Drug & supplement interaction

Horsetail + Riociguat

Riociguat brand name: Adempas.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Horsetail and Riociguat in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Horsetail and Riociguat

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Riociguat and Horsetail in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Horsetail safety at a glance

Horsetail overall Use caution May be used short-term by healthy adults, but long-term use and unverified products carry real risks.
Pregnancy Avoid Not enough safety data; avoid use during pregnancy.
Breastfeeding Avoid Not enough safety data; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Riociguat and Horsetail? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Riociguat

Interactions in our licensed database are recorded against drug classes, not just single drug names. Riociguat is filed under 4 classifications — including antihypertensive drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Horsetail has documented interactions with 5 drug classes — the most serious being antidiabetes drugs (moderate), diuretic drugs (moderate) and efavirenz (sustiva) (moderate) — and none of Riociguat’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Horsetail Does Interact With Other Medications

Horsetail has 188 moderate known drug interactions in our database — Riociguat isn’t one of them. If you take anything else, check it against the full list below.

Moderate 188 No known interaction 2,642 (incl. Riociguat)
Taking anything else?

Check Another of Your Medications Against Horsetail

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

What to actually watch for

No Interaction Found — But Data Suggests Horsetail and Riociguat May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Bloating or gas / Nausea Additional detail

    Horsetail

    “Orally, horsetail has been associated with mild gastrointestinal side effects including abdominal distension, increased frequency of bowel movements, and nausea. Orally, chronic consumption of horsetail infusion has been associated with acute pancreatitis.”

    Horsetail · Natural Medicines adverse-effect record, reported in dyslipidemia.

    2 sources cited
    1. 55576. Tiktinskii, O. L. and Bablumian, I. A. [Therapeutic action of Java tea and field horsetail in uric acid diathesis]. Urol.Nefrol.(Mosk) 1983;3(1):47-50.
    2. 97574. García Gavilán MD, Moreno García AM, Rosales Zabal JM, Navarro Jarabo JM, Sánchez Cantos A. Case of drug-induced acute pancreatitis produced by horsetail infusions. Rev Esp Enferm Dig. 2017 Apr;109(4):301-304. PubMed

    Riociguat

    Listed in the ADVERSE REACTIONS section of the FDA label for Riociguat. Read the label on DailyMed ›

  • Diarrhea Additional detail

    Horsetail

    Recorded for Horsetail in the same Natural Medicines adverse-effect record shown under Bloating or gas / Nausea above.

    Riociguat

    Listed in the ADVERSE REACTIONS section of the FDA label for Riociguat. Read the label on DailyMed ›

Reported for Horsetail but not commonly for Riociguat: pancreatitis, raised blood pressure, low sodium and a skin rash.

Effects for Riociguat come from the ADVERSE REACTIONS section of its FDA label; effects for Horsetail come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Riociguat Is Prescribed For, and What Horsetail Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Riociguat is a prescription medicine with approved uses on its FDA label. Horsetail is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Riociguat is prescribed for: Riociguat tablets — sold as Adempas and under the generic name Riociguat — are used to treat adults with two types of pulmonary hypertension (high blood pressure in the lungs). The first is chronic thromboembolic pulmonary hypertension (CTEPH), a condition caused by blood clots in the lung arteries, either after surgery or when surgery is not an option. The second is pulmonary arterial hypertension (PAH), where the arteries carrying blood to the lungs are narrowed or blocked. In both conditions, riociguat helps improve exercise ability and functional status, and in PAH it also helps slow the disease from getting worse.

Horsetail has been studied for:

  • Hypertension studied, not established Horsetail has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Horsetail for hypertension

    Oral horsetail seems to reduce blood pressure in patients with hypertension.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Riociguat on your own; if you are taking Horsetail for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Horsetail or Riociguat

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

This page covers Horsetail only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Riociguat page lists 230 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 6 major · 187 moderate · 37 minor.

From our pharmacist’s overview on the Riociguat page

“Riociguat (Adempas) works by relaxing the blood vessels in your lungs, which also lowers blood pressure, so I read this list of 230 supplements and herbs with real concern, and the six rated major are what to understand first. Grapefruit can push riociguat levels up and intensify its effect, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Riociguat interaction page

One more smart check

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

We hold 2,089 real supplement products containing Horsetail, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Horsetail. Even though Horsetail itself has no known interaction with Riociguat, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Horsetail and Riociguat 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 Horsetail
Top 10%

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

29 days ago today
Medication Riociguat
Steady interest

#2,123 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Horsetail reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Horsetail and Riociguat records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Horsetail

What is Horsetail?

Horsetail
  • Fluid retention (mild diuretic)
  • Urinary and bladder concerns
  • Hair, skin, and nail support
  • Wound healing
  • Bone health

Horsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. It can cause thiamine (vitamin B1) loss with long-term use, and some related species are toxic, so choose products carefully and talk to your pharmacist or doctor before using it.

Equisetum arvense · Equisetaceae · Aerial parts (stems) · Tea, capsules, tablets, liquid extract, tincture, dried herb

An interaction check asks whether these two react with each other — it does not ask whether Horsetail is a good idea for someone in your situation. Here is what our Horsetail record says about it on its own.

Horsetail: dosing

There is no well-established standardized dose for horsetail. The right amount can vary by product, form (tea, capsule, or extract), and how it is prepared.The safest approach is to follow the directions on the product label and not exceed them.

From our Horsetail monograph — the full record covers uses, side effects and every documented interaction.

Read the full Horsetail monograph & all interactions
Medication

About Riociguat

What Is Riociguat Used For?

