Drug & supplement interaction

Guarumo + Diltiazem, Enalapril

Diltiazem, Enalapril brand name: Teczem.

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

Guarumo has a moderate interaction with Diltiazem, Enalapril. Evidence from animal research suggests that aqueous and ethanolic extracts of guarumo leaf can lower blood pressure when administered intravenously to rats.

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

Guarumo and Diltiazem, Enalapril

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Diltiazem, Enalapril

Diltiazem, Enalapril falls under ANTIHYPERTENSIVE DRUGS — the group Guarumo interacts with.

Evidence from animal research suggests that aqueous and ethanolic extracts of guarumo leaf can lower blood pressure when administered intravenously to rats. Theoretically, concomitant use of antihypertensive drugs with guarumo might enhance therapeutic effects and increase the risk of hypotension. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many 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

Teczem combines two blood pressure medicines: diltiazem (a calcium channel blocker) and enalapril (an ACE inhibitor). Both are designed to relax your blood vessels and bring your blood pressure down. Guarumo tea has been studied mostly in animals, where it seemed to lower blood pressure on its own. So the concern here is simple addition: if guarumo nudges your pressure down a little and your Teczem is already doing the same job, the two together could push it down too far.

If that happened, you might feel dizzy, lightheaded, tired, or get a headache, especially when standing up quickly. This is theoretical and based on animal research, so I don't want to alarm you. Still, please check with your pharmacist or doctor before adding guarumo, and don't change your Teczem on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Vidrio, H., Garcia-Marquez, F., Reyes, J., and Soto, R. M. Hypotensive activity of Cecropia obtusifolia. J Pharm Sci 1982;71:475-76. PubMed
  2. Salas, I., Brenes, J. R., and Morales, O. M. Antihypertensive effect of Cecropia obtusifolia (Moraceae) leaf extract on rats. Rev Biol Trop 1987;35(1):127-30.
  3. Salas, I. G., Morales, O. M., and Brenes, J. R. Effect of chronic administration of Cecropia obtusifolia (Moraceae) on mean arterial pressure in rats. Rev Biol Trop 1987;35(2):359-62.

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 Diltiazem, Enalapril one above is one of them. If you take anything else, check it against the full list below.

Moderate 504 No known interaction 2,326 (incl. Diltiazem, Enalapril)
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 Diltiazem, Enalapril

This page covers Guarumo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diltiazem, Enalapril page lists 271 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), Asarabacca (major) and Coleus (major).

By severity: 9 major · 220 moderate · 42 minor.

From our pharmacist’s overview on the Diltiazem, Enalapril page

“Anyone taking Teczem (diltiazem with enalapril) for blood pressure should know that most of the 271 supplements with an interaction on file hit the same targets as the drug itself. The bulk either add to its blood-pressure-lowering effect or change how the body handles diltiazem, which is processed by an enzyme called CYP3A4.”

Reviewed by 2 · Jul 18, 2026

Open the Diltiazem, Enalapril interaction page

How much people look this up

Where Guarumo and Diltiazem, Enalapril 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

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

29 days ago today
Medication Diltiazem, Enalapril
Steady interest

#1,686 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
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
504 Moderate 2,325 No 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

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

Showing the 60 most looked-up of 2,325 medications checked with no known interaction — see the full Guarumo list.

See the full Guarumo interactions page
See every supplement checked against Diltiazem, Enalapril, 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
Guarumo monograph › Uses, safety, and every drug interaction in one place Diltiazem, Enalapril supplement interactions › Every supplement checked against Diltiazem, Enalapril, 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 Guarumo and Diltiazem, Enalapril Together: Common Questions

Can you take Guarumo with Diltiazem, Enalapril?
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 Diltiazem, Enalapril 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 Diltiazem, Enalapril 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.