Drug & supplement interaction

Fever Bark + Nicardipine

Nicardipine brand names: Cardene, Cardene SR, Cardene IV.

Moderate Interaction
The bottom line Moderate

Nicardipine falls into 2 drug categories that Fever Bark can interact with; the most serious is rated moderate. Theoretically, fever bark might alter the effects of antihypertensive drugs.

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

Fever Bark and Nicardipine

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

Why Are There 2 Interactions?

Fever Bark interacts with whole categories of medication. Nicardipine falls into 2 of those categories, so it can interact with Fever Bark 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 Nicardipine

Nicardipine falls under ANTIHYPERTENSIVE DRUGS — the group Fever Bark interacts with.

Theoretically, fever bark might alter the effects of antihypertensive drugs.
Yohimbine, a constituent of fever bark, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Conversely, reserpine can reduce both systolic and diastolic blood pressure. Theoretically, concomitant use of fever bark and antihypertensive drugs can interfere with blood pressure control.
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

Here's the tricky thing about fever bark and your nicardipine (Cardene). This bark contains a mix of plant alkaloids that pull your blood pressure in opposite directions. One of them, a yohimbine-like compound, can raise blood pressure, while another, a reserpine-like compound, can lower it. Either way, it can throw off the careful blood pressure control nicardipine is meant to provide.

If your pressure swings up, you might lose the benefit you're counting on. If it drops too far, you could feel dizzy, lightheaded, flushed, or get a headache or a fast heartbeat. To be clear, this concern is theoretical and based on how the chemicals behave, not on solid human studies. Still, I'd skip the fever bark and check with your pharmacist or doctor first.

References
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  3. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
  4. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

2 of 2

Nicardipine also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of yohimbine, a constituent of fever bark.
In vitro and clinical research shows that the fever bark constituent, yohimbine, is metabolized by CYP3A4 enzymes.
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 the concern runs the opposite direction from what you might expect. Nicardipine is a calcium channel blocker that happens to slow down the CYP3A4 enzyme. Fever bark contains yohimbine, and yohimbine is broken down by that same enzyme. So by taking nicardipine, you could slow the clearance of yohimbine, letting it build up in your body.

That matters because yohimbine can push blood pressure and heart rate up, plus cause jitteriness, anxiety, and a racing feeling. That partly works against what nicardipine is trying to do for your blood pressure or chest pain. Keep in mind this is theoretical, based on how the chemicals behave, not real-world reports. Still, fever bark is potent and poorly studied, so please check with your pharmacist or doctor before combining them.

References
  1. Le Corre P, Parmer RJ, Kailasam MT, et al. Human sympathetic activation by alpha2-adrenergic blockade with yohimbine: Bimodal, epistatic influence of cytochrome P450-mediated drug metabolism. Clin Pharmacol Ther. 2004;76(2):139-53.
  2. Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9. 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

Fever Bark Also Interacts With Other Medications

Fever Bark has 40 major, 673 moderate, 87 minor known drug interactions in our database — the Nicardipine 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 Fever Bark

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

Everything else you take

See Every Supplement That Interacts With Nicardipine

This page covers Fever Bark only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nicardipine page lists 243 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), Arsenic (major) and Cesium (major).

By severity: 11 major · 191 moderate · 41 minor.

From our pharmacist’s overview on the Nicardipine page

“Nicardipine (Cardene) works by relaxing blood vessels to bring blood pressure down, so a supplement that shifts how much of the drug reaches your blood, or that moves blood pressure on its own, is worth genuine care rather than a shrug. Grapefruit can raise nicardipine levels enough to intensify its effects, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Nicardipine interaction page

How much people look this up

Where Fever Bark and Nicardipine 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 Fever Bark
Steady interest

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

29 days ago today
Medication Nicardipine
Steady interest

#1,917 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 Fever Bark

What is Fever Bark?

Fever Bark
  • Fever
  • Diarrhea
  • Malaria (traditional)
  • Digestive complaints
  • Bitter tonic

Fever bark is the bark of the Australian tree Alstonia constricta, used in traditional medicine for fever, diarrhea, and infections. There is very little reliable human research to support these uses, and the bark contains potent alkaloids that may cause serious side effects. It is best avoided unless used under direct medical supervision.

Read the full Fever Bark monograph & all interactions
Medication

About Nicardipine

What Is Nicardipine Used For?

Brand names: Cardene, Cardene SR, Cardene IV

Nicardipine Hydrochloride capsules are used to treat high blood pressure (hypertension) and chronic stable angina (chest pain that comes on with physical effort). The capsules can be used alone or combined with other blood pressure or heart medications.

Intravenous (IV) nicardipine products — including Cardene I.V., Nicardipine Hydrochloride Injection, and Nicardipine Hydrochloride in Sodium Chloride — are used for the short-term treatment of high blood pressure in hospital settings when a patient cannot take oral medication. Once stable, patients are switched to oral therapy.

See full Nicardipine drug information
Keep checking

Other Drugs & Fever Bark

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

40Major
673Moderate
87Minor
2,029No known interaction
Major

40 interactions

Moderate

673 interactions

Showing 60 of 673 moderate interactions — see all 673 on the Fever Bark page.

Minor

87 interactions

Showing 60 of 87 minor interactions — see all 87 on the Fever Bark page.

No interaction 2,029 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 Fever Bark and Nicardipine Together: Common Questions

Can you take Fever Bark with Nicardipine?
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 Fever Bark and Nicardipine?
Nicardipine belongs to more than one drug category, and Fever Bark 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 Fever Bark and Nicardipine 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.