Drug & supplement interaction

Ilex Guayusa + Dipyridamole

Dipyridamole brand names: Persantine, Dipyridamole, Persantin, Persantin Injection, Persantin Retard.

Moderate Interaction
The bottom line Moderate

Dipyridamole falls into 2 drug categories that Ilex Guayusa can interact with; the most serious is rated moderate. Theoretically, Ilex guayusa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Ilex Guayusa and Dipyridamole

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

Why Are There 2 Interactions?

Ilex Guayusa interacts with whole categories of medication. Dipyridamole falls into 2 of those categories, so it can interact with Ilex Guayusa 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 Dipyridamole

Dipyridamole falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Ilex Guayusa interacts with.

Theoretically, Ilex guayusa may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Ilex guayusa contains caffeine. Caffeine is reported to have antiplatelet activity. Theoretically, caffeine in Ilex guayusa might increase the risk of bleeding when used concomitantly with these agents. However, this interaction has not been reported in humans. There is some evidence that caffeinated coffee might increase the fibrinolytic activity in blood.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with guayusa tea and your dipyridamole. Dipyridamole already works to keep platelets from clumping together, which is how it lowers clot risk after a valve replacement. Guayusa is basically a caffeine source, and caffeine is thought to have a mild blood-thinning, anti-clotting effect of its own. So in theory, stacking the two could nudge your bleeding risk up a little.

I want to be honest about the strength of this, though. This is a theoretical concern based on how caffeine behaves, not something actually seen in people. A normal cup or two probably won't be a big deal. Still, watch for easy bruising, nosebleeds, or bleeding gums, and check with your pharmacist or doctor before making guayusa a daily habit.

References
  1. Ali M, Afzal M. A potent inhibitor of thrombin stimulated platelet thromboxane formation from unprocessed tea. Prostaglandins Leukot Med 1987;27:9-13. PubMed
  2. Ardlie NG, Glew G, Schultz BG, Schwartz CJ. Inhibition and reversal of platelet aggregation by methyl xanthines. Thromb Diath Haemorrh 1967;18:670-3. DOI
  3. Samarrae WA, Truswell AS. Short-term effect of coffee on blood fibrinolytic activity in healthy adults. Atherosclerosis 1977;26:255-60. PubMed
Moderate

DIPYRIDAMOLE (Persantine)

2 of 2
Theoretically, Ilex guayusa might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Ilex guayusa contains caffeine. Caffeine is a methylxanthine that may inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products such as Ilex guayusa, be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.
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 key thing to know about guayusa and dipyridamole. Guayusa naturally contains caffeine, and caffeine works against one of the ways dipyridamole opens up your blood vessels. When dipyridamole is given before a heart stress test, doctors are counting on it to widen the vessels so they can see how your heart responds. Caffeine can blunt that effect and muddy the test results.

For everyday clot prevention after a valve replacement, this is mainly a concern around testing, not your regular dosing. Still, most clinics ask you to avoid caffeine and guayusa for about 24 hours before a pharmacological stress test. Please check with your doctor or pharmacist so your test reads accurately.

References
  1. Underwood DA. Which medications should be held before a pharmacologic or exercise stress test? Cleve Clin J Med 2002;69:449-50. PubMed
  2. Aqel RA, Zoghbi GJ, Trimm JR, et al. Effect of caffeine administered intravenously on intracoronary-administered adenosine-induced coronary hemodynamics in patients with coronary artery disease. Am J Cardiol 2004;93:343-6. PubMed
  3. Zheng XM, Williams RC. Serum caffeine levels after 24-hour abstention: clinical implications on dipyridamole (201)Tl myocardial perfusion imaging. J Nucl Med Technol 2002;30:123-7.
  4. Smits P, Straatman C, Pijpers E, Thien T. Dose-dependent inhibition of the hemodynamic response to dipyridamole by caffeine. Clin Pharmacol Ther 1991;50:529-37. PubMed
  5. Banko, L. T., Haq, S. A., Rainaldi, D. A., Klem, I., Siegler, J., Fogel, J., Sacchi, T. J., and Heitner, J. F. Incidence of caffeine in serum of patients undergoing dipyridamole myocardial perfusion stress test by an intensive versus routine caffeine his
  6. Smits, P., Corstens, F. H., Aengevaeren, W. R., Wackers, F. J., and Thien, T. False-negative dipyridamole-thallium-201 myocardial imaging after caffeine infusion. J Nucl.Med. 1991;32(8):1538-1541. DOI

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

Ilex Guayusa Also Interacts With Other Medications

Ilex Guayusa has 8 major, 469 moderate, 127 minor known drug interactions in our database — the Dipyridamole 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 Ilex Guayusa

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

Everything else you take

See Every Supplement That Interacts With Dipyridamole

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

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

By severity: 4 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Dipyridamole page

“Dipyridamole (Persantine) keeps platelets from clumping so clots don't form, often after a stroke or heart valve surgery, and that job is exactly why the 219 supplements on this page warrant real vigilance. The bulk of the list, including most of the 190 moderate entries, adds its own blood-thinning or antiplatelet effect on top of the…”

Reviewed by 2 · Jul 18, 2026

Open the Dipyridamole interaction page

How much people look this up

Where Ilex Guayusa and Dipyridamole 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 Ilex Guayusa
Steady interest

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

29 days ago today
Medication Dipyridamole
Steady interest

#1,927 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 Ilex Guayusa

What is Ilex Guayusa?

  • Energy and alertness
  • Mental focus
  • Antioxidant support
  • Appetite control
  • Athletic and physical performance

Ilex guayusa is a caffeine-containing holly leaf from the Amazon, traditionally brewed as a tea for energy and alertness, much like yerba mate or green tea. There is limited human research confirming specific health benefits, and its main reliable effect comes from its caffeine content. Because it is a stimulant, use it cautiously and check with your pharmacist or doctor if you have heart concerns or are pregnant.

Read the full Ilex Guayusa monograph & all interactions
Medication

About Dipyridamole

What Is Dipyridamole Used For?

Brand names: Persantine, Dipyridamole, Persantin, Persantin Injection, Persantin Retard

Dipyridamole has two separate uses, depending on the product.

Dipyridamole tablets are used with warfarin-type blood thinners (coumarin anticoagulants) to help prevent blood clot complications after cardiac valve replacement surgery. Dipyridamole Injection (intravenous) is used as an alternative to exercise in thallium heart imaging, to help evaluate coronary artery disease in people who cannot exercise adequately.

See full Dipyridamole drug information
Keep checking

Other Drugs & Ilex Guayusa

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

8Major
469Moderate
127Minor
2,225No known interaction
Major

8 interactions

Moderate

469 interactions

Showing 60 of 469 moderate interactions — see all 469 on the Ilex Guayusa page.

Minor

127 interactions

Showing 60 of 127 minor interactions — see all 127 on the Ilex Guayusa page.

No interaction 2,225 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 Ilex Guayusa and Dipyridamole Together: Common Questions

Can you take Ilex Guayusa with Dipyridamole?
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 Ilex Guayusa and Dipyridamole?
Dipyridamole belongs to more than one drug category, and Ilex Guayusa 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 Ilex Guayusa and Dipyridamole 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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