Drug & supplement interaction

Hibiscus Sabdariffa + Agomelatine

Agomelatine brand name: Valdoxan.

Minor Interaction
The bottom line Minor

Agomelatine falls into 3 drug categories that Hibiscus Sabdariffa can interact with; the most serious is rated minor. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C19 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Hibiscus Sabdariffa and Agomelatine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Hibiscus Sabdariffa interacts with whole categories of medication. Agomelatine falls into 3 of those categories, so it can interact with Hibiscus Sabdariffa in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 3

Why this applies to Agomelatine

Agomelatine falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Hibiscus Sabdariffa interacts with.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C19 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C19. This interaction has not been reported in humans.
Severity Minor 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 gist for agomelatine (Valdoxan): your liver uses a few enzymes to break it down, and one of them is CYP2C19. In a lab dish, concentrated hibiscus extract slowed that enzyme a bit. If that were to happen in your body, agomelatine might clear a little more slowly and its levels could nudge upward, possibly meaning more of its usual effects like drowsiness, dizziness, headache, or nausea.

I want to be honest about how shaky this is. It comes from test-tube work only and has never actually been seen in people, so it's labeled theoretical and minor. A cup of tart hibiscus tea is very unlikely to matter, while concentrated supplements are the bigger question mark. If you take agomelatine, just run hibiscus supplements past your pharmacist or doctor first.

References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

Agomelatine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP1A2 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP1A2. This interaction has not been reported in humans.
Severity Minor 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 gist for agomelatine (Valdoxan). Your body relies heavily on a liver enzyme called CYP1A2 to break this medicine down. In a lab dish, hibiscus extract slowed that same enzyme. If it did the same thing in people, agomelatine could clear a little more slowly and build up, which in theory might mean more drowsiness, dizziness, headache, or nausea.

The reassuring part: this is only a theoretical concern from test-tube research, and it has never actually been reported in a real person. A cup or two of tart hibiscus tea is unlikely to cause trouble. Concentrated hibiscus supplements are the bigger unknown. Since agomelatine already needs liver monitoring, just mention any hibiscus product to your pharmacist or doctor first.

References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 3

Agomelatine also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C9 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C9. This interaction has not been reported in humans.
Severity Minor 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 basic idea with hibiscus and agomelatine (Valdoxan). Lab studies in test tubes suggest hibiscus extract may slow down an enzyme called CYP2C9, which is one of the pathways your body uses to break this medicine down. If that clearing slows, a little more agomelatine could stick around, which in theory might mean more of its usual effects, like drowsiness, dizziness, headache, or nausea.

That said, I want to keep this in perspective. This is only a theoretical concern from lab work, and it has never actually been reported in people. A cup or two of tart hibiscus tea is unlikely to cause trouble, though concentrated supplements deserve more caution. If you're planning to use hibiscus regularly, just give your pharmacist or doctor a heads-up first.

References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.

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

Hibiscus Sabdariffa Also Interacts With Other Medications

Hibiscus Sabdariffa has 2 major, 266 moderate, 818 minor known drug interactions in our database — the Agomelatine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Hibiscus Sabdariffa

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

Everything else you take

See Every Supplement That Interacts With Agomelatine

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Agomelatine page lists 135 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Artichoke (moderate) and Ashitaba (moderate).

By severity: 1 major · 94 moderate · 40 minor.

Open the Agomelatine interaction page

How much people look this up

Where Hibiscus Sabdariffa and Agomelatine 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 Hibiscus Sabdariffa
Top half

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

29 days ago today
Medication Agomelatine
Top half

#795 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 Hibiscus Sabdariffa

What is Hibiscus Sabdariffa?

Hibiscus Sabdariffa
  • High blood pressure
  • Heart and cholesterol health
  • Digestive upset
  • Antioxidant support
  • Fever and general wellness

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and while hibiscus tea is generally well tolerated in food amounts, concentrated supplements should be used cautiously and avoided in pregnancy. Talk to your pharmacist or doctor before using it for a medical condition.

Read the full Hibiscus Sabdariffa monograph & all interactions
Keep checking

Other Drugs & Hibiscus Sabdariffa

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

2Major
266Moderate
818Minor
1,743No known interaction
Major

2 interactions

Moderate

266 interactions

Showing 60 of 266 moderate interactions — see all 266 on the Hibiscus Sabdariffa page.

Minor

818 interactions

Showing 60 of 818 minor interactions — see all 818 on the Hibiscus Sabdariffa page.

No interaction 1,743 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

Keep exploring
Pharmacist Counseling Corner

Taking Hibiscus Sabdariffa and Agomelatine Together: Common Questions

Can you take Hibiscus Sabdariffa with Agomelatine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Hibiscus Sabdariffa and Agomelatine?
Agomelatine belongs to more than one drug category, and Hibiscus Sabdariffa interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Hibiscus Sabdariffa and Agomelatine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Agomelatine and Hibiscus Sabdariffa?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.