Drug & supplement interaction

Goji + Bosentan

Bosentan brand name: Tracleer.

Moderate Interaction
The bottom line Moderate

Bosentan falls into 3 drug categories that Goji can interact with; the most serious is rated moderate. Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Goji and Bosentan

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Goji interacts with whole categories of medication. Bosentan falls into 3 of those categories, so it can interact with Goji in 3 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 3

Why this applies to Bosentan

Bosentan falls under ANTIHYPERTENSIVE DRUGS — the group Goji interacts with.

Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.
Animal and in vitro research suggest that goji root bark has hypotensive effects. However, goji fruit juice does not appear to reduce systolic or diastolic blood pressure 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 practical takeaway for your Tracleer (bosentan). The concern on file isn't about the goji fruit you'd eat or drink as juice. It's specifically the root bark, which in lab and animal studies has shown a mild blood-pressure-lowering effect. Since bosentan already relaxes blood vessels to treat your lung pressure, the theory is that goji root bark could add to that and nudge your blood pressure down a bit more than expected.

I'll be honest, this is theoretical and based on early research, not real cases in people. Goji fruit juice didn't lower blood pressure in human studies. Still, if a concentrated goji root bark supplement ever left you feeling dizzy, lightheaded, or unusually tired, mention it to your pharmacist or doctor before changing anything.

References
  1. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. Boca Raton, FL: CRC Press, LLC 1999.
  2. Amagase H, Nance DM. A randomized, double-blind, placebo-controlled, clinical study of the general effects of a standardized Lycium barbarum (goji) juice, GoChi. J Altern Complement Med 2008;14:403-12.
  3. Potterat O. Goji (Lycium barbarum and L. chinense): Phytochemistry, pharmacology and safety in the perspective of traditional uses and recent popularity. Planta Med 2010;76(1):7-19.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

Bosentan also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C9 enzymes. Additionally, multiple case reports suggest that goji berry concentrated tea and juice inhibit the metabolism of warfarin, a CYP2C9 substrate. Concomitant use with goji may decrease metabolism and increase levels of CYP2C9 substrates.
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: your body clears bosentan partly through a liver enzyme called CYP2C9, and goji berry may slow that enzyme down. If goji blocks it, bosentan can hang around longer and build up to higher levels than usual. Bosentan is the active drug (not a prodrug), so more of it means a stronger effect and a higher chance of its typical side effects, things like headache, flushing, swelling in the legs, low blood pressure, or strain on the liver.

Honestly, this is mostly theoretical, coming from lab studies and a few warfarin case reports, not strong human data with bosentan. Eating goji berries as a food is unlikely to matter. Concentrated goji juice, tea, or supplements are more of a concern. Please run it by your pharmacist or doctor before mixing them.

References
  1. Lam AY, Elmer GW, Mohutsky MA. Possible interaction between warfarin and Lycium Barbarum. Ann Pharmacother 2001;35:1199-201.
  2. Guzmán CE, Guzmán-Moreno CG, Assad-Morell JL, Edgar Francisco Carrizales-Sepúlveda EF. Flecainide toxicity associated with the use of goji berries: a case report. Eur Heart J Case Rep. 2021;5(6):ytab204. PubMed
  3. Liu R, Tam TW, Mao J, et al. In vitro activity of Lycium barbarum (Goji) against major human phase I metabolism enzymes. Complement Integr Med. 2016;13(3):257-265.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Bosentan also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.
In vitro research shows that goji berry juice inhibits CYP3A4 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP3A4 substrates. However, this 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 simple version. Your body clears bosentan partly through a liver enzyme called CYP3A4. Lab studies suggest goji berry juice can slow that same enzyme down. In theory, if goji blocks CYP3A4, your body might break down bosentan a little more slowly, letting levels creep up.

If that happened, you could notice more of bosentan's usual effects, things like headache, flushing, swelling in the legs or ankles, or feeling lightheaded. I want to be honest though: this is based only on test-tube research and has not been seen in real patients. Eating goji berries as a food is unlikely to be an issue. Concentrated goji supplements are where I'd be more careful. Since bosentan also needs liver monitoring, just check with your pharmacist or doctor before adding any goji product.

References
  1. Liu R, Tam TW, Mao J, et al. In vitro activity of Lycium barbarum (Goji) against major human phase I metabolism enzymes. Complement Integr Med. 2016;13(3):257-265.

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

Goji Also Interacts With Other Medications

Goji has 2 major, 929 moderate, 68 minor known drug interactions in our database — the Bosentan 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 Goji

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

Everything else you take

See Every Supplement That Interacts With Bosentan

This page covers Goji only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bosentan page lists 266 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), Apple (major) and Beer (major).

By severity: 11 major · 216 moderate · 39 minor.

Open the Bosentan interaction page

One more smart check

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

We hold 1,738 real supplement products containing Goji, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Goji. Your product may carry other ingredients that interact with Bosentan too, on top of Goji — 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 Goji and Bosentan 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 Goji
Top 10%

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

29 days ago today
Medication Bosentan
Steady interest

#1,679 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 Goji

What is Goji?

Goji
  • General antioxidant support
  • Eye health
  • Immune support
  • Anti-aging and well-being
  • Blood sugar support

Goji berries are a nutritious fruit rich in antioxidants, vitamins, and plant polysaccharides, and they are safe for most people as a food. While they are popular for eye health, immune support, and general wellness, strong human evidence for most health claims is limited. Talk with your pharmacist or doctor before using concentrated goji supplements, especially if you take medications or are pregnant.

Read the full Goji monograph & all interactions
Medication

About Bosentan

What Is Bosentan Used For?

Brand name: Tracleer

Bosentan is used to treat pulmonary arterial hypertension (PAH) — high blood pressure in the arteries of the lungs. In adults, it helps improve the ability to exercise and slows how quickly the disease gets worse.

In children aged 3 years and older with idiopathic (no known cause) or congenital (present from birth) PAH, bosentan is used to lower resistance in the lung blood vessels, which is expected to improve exercise ability. Tracleer is one brand approved for both adults and pediatric patients with PAH.

See full Bosentan drug information
Keep checking

Other Drugs & Goji

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

2Major
929Moderate
68Minor
1,830No known interaction
Major

2 interactions

Moderate

929 interactions

Showing 60 of 929 moderate interactions — see all 929 on the Goji page.

Minor

68 interactions

Showing 60 of 68 minor interactions — see all 68 on the Goji page.

No interaction 1,830 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 Goji and Bosentan Together: Common Questions

Can you take Goji with Bosentan?
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 3 interactions listed for Goji and Bosentan?
Bosentan belongs to more than one drug category, and Goji 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 Goji and Bosentan 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.