Drug & supplement interaction

Guarumo + Brexanolone

Brexanolone brand name: Zulresso.

Moderate Interaction
The bottom line Moderate

Guarumo has a moderate interaction with Brexanolone. In an animal study, an aqueous extract of guarumo depressed the central nervous system, inducing significant motor incoordination and muscle relaxant activity.

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

Guarumo and Brexanolone

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

Moderate

CNS DEPRESSANTS

Why this applies to Brexanolone

Brexanolone falls under CNS DEPRESSANTS — the group Guarumo interacts with.

In an animal study, an aqueous extract of guarumo depressed the central nervous system, inducing significant motor incoordination and muscle relaxant activity. Theoretically, guarumo might potentiate the sedative effects of drugs.
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 with Brexanolone (Zulresso): it's already a strong sedating medicine. It's given as a continuous IV drip in a monitored hospital setting precisely because it can cause heavy drowsiness, dizziness, and even sudden excessive sleepiness or loss of consciousness. So anything that piles on more sedation is worth flagging.

The concern with guarumo is just that. In an animal study, a guarumo leaf extract calmed the nervous system and caused muscle relaxation and poor coordination. In theory, layering it on top of Brexanolone could deepen that sleepiness or grogginess. To be honest, this is weak, lab-and-animal-level evidence, not proven in people. Still, since you'll be closely watched during treatment, mention any supplement like this to your care team beforehand.

References
  1. Perez-Guerrero, C., Herrera, M. D., Ortiz, R., Alvarez, de Sotomayor, and Fernandez, M. A. A pharmacological study of Cecropia obtusifolia Bertol aqueous extract. J Ethnopharmacol 2001;76(3):279-84. 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

Guarumo Also Interacts With Other Medications

Guarumo has 504 moderate known drug interactions in our database — the Brexanolone 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 Guarumo

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

Everything else you take

See Every Supplement That Interacts With Brexanolone

This page covers Guarumo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Brexanolone page lists 79 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 67 moderate · 6 minor.

From our pharmacist’s overview on the Brexanolone page

“Brexanolone (Zulresso) is an IV infusion for postpartum depression, and it already carries a boxed warning for excessive sedation and sudden loss of consciousness during treatment. That built-in risk is exactly what most of these 79 supplements press on, so treat this list with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Brexanolone interaction page

How much people look this up

Where Guarumo and Brexanolone 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 Guarumo
Top half

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

29 days ago today
Medication Brexanolone
Top half

#875 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 Guarumo

What is Guarumo?

Guarumo
  • Type 2 diabetes / blood sugar support
  • High blood pressure
  • Cough, asthma, and bronchitis
  • Heart failure symptoms
  • Liver and rheumatic complaints

Guarumo (Cecropia obtusifolia) is a tropical tree used in Latin American traditional medicine, most often as a leaf tea for diabetes and high blood pressure. Some early laboratory and small human studies suggest it may modestly affect blood sugar, but the evidence is limited and not strong enough to recommend it as a treatment. Talk with your pharmacist or doctor before using it, especially if you have a chronic condition or take medication.

Read the full Guarumo monograph & all interactions
Medication

About Brexanolone Injection

What Is Brexanolone Injection Used For?

Brand name: Zulresso

  • Brexanolone injection is used for the treatment of postpartum depression (PPD) in adults. Brexanolone injection is in a class of medications called neurosteroid antidepressants. It works by changing the activity of certain natural substances in the brain.

See full Brexanolone Injection drug information
Keep checking

Other Drugs & Guarumo

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

0Major
504Moderate
0Minor
2,325No known interaction
Moderate

504 interactions

Showing 60 of 504 moderate interactions — see all 504 on the Guarumo page.

No interaction 2,325 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 Guarumo and Brexanolone Together: Common Questions

Can you take Guarumo with Brexanolone?
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 Guarumo and Brexanolone 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 Brexanolone and Guarumo?

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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.