Drug & supplement interaction

Holy Basil + Alteplase, tPA

Alteplase, tPA brand names: Activase, Actilyse.

Moderate Interaction
The bottom line Moderate

Holy Basil has a moderate interaction with Alteplase, tPA. Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.

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

Holy Basil and Alteplase, tPA

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Alteplase, tPA

Alteplase, tPA falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Holy Basil interacts with.

Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Animal research shows that holy basil seed oil can prolong bleeding time, possibly due to inhibition of platelet aggregation. However, it is not known if this occurs in humans.
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: alteplase (tPA) is a powerful clot-busting drug given in the hospital for things like a stroke, a heart attack, or a serious blood clot. It works fast to break down clots, and its biggest risk is bleeding. Holy basil seed oil has been shown in animal studies to slow down platelets and lengthen bleeding time, so on paper, combining the two could add to that bleeding risk.

I want to be straight with you, though: this is theoretical and based only on lab and animal work, not people. Also, alteplase is given by doctors in an emergency, so they'll already be weighing your bleeding risk. Still, always tell the care team about any supplements you take. Never start or stop anything on your own without checking with your pharmacist or doctor.

References
  1. Singh S, Rehan HM, Majumdar DK. Effect of Ocimum sanctum fixed oil on blood pressure, blood clotting time and pentobarbitone-induced sleeping time. J Ethnopharmacol 2001;78:139-43. 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

Holy Basil Also Interacts With Other Medications

Holy Basil has 211 moderate known drug interactions in our database — the Alteplase, tPA 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 Holy Basil

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

From our Q&A

Questions About Holy Basil or Alteplase, tPA

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Holy Basil or Alteplase, tPA, 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 Alteplase, tPA

This page covers Holy Basil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alteplase, tPA page lists 219 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 191 moderate · 25 minor.

From our pharmacist’s overview on the Alteplase, tPA page

“Nobody plans to receive alteplase (Activase, tPA). It arrives by IV in an emergency to dissolve the clot behind a stroke or heart attack, so the supplements already in your system at that moment matter, and this list deserves real weight.”

Reviewed by 2 · Jul 18, 2026

Open the Alteplase, tPA interaction page

One more smart check

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

We hold 1,867 real supplement products containing Holy Basil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Holy Basil. Your product may carry other ingredients that interact with Alteplase, tPA too, on top of Holy Basil — 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 Holy Basil and Alteplase, tPA 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 Holy Basil
Top 10%

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

29 days ago today
Medication Alteplase, tPA
Steady interest

#1,767 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 Holy Basil

What is Holy Basil?

Holy Basil
  • Stress and anxiety
  • Blood sugar support
  • Respiratory complaints
  • General immune and wellness support
  • Inflammation

Holy basil (tulsi) is a traditional Ayurvedic herb most often used today for stress and general wellness, but the human evidence is mostly small and preliminary. It is generally well tolerated by most adults, but it should be avoided in pregnancy and used cautiously by anyone with health conditions or taking medications. Talk to your pharmacist or doctor before starting it.

Read the full Holy Basil monograph & all interactions
Keep checking

Other Drugs & Holy Basil

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

0Major
211Moderate
0Minor
2,618No known interaction
Moderate

211 interactions

Showing 60 of 211 moderate interactions — see all 211 on the Holy Basil page.

No interaction 2,618 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 Holy Basil and Alteplase, tPA Together: Common Questions

Can you take Holy Basil with Alteplase, tPA?
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 Holy Basil and Alteplase, tPA 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.