Drug & supplement interaction

Guggul + Sildenafil Citrate

Sildenafil Citrate brand name: Viagra.

Moderate Interaction
The bottom line Moderate

Guggul has a moderate interaction with Sildenafil Citrate. Theoretically, guggul might reduce the effects of CYP3A4 substrates.

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

Guggul and Sildenafil Citrate

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Sildenafil Citrate

Sildenafil Citrate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Guggul interacts with.

Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Viagra (sildenafil). Your liver clears this drug using an enzyme called CYP3A4. Lab and animal studies hint that guggul may speed that enzyme up. If that happens in people, your body could break sildenafil down a little faster, which might leave less of it working when you need it. In plain terms, your dose could feel weaker, and you may notice a softer or shorter-lasting erection.

I want to be honest about how shaky this is. The evidence is only test-tube and animal data, so we really don't know how much it matters in real life. Sildenafil is not a prodrug, so the direction here is reduced effect, not extra side effects. Before mixing the two, just run it by your pharmacist or doctor.

References
  1. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. 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

Guggul Also Interacts With Other Medications

Guggul has 756 moderate known drug interactions in our database — the Sildenafil Citrate 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 Guggul

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

From our Q&A

Questions About Guggul or Sildenafil Citrate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Guggul or Sildenafil Citrate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sildenafil Citrate

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sildenafil Citrate page lists 160 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Mistletoe (major), Grapefruit (major), Hawthorn (major) and St. John's Wort (major).

Open the Sildenafil Citrate interaction page

One more smart check

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

We hold 955 real supplement products containing Guggul, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guggul. Your product may carry other ingredients that interact with Sildenafil Citrate too, on top of Guggul — 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 Guggul and Sildenafil Citrate 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 Guggul
Top 25%

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

29 days ago today
Medication Sildenafil Citrate
Top half

#966 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 Guggul

What is Guggul?

Guggul
  • High cholesterol
  • Joint pain and arthritis
  • Weight management
  • Acne
  • Skin conditions

Guggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can cause stomach upset and skin rashes. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Guggul monograph & all interactions
Medication

About Sildenafil

What Is Sildenafil Used For?

Brand name: Viagra

Sildenafil treats two distinct conditions depending on the product. Viagra (tablet) and Vybrique (dissolving oral film) are approved for erectile dysfunction (ED) — difficulty getting or keeping an erection. Generic sildenafil tablets and oral film are also approved for ED.

Revatio and several generic sildenafil products (tablets, oral suspension, and injection) are used for pulmonary arterial hypertension (PAH) — high blood pressure in the arteries of the lungs — in adults to improve exercise ability and slow the disease from getting worse. Revatio oral suspension and injection are also approved for PAH in children ages 1 to 17.

See full Sildenafil drug information
Keep checking

Other Drugs & Guggul

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

0Major
756Moderate
0Minor
2,073No known interaction
Moderate

756 interactions

Showing 60 of 756 moderate interactions — see all 756 on the Guggul page.

No interaction 2,073 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 Guggul and Sildenafil Citrate Together: Common Questions

Can you take Guggul with Sildenafil Citrate?
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 Guggul and Sildenafil Citrate 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 Sildenafil Citrate and Guggul?

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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.