Drug & supplement interaction

Forsythia + Vorapaxar

Vorapaxar brand name: Zontivity.

Moderate Interaction
The bottom line Moderate

Forsythia has a moderate interaction with Vorapaxar. 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 Vorapaxar

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Vorapaxar

Vorapaxar 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 the basic idea with vorapaxar (Zontivity). This medicine is already a potent blood thinner, working by blocking platelets from clumping together so you don't form dangerous clots. The concern with forsythia is that some of its plant compounds may also nudge platelets to stick together less, possibly through a pathway called platelet activating factor. Stack that on top of vorapaxar (which you're likely taking alongside aspirin and clopidogrel) and in theory you could see a bit more bleeding, things like easy bruising, nosebleeds, bleeding gums, or blood that's slower to stop.

Now, the honest part: this is based only on lab and animal work, and it's rated unlikely to actually happen. I'm not telling you to avoid it, just loop in your pharmacist or doctor first since vorapaxar already carries real bleeding risk on its own.

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 Vorapaxar 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 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 Vorapaxar

This page covers Forsythia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vorapaxar page lists 282 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 236 moderate · 41 minor.

From our pharmacist’s overview on the Vorapaxar page

“Vorapaxar (Zontivity) keeps platelets from clumping after a heart attack or clogged leg arteries, so it raises bleeding risk by design, and adding supplements calls for real caution. Of the 282 ingredients on file, 202 can thin the blood further, stacking their antiplatelet effects on the drug's.”

Reviewed by 2 · Jul 18, 2026

Open the Vorapaxar 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 Vorapaxar 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 Vorapaxar 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 Vorapaxar
Steady interest

#2,814 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
Medication

About Vorapaxar

What Is Vorapaxar Used For?

Brand name: Zontivity

Zontivity (vorapaxar) is used to lower the risk of heart attack, stroke, cardiovascular death, and the need for urgent procedures to open blocked arteries. It is prescribed for people who have already had a heart attack or who have peripheral arterial disease (PAD) — a condition where arteries outside the heart become narrowed or blocked.

Zontivity is not used alone. It is given alongside aspirin and/or clopidogrel as part of a broader antiplatelet treatment plan.

See full Vorapaxar drug information
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
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
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 Forsythia and Vorapaxar Together: Common Questions

Can you take Forsythia with Vorapaxar?
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 Vorapaxar 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 Vorapaxar 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.