Drug & supplement interaction

Fever Bark + Telmisartan

Telmisartan brand name: Micardis.

Moderate Interaction
The bottom line Moderate

Fever Bark has a moderate interaction with Telmisartan. Theoretically, fever bark might alter the effects of antihypertensive drugs.

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

Fever Bark and Telmisartan

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Telmisartan

Telmisartan 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 thing about pairing fever bark with telmisartan: this herb is a bit of a wildcard for blood pressure. It contains two opposing alkaloids. One (a yohimbine-like compound) can push blood pressure up, while another (a reserpine-like compound) can pull it down. Telmisartan's whole job is to keep your pressure steady, so adding something this unpredictable on top of it can throw off that control in either direction.

What might that feel like? If your pressure dips too low, you could get dizzy, lightheaded, or faint when you stand up. If it climbs, you lose the protection telmisartan is giving you. To be fair, this is a theoretical concern based on how the alkaloids work, not strong human studies. Still, please check with your pharmacist or doctor before combining them.

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.

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 Telmisartan one above is one of 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.

From our Q&A

Questions About Fever Bark or Telmisartan

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Fever Bark or Telmisartan, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Telmisartan

This page covers Fever Bark only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Telmisartan page lists 140 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 · 114 moderate · 22 minor.

From our pharmacist’s overview on the Telmisartan page

“Telmisartan (Micardis) has one job, holding blood pressure in a safe range, and most of the 140 supplements and herbs listed here can either pile onto that effect or push against it, so I'd approach these combinations with real care. Four carry a major rating and deserve your attention first: two toxic plants that act directly on the h…”

Reviewed by 2 · Jul 18, 2026

Open the Telmisartan interaction page

How much people look this up

Where Fever Bark and Telmisartan 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

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

29 days ago today
Medication Telmisartan
Top 25%

#451 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 Telmisartan

What Is Telmisartan Used For?

Brand name: Micardis

Telmisartan tablets — sold as Micardis and the generic telmisartan — treat high blood pressure (hypertension). Bringing blood pressure down lowers the risk of strokes and heart attacks.

Micardis and telmisartan tablets are also approved to reduce the risk of heart attack, stroke, or death from cardiovascular causes in patients 55 or older who are at high cardiovascular risk and cannot take ACE inhibitors. This use is for patients with a history of conditions such as coronary artery disease, peripheral arterial disease, stroke, TIA (mini-stroke), or high-risk diabetes with signs of organ damage.

See full Telmisartan 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 Telmisartan Together: Common Questions

Can you take Fever Bark with Telmisartan?
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 Fever Bark and Telmisartan 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.