Drug & supplement interaction

Guarumo + Selexipag

Selexipag brand name: Uptravi.

Moderate Interaction
The bottom line Moderate

Guarumo has a moderate interaction with Selexipag. 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 Selexipag

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Selexipag

Selexipag 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

Here's the simple version. Selexipag (Uptravi) widens the blood vessels in your lungs to ease the strain of pulmonary arterial hypertension. Guarumo, a leaf tea used in traditional medicine, may have a mild blood-pressure-lowering effect of its own. If you stack the two, their effects could add up, so in theory your blood pressure might dip lower than expected.

With Selexipag that could mean more dizziness, lightheadedness, flushing, headache, or feeling faint when you stand up. I'll be honest though: this concern comes only from animal studies where guarumo extract was given by injection, so the real-world risk in people is uncertain and probably modest. Still, before adding guarumo, please run it by your pharmacist or doctor first.

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 Selexipag 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 Selexipag

This page covers Guarumo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selexipag page lists 291 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), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Selexipag page

“People take selexipag (Uptravi) for pulmonary arterial hypertension, dangerously high pressure in the arteries of the lungs, and that diagnosis raises the stakes on this list of 291 interacting supplements. I would treat it with real vigilance.”

Reviewed by 2 · Jul 18, 2026

Open the Selexipag interaction page

How much people look this up

Where Guarumo and Selexipag 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

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

29 days ago today
Medication Selexipag
Steady interest

#1,863 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 Selexipag

What Is Selexipag Used For?

Brand name: Uptravi

Selexipag tablets are used to treat pulmonary arterial hypertension (PAH, WHO Group I) — a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to reduce the chances of being hospitalized because of PAH.

Uptravi (selexipag) tablets are approved for both adults and children aged 2 years and older. Uptravi for injection (intravenous) is also available for adult patients who are already on Uptravi tablets but temporarily cannot take medicine by mouth.

See full Selexipag 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 Selexipag Together: Common Questions

Can you take Guarumo with Selexipag?
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 Selexipag 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.