Brand name: Adempas

Riociguat tablets — sold as Adempas and under the generic name Riociguat — are used to treat adults with two types of pulmonary hypertension (high blood pressure in the lungs).

The first is chronic thromboembolic pulmonary hypertension (CTEPH), a condition caused by blood clots in the lung arteries, either after surgery or when surgery is not an option. The second is pulmonary arterial hypertension (PAH), where the arteries carrying blood to the lungs are narrowed or blocked. In both conditions, riociguat helps improve exercise ability and functional status, and in PAH it also helps slow the disease from getting worse.

Most-Reported Side Effects for Riociguat

From FAERS, the FDA’s public side-effect reporting system (32,415 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 5,718 reports
Headache 4,513 reports
Nausea 3,769 reports
Diarrhea 3,533 reports
Dizziness 3,522 reports
See full Riociguat drug information
Keep checking

Other Drugs & Horsetail

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

0Major
188Moderate
0Minor
2,641No known interaction
188 Moderate 2,641 No interaction
Moderate

188 interactions

Showing 60 of 188 moderate interactions — see all 188 on the Horsetail page.

No interaction 2,641 drugs checked — show the list

We also checked Horsetail against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,641 medications checked with no known interaction — see the full Horsetail list.

See the full Horsetail interactions page
See every supplement checked against Riociguat, ranked by severity
Evidence & sources

Horsetail References

The 14 references that drive our Horsetail monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Sudan BJ. Seborrhoeic dermatitis induced by nicotine of horsetails (Equisetum arvense L.). Contact Dermatitis 1985;13:201-2.
  2. Perez Gutierrez RM, Laguna GY, Walkowski A. Diuretic activity of Mexican equisetum. J Ethnopharmacol 1985;14:269-72. PubMed
  3. Lemus I, Garcia R, Erazo S, et al. Diuretic activity of an Equisetum bogotense tea (Platero herb): evaluation in healthy volunteers. J Ethnopharmacol 1996;54:55-8. PubMed
  4. Revilla MC, Andrade-Cetto A, Islas S, Wiedenfeld H. Hypoglycemic effect of Equisetum myriochaetum aerial parts on type 2 diabetic patients. J Ethnopharmacol 2002;81:117-20. PubMed
  5. Tiktinskii, O. L. and Bablumian, I. A. [Therapeutic action of Java tea and field horsetail in uric acid diathesis]. Urol.Nefrol.(Mosk) 1983;3(1):47-50.
  6. Henderson JA, Evans EV, and McIntosh RA. The antithiamine action of Equisetum. J Amer Vet Med Assoc 1952;120:375-378.
  7. Carneiro DM, Freire RC, Honório TC, Zoghaib I, Cardoso FF, Tresvenzol LM, de Paula JR, Sousa AL, Jardim PC, da Cunha LC. Randomized, Double-Blind Clinical Trial to Assess the Acute Diuretic Effect of Equisetum arvense (Field Horsetail) in Healthy Voluntee
  8. Klnçalp S, Ekiz F, Basar Ö, Coban S, Yüksel O. Equisetum arvense (Field Horsetail)-induced liver injury. Eur J Gastroenterol Hepatol. 2012 Feb;24(2):213-4. PubMed
  9. Ortega García JA, Angulo MG, Sobrino-Najul EJ, Soldin OP, Mira AP, Martínez-Salcedo E, Claudio L. Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense) herbal remedy and alcohol: a case report. J Med Case Rep. 2011 M PubMed
  10. Cordova E, Morganti L, Rodriguez C. Possible Drug-Herb Interaction between Herbal Supplement Containing Horsetail (Equisetum arvense) and Antiretroviral Drugs. J Int Assoc Provid AIDS Care. 2017;16(1):11-13.
  11. García Gavilán MD, Moreno García AM, Rosales Zabal JM, Navarro Jarabo JM, Sánchez Cantos A. Case of drug-induced acute pancreatitis produced by horsetail infusions. Rev Esp Enferm Dig. 2017 Apr;109(4):301-304. PubMed
  12. Vieira GT, de Oliveira TT, Carneiro MAA, et al. Antidiabetic effect of Equisetum giganteum L. extract on alloxan-diabetic rabbit. J Ethnopharmacol. 2020;260:112898. PubMed
  13. Health Canada. Organism-Equisetum arvense. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=6117&lang=eng. Accessed 21-July 2021.
  14. Bates D, Duong TB, Kheyson S, Moore K. Hyponatremia Secondary to Decreased Oral Intake and SIADH and Possibly Exacerbated by Horsetail (Equisetum arvense). Can J Hosp Pharm 2021;74(4):386-389. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Horsetail and Riociguat Together: Common Questions

Is it safe to take Horsetail with Riociguat?
We do not list a known interaction between Horsetail and Riociguat. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Horsetail and Riociguat have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Horsetail and Riociguat used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Horsetail in each. That is a conversation for your prescriber, especially if Riociguat is being adjusted to a target.
How was the Horsetail and Riociguat combination checked?
Interactions in our licensed database are recorded against drug classes. Riociguat is filed under 4 classifications, and Horsetail has documented interactions with 5 drug classes — none of Riociguat's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Horsetail interact with any other medications?
Yes. Horsetail has 188 documented drug interactions in our database — Riociguat is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Riociguat interact with any supplements?
Yes. Riociguat has documented interactions with 230 supplements in our database — Horsetail is not one of them. The Riociguat interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Horsetail monograph Uses, safety profile, and every drug interaction in one place Riociguat drug information The full plain-English guide to this medication Riociguat supplement interactions Every supplement checked against Riociguat, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 14 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Riociguat and Horsetail?

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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.