek and Macitentan

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

Minor

Antihypertensive Drugs

Why this applies to Macitentan

Macitentan falls under Antihypertensive Drugs — the group Fenugreek interacts with.

Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.
Severity Minor Likelihood Possible Evidence C

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 simple version: macitentan (Opsumit) relaxes the blood vessels in your lungs to ease the strain of pulmonary arterial hypertension, and it can lower your overall blood pressure a bit too. Fenugreek, when taken in concentrated supplement doses, may also nudge blood pressure downward. Put them together and those effects could stack, so your numbers might dip a little lower than expected.

Honestly, this is a minor concern, and the evidence is mostly from animal studies, so don't panic. If you do combine them, just keep an eye out for signs of low blood pressure like dizziness, lightheadedness when standing up, or feeling unusually tired, and check your pressure now and then. The fenugreek you sprinkle on food is very unlikely to matter. Before adding a fenugreek supplement, run it by your pharmacist or doctor.

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

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

Fenugreek Also Interacts With Other Medications

Fenugreek has 224 moderate, 164 minor known drug interactions in our database — the Macitentan one above is one of them. If you take anything else, check it against the full list below.

Moderate 224 Minor 164 No known interaction 2,442 (incl. Macitentan)
Taking anything else?

Check Another of Your Medications Against Fenugreek

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

Everything else you take

See Every Supplement That Interacts With Macitentan

This page covers Fenugreek only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Macitentan page lists 253 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), Beer (major) and Grapefruit (major).

By severity: 9 major · 205 moderate · 39 minor.

From our pharmacist’s overview on the Macitentan page

“If you take macitentan (Opsumit) for pulmonary arterial hypertension, study this page rather than skim it. It lists 253 supplement and herbal ingredients, nine rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Macitentan interaction page

One more smart check

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

We hold 2,385 real supplement products containing Fenugreek, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fenugreek. Your product may carry other ingredients that interact with Macitentan too, on top of Fenugreek — 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 Fenugreek and Macitentan 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 Fenugreek
Top 10%

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

29 days ago today
Medication Macitentan
Top 5%

#87 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 Fenugreek

What is Fenugreek?

Fenugreek
  • Blood sugar control
  • Boosting breast milk supply
  • High cholesterol
  • Digestive upset
  • Low testosterone or libido

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blood sugar, but overall the evidence is mixed and far from settled. It is generally well tolerated as food, but talk with your pharmacist or doctor before using it as a supplement, especially if you are pregnant.

Read the full Fenugreek monograph & all interactions
Medication

About Macitentan

What Is Macitentan Used For?

Brand name: Opsumit

Macitentan tablets — sold under the brand name Opsumit — are used to treat pulmonary arterial hypertension (PAH, WHO Group I), a serious condition where the blood pressure in the arteries supplying the lungs is abnormally high. The goal is to slow down how quickly the disease gets worse and to lower the chances of being hospitalized because of it.

In clinical studies, it was shown to be effective in adults with mostly moderate-to-severe PAH symptoms. Patients in those studies had PAH caused by unknown or inherited reasons, connective tissue disorders, or congenital heart disease with repaired heart shunts.

See full Macitentan drug information
Keep checking

Other Drugs & Fenugreek

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

0Major
224Moderate
164Minor
2,441No known interaction
224 Moderate 164 Minor 2,441 No interaction
Moderate

224 interactions

Showing 60 of 224 moderate interactions — see all 224 on the Fenugreek page.

Minor

164 interactions

Showing 60 of 164 minor interactions — see all 164 on the Fenugreek page.

No interaction 2,441 drugs checked — show the list

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

Showing the 60 most looked-up of 2,441 medications checked with no known interaction — see the full Fenugreek list.

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

Can you take Fenugreek with Macitentan?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Fenugreek and Macitentan interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Macitentan and Fenugreek?

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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.