Drug & supplement interaction

Guarumo + Remifentanil

Remifentanil brand name: Ultiva.

Moderate Interaction
The bottom line Moderate

Guarumo has a moderate interaction with Remifentanil. 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 Remifentanil

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

Moderate

CNS DEPRESSANTS

Why this applies to Remifentanil

Remifentanil 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 short version: remifentanil (Ultiva) is a very strong opioid given through an IV during surgery or in intensive care, always under close monitoring by an anesthesia team. Its main job is to ease pain and calm the body, but it also slows breathing and can drop your blood pressure and alertness. Guarumo appears, at least in one animal study, to have its own calming, muscle-relaxing effect on the nervous system.

The worry is that stacking two things that quiet the brain could add up, leading to deeper sedation or slower breathing. I'll be honest though: this is only a theoretical concern from animal data, not proven in people. Since remifentanil is handled entirely in a hospital setting, mention any guarumo use to your care team beforehand so they can watch you closely.

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 Remifentanil 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 Remifentanil

This page covers Guarumo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Remifentanil page lists 100 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 7 major · 78 moderate · 15 minor.

From our pharmacist’s overview on the Remifentanil page

“Remifentanil (Ultiva) is a powerful, ultra-fast-acting opioid infused during surgery and procedures, so anything that deepens sedation or slows breathing alongside it is a genuine hazard, and this list warrants real vigilance. Of the 100 supplements and herbs with an interaction on file, 78 add to that same sedative load on the brain,…”

Reviewed by 2 · Jul 18, 2026

Open the Remifentanil interaction page

How much people look this up

Where Guarumo and Remifentanil 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

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

29 days ago today
Medication Remifentanil
Steady interest

#2,718 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
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 Remifentanil Together: Common Questions

Can you take Guarumo with Remifentanil?
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 Remifentanil 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.