Drug & supplement interaction

Forsythia + Alteplase, tPA

Alteplase, tPA brand names: Activase, Actilyse.

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

Forsythia has a moderate interaction with Alteplase, tPA. Theoretically, taking forsythia with anticoagulant or antiplatelet drugs might increase the risk of bleeding due to decreased platelet aggregation.

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

Forsythia and Alteplase, tPA

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Alteplase, tPA

Alteplase, tPA falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Forsythia interacts with.

Theoretically, taking forsythia with anticoagulant or antiplatelet drugs might increase the risk of bleeding due to decreased platelet aggregation. Forsythia might reduce platelet aggregation by inhibiting platelet activating factor. Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's something worth knowing about alteplase (tPA): it's not a pill you take at home. It's a powerful clot-busting medicine given through an IV in the hospital, usually during an emergency like a stroke, heart attack, or a serious blood clot in the lungs. By its nature, it already carries a real bleeding risk while it's working.

The concern on file is that forsythia might make platelets a little less sticky, which could in theory add to bleeding risk. But honestly, this is based only on lab and animal studies, so it's quite weak and unproven. And practically speaking, nobody is sipping cold-and-flu herbs while getting emergency tPA in a hospital bed. If you take forsythia regularly, just mention it to your medical team so they have the full picture.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Iwakami S, Wu JB, Ebizuka Y, Sankawa U. Platelet activating factor (PAF) antagonists contained in medicinal plants: lignans and sesquiterpenes. Chem Pharm Bull (Tokyo) 1992;40:1196-8. 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

Forsythia Also Interacts With Other Medications

Forsythia has 121 moderate, 1 minor known drug interactions in our database — the Alteplase, tPA one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 Minor 1 No known interaction 2,708 (incl. Alteplase, tPA)
Taking anything else?

Check Another of Your Medications Against Forsythia

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

Everything else you take

See Every Supplement That Interacts With Alteplase, tPA

This page covers Forsythia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alteplase, tPA page lists 219 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 191 moderate · 25 minor.

From our pharmacist’s overview on the Alteplase, tPA page

“Nobody plans to receive alteplase (Activase, tPA). It arrives by IV in an emergency to dissolve the clot behind a stroke or heart attack, so the supplements already in your system at that moment matter, and this list deserves real weight.”

Reviewed by 2 · Jul 18, 2026

Open the Alteplase, tPA interaction page

One more smart check

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

We hold 355 real supplement products containing Forsythia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Forsythia. Your product may carry other ingredients that interact with Alteplase, tPA too, on top of Forsythia — 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 Forsythia and Alteplase, tPA 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 Forsythia
Top 25%

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

29 days ago today
Medication Alteplase, tPA
Steady interest

#1,790 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 Forsythia

What is Forsythia?

  • Colds and flu symptoms
  • Sore throat
  • Fever
  • Inflammation
  • Antimicrobial support

Forsythia is a traditional Chinese herb, used mainly for cold and flu symptoms and as part of multi-herb formulas. Most evidence comes from laboratory, animal, and traditional use rather than strong human studies, so its real-world benefits remain unproven. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Forsythia monograph & all interactions
Keep checking

Other Drugs & Forsythia

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

0Major
121Moderate
1Minor
2,707No known interaction
121 Moderate 1 Minor 2,707 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Forsythia page.

Minor

1 interaction

No interaction 2,707 drugs checked — show the list

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

Showing the 60 most looked-up of 2,707 medications checked with no known interaction — see the full Forsythia list.

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

Can you take Forsythia with Alteplase, tPA?
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 Forsythia and Alteplase, tPA 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

Still Have a Question About Alteplase, tPA and Forsythia?

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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.