Drug & supplement interaction

Fo-ti + Treprostinil (Oral)

Treprostinil (Oral) brand names: Remodulin, Orenitram.

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

Treprostinil (Oral) falls into 2 drug categories that Fo-ti can interact with; the most serious is rated moderate. Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants.

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

Fo-ti and Treprostinil (Oral)

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

Why Are There 2 Interactions?

Fo-ti interacts with whole categories of medication. Treprostinil (Oral) falls into 2 of those categories, so it can interact with Fo-ti in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Treprostinil (Oral)

Treprostinil (Oral) falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Fo-ti interacts with.

Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery. Theoretically, concomitant use of fo-ti with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients. Until more is known, monitor patients taking fo-ti and drugs that affect bleeding.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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's the thing to know about pairing Fo-ti with oral treprostinil. Treprostinil isn't a blood thinner in the usual sense, but it's a prostacyclin that relaxes blood vessels and naturally makes platelets less sticky, so it can add to bleeding risk on its own. Common side effects already include headache, flushing, jaw pain, diarrhea, and easy bruising.

The worry with Fo-ti is mostly about the liver. There are real (though rare) reports of Fo-ti causing liver injury, and a damaged liver makes fewer clotting factors. Stack that on top of treprostinil's mild blood-thinning effect and you could tip toward more bruising, nosebleeds, or harder-to-stop bleeding. This is anecdotal, not proven for treprostinil specifically. Please run it by your pharmacist or doctor before combining them, and watch for unusual bruising or yellowing skin.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. PubMed
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

2 of 2

Treprostinil (Oral) also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.
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's the gist for your oral treprostinil (Remodulin). Your body uses a liver enzyme called CYP2C8 to help clear this drug. Lab studies hint that Fo-ti may slow that enzyme down. If it does, treprostinil could build up a bit more than expected, which might mean stronger side effects like headache, flushing, nausea, diarrhea, jaw pain, or lightheadedness.

The key word here is theoretical. This comes from test-tube research only and hasn't actually been seen in real people, so I don't want you to panic. Still, since Fo-ti has also been linked to liver injury in some reports, it's worth a quick chat with your pharmacist or doctor before combining the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. 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

Fo-ti Also Interacts With Other Medications

Fo-ti has 1,256 moderate known drug interactions in our database — the Treprostinil (Oral) one above is among them. If you take anything else, check it against the full list below.

Moderate 1,256 No known interaction 1,574 (incl. Treprostinil (Oral))
Taking anything else?

Check Another of Your Medications Against Fo-ti

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

Everything else you take

See Every Supplement That Interacts With Treprostinil (Oral)

This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil (Oral) page lists 291 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), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Treprostinil (Oral) page

“With treprostinil (Orenitram), a medicine that opens narrowed lung arteries in pulmonary arterial hypertension, supplements deserve more scrutiny than usual. The drug widens blood vessels and dampens platelet clumping, and nearly everything on this list leans on one of those two levers.”

Reviewed by 2 · Jul 18, 2026

Open the Treprostinil (Oral) interaction page

One more smart check

Taking Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions

We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Treprostinil (Oral) too, on top of Fo-ti — 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 Fo-ti and Treprostinil (Oral) 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 Fo-ti
Top 25%

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

29 days ago today
Medication Treprostinil (Oral)
Top 25%

#530 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 Fo-ti

What is Fo-ti?

  • Anti-aging and longevity
  • Hair graying and hair loss
  • General tonic for vitality
  • Constipation
  • High cholesterol

Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.

Read the full Fo-ti monograph & all interactions
Medication

About Treprostinil

What Is Treprostinil Used For?

Brand names: Remodulin, Orenitram

Treprostinil treats pulmonary arterial hypertension (PAH; WHO Group 1) — high blood pressure in the arteries of the lungs. Depending on the product and route, it is used to improve exercise ability, delay disease progression, or reduce symptoms tied to physical activity. Remodulin and treprostinil injection products are also indicated for patients who need to transition away from another PAH medicine called epoprostenol.

Tyvaso, Tyvaso DPI, and Yutrepia (inhaled forms) are additionally approved to treat pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) — lung-pressure problems caused by scarring or inflammation in the lung tissue itself. Orenitram (extended-release oral tablet) is specifically indicated to delay disease progression and improve exercise capacity in PAH.

See full Treprostinil drug information
Keep checking

Other Drugs & Fo-ti

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

0Major
1,256Moderate
0Minor
1,573No known interaction
1,256 Moderate 1,573 No interaction
Moderate

1,256 interactions

Showing 60 of 1,256 moderate interactions — see all 1,256 on the Fo-ti page.

No interaction 1,573 drugs checked — show the list

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

Showing the 60 most looked-up of 1,573 medications checked with no known interaction — see the full Fo-ti list.

See the full Fo-ti interactions page
See every supplement checked against Treprostinil (Oral), 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
Fo-ti monograph › Uses, safety, and every drug interaction in one place Treprostinil (Oral) supplement interactions › Every supplement checked against Treprostinil (Oral), ranked by severity Treprostinil 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 Fo-ti and Treprostinil (Oral) Together: Common Questions

Can you take Fo-ti with Treprostinil (Oral)?
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 Fo-ti and Treprostinil (Oral)?
Treprostinil (Oral) belongs to more than one drug category, and Fo-ti 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 Fo-ti and Treprostinil (Oral) 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.