Drug & supplement interaction

Hibiscus Sabdariffa + Simvastatin

Simvastatin brand name: Zocor.

Moderate Interaction
The bottom line Moderate

Simvastatin falls into 2 drug categories that Hibiscus Sabdariffa can interact with; the most serious is rated moderate. Taking Hibiscus sabdariffa with simvastatin might reduce the levels and clinical effects of simvastatin.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hibiscus Sabdariffa and Simvastatin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Hibiscus Sabdariffa interacts with whole categories of medication. Simvastatin falls into 2 of those categories, so it can interact with Hibiscus Sabdariffa in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

SIMVASTATIN (Zocor)

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Taking Hibiscus sabdariffa with simvastatin might reduce the levels and clinical effects of simvastatin.
A pharmacokinetic study in humans shows that taking a beverage prepared with dried Hibiscus sabdariffa flower 300 grams concurrently with a single dose of simvastatin 40 mg increases the clearance of simvastatin by about 45% and reduces peak levels of simvastatin by 18%.
Severity Moderate Likelihood Probable Evidence B

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: drinking hibiscus tea may make your body clear simvastatin faster, leaving less of it in your bloodstream. In a human study, a strong hibiscus drink boosted simvastatin's clearance by about 45% and lowered its peak level by roughly 18%. Since simvastatin's whole job is to lower your LDL (bad) cholesterol, having less of it around could mean it doesn't work quite as well.

This doesn't add side effects, it just may chip away at the benefit. The study used a concentrated amount of hibiscus, so an occasional cup of tea is unlikely to be a big deal, but regular concentrated use could matter. Please don't stop either one. Just mention your hibiscus habit to your pharmacist or doctor so they can keep an eye on your cholesterol numbers.

References
  1. Showande SJ, Adegbolagun OM, Igbinoba SI, Fakeye TO. In vivo pharmacodynamic and pharmacokinetic interactions of Hibiscus sabdariffa calyces extracts with simvastatin. J Clin Pharm Ther. 2017;42(6):695-703.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

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Why this applies to Simvastatin

Simvastatin falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Hibiscus Sabdariffa interacts with.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP3A4. 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 simple version: your body uses a liver enzyme called CYP3A4 to break down simvastatin. In laboratory dishes, hibiscus extract has slowed that enzyme down a bit. If that were to happen in real life, more simvastatin could linger in your blood, which in theory might raise the odds of statin side effects like muscle aches, soreness, or rarely more serious muscle problems.

But here's the key part: this is only a theory based on test-tube work. It has not actually been reported in people, and a cup or two of tart hibiscus tea is unlikely to cause trouble. Concentrated hibiscus supplements are the bigger unknown. If you want to use those regularly, just run it by 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.

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, 265 moderate, 819 minor known drug interactions in our database — the Simvastatin 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.

From our Q&A

Questions About Hibiscus Sabdariffa or Simvastatin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hibiscus Sabdariffa or Simvastatin, 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 Simvastatin

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Simvastatin page lists 183 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 8 major · 139 moderate · 36 minor.

Open the Simvastatin interaction page

How much people look this up

Where Hibiscus Sabdariffa and Simvastatin 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

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

29 days ago today
Medication Simvastatin
Top half

#786 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
Medication

About Simvastatin

What Is Simvastatin Used For?

Brand name: Zocor

Simvastatin tablets are used alongside a cholesterol-lowering diet to treat high LDL cholesterol (bad cholesterol), high triglycerides, and certain inherited cholesterol disorders, including heterozygous familial hypercholesterolemia (HeFH) in adults and children aged 10 and older, and homozygous familial hypercholesterolemia (HoFH) in adults.

In adults who already have coronary heart disease, cerebrovascular disease, peripheral vascular disease, or diabetes and are at high risk for heart events, simvastatin is also used to reduce the risk of death from heart disease, non-fatal heart attack, stroke, and the need for procedures to open blocked arteries. Zocor is one brand-name product containing simvastatin and carries these same indications.

See full Simvastatin drug information
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
265Moderate
819Minor
1,743No known interaction
Major

2 interactions

Moderate

265 interactions

Showing 60 of 265 moderate interactions — see all 265 on the Hibiscus Sabdariffa page.

Minor

819 interactions

Showing 60 of 819 minor interactions — see all 819 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

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Pharmacist Counseling Corner

Taking Hibiscus Sabdariffa and Simvastatin Together: Common Questions

Can you take Hibiscus Sabdariffa with Simvastatin?
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.
Why are there 2 interactions listed for Hibiscus Sabdariffa and Simvastatin?
Simvastatin 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 Simvastatin 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.