Drug & supplement interaction

Horny Goat Weed + Ibuprofen, Oxycodone

Ibuprofen, Oxycodone brand name: Combunox.

Moderate Interaction
The bottom line Moderate

Ibuprofen, Oxycodone falls into 2 drug categories that Horny Goat Weed can interact with; the most serious is rated moderate. Theoretically, horny goat weed might increase the risk of bleeding.

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

Horny Goat Weed and Ibuprofen, Oxycodone

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

Why Are There 2 Interactions?

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Ibuprofen, Oxycodone

Ibuprofen, Oxycodone falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Horny Goat Weed interacts with.

Theoretically, horny goat weed might increase the risk of bleeding.
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation. This effect has not been reported 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

The product you're asking about (Combunox) pairs ibuprofen with oxycodone. The piece that matters for horny goat weed here is the ibuprofen half. Ibuprofen is an NSAID, and on its own it can thin the blood a bit and irritate the stomach lining, which raises bleeding risk. Horny goat weed has shown, in lab and animal studies only, that it can keep platelets from sticking together. Stack those two and the theoretical concern is a little more bruising, nosebleeds, or stomach bleeding.

I want to be honest though: this effect has not been seen in actual people, so the evidence is weak. Still, since you're already on an NSAID, it's worth a quick chat with your pharmacist or doctor before combining them, especially if you notice easy bruising or dark stools.

References
  1. Irfan M, Kwon TH, Lee DH, et al. Antiplatelet and Antithrombotic Effects of Epimedium koreanum Nakai. Evid Based Complement Alternat Med. Apr 2021;2021:7071987. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Ibuprofen, Oxycodone also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression. This effect has not been reported 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

This Combunox combo pairs oxycodone (a strong opioid pain reliever) with ibuprofen (an anti-inflammatory). The oxycodone half is partly broken down by a liver enzyme called CYP3A4. In test-tube studies, horny goat weed appears to slow that same enzyme down. If that were to happen in real life, oxycodone could clear more slowly and build up, which might mean stronger effects like extra drowsiness, dizziness, slowed breathing, constipation, or nausea.

Here's the honest part: this is only laboratory data, and it has not been shown to happen in actual people. So I wouldn't lose sleep over it, but since oxycodone is a serious medicine, please run this past your pharmacist or doctor before combining the two.

References
  1. Li K, Yu XH, Maskey AR, et al. Cytochrome P450 3A4 suppression by epimedium and active compound kaempferol leads to synergistic anti-inflammatory effect with corticosteroid. Front Pharmacol 2023;13:1042756. 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

Horny Goat Weed Also Interacts With Other Medications

Horny Goat Weed has 962 moderate known drug interactions in our database — the Ibuprofen, Oxycodone 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 Horny Goat Weed

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

From our Q&A

Questions About Horny Goat Weed or Ibuprofen, Oxycodone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Horny Goat Weed or Ibuprofen, Oxycodone, 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 Ibuprofen, Oxycodone

This page covers Horny Goat Weed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibuprofen, Oxycodone page lists 356 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Danshen (major).

By severity: 13 major · 303 moderate · 40 minor.

From our pharmacist’s overview on the Ibuprofen, Oxycodone page

“Combunox puts oxycodone, an opioid, together with the NSAID ibuprofen, and I want you to read this page carefully rather than skim it. Of the 356 supplements and herbs on file, 202 can raise your bleeding risk on top of what ibuprofen already does, and 78 can deepen the drowsiness and slowed breathing that come with oxycodone.”

Reviewed by 2 · Jul 18, 2026

Open the Ibuprofen, Oxycodone interaction page

One more smart check

Taking Horny Goat Weed as Part of a Dietary Supplement Product? Check It for Interactions

We hold 183 real supplement products containing Horny Goat Weed, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Horny Goat Weed. Your product may carry other ingredients that interact with Ibuprofen, Oxycodone too, on top of Horny Goat Weed — 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 Horny Goat Weed and Ibuprofen, Oxycodone 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 Horny Goat Weed
Top 25%

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

29 days ago today
Medication Ibuprofen, Oxycodone
Steady interest

#1,711 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 Horny Goat Weed

What is Horny Goat Weed?

Horny Goat Weed
  • Erectile dysfunction
  • Low libido
  • Fatigue and low energy
  • Bone health
  • Joint and menopausal symptoms
  • General 'vitality' or performance

Horny goat weed (Epimedium) is a traditional Chinese herb most often marketed for low libido and erectile problems, but solid human evidence for these uses is lacking. While short-term use seems generally tolerated by some people, quality and safety are not well studied, so talk to your pharmacist or doctor before trying it—especially if you have heart problems or take other medicines.

Read the full Horny Goat Weed monograph & all interactions
Keep checking

Other Drugs & Horny Goat Weed

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

0Major
962Moderate
0Minor
1,867No known interaction
Moderate

962 interactions

Showing 60 of 962 moderate interactions — see all 962 on the Horny Goat Weed page.

No interaction 1,867 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 Horny Goat Weed and Ibuprofen, Oxycodone Together: Common Questions

Can you take Horny Goat Weed with Ibuprofen, Oxycodone?
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 Horny Goat Weed and Ibuprofen, Oxycodone?
Ibuprofen, Oxycodone belongs to more than one drug category, and Horny Goat Weed 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 Horny Goat Weed and Ibuprofen, Oxycodone 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.