Drug & supplement interaction

Ilex Guayusa + Salmeterol

Salmeterol brand name: Serevent.

Moderate Interaction
The bottom line Moderate

Ilex Guayusa has a moderate interaction with Salmeterol. Theoretically, concomitant use of large amounts of Ilex guayusa might increase cardiac inotropic effects of beta-agonists.

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

Ilex Guayusa and Salmeterol

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

Moderate

BETA-ADRENERGIC AGONISTS

Why this applies to Salmeterol

Salmeterol falls under BETA-ADRENERGIC AGONISTS — the group Ilex Guayusa interacts with.

Theoretically, concomitant use of large amounts of Ilex guayusa might increase cardiac inotropic effects of beta-agonists.
Ilex guayusa contains caffeine. Caffeine can increase cardiac inotropic effects of beta-agonists.
Severity Moderate Likelihood Probable Evidence D

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: your inhaler, salmeterol (Serevent), is a long-acting beta-agonist that relaxes the airways but can also gently stimulate the heart, sometimes causing a faster heartbeat, palpitations, or a jittery, shaky feeling. Guayusa tea is basically a caffeine source, and caffeine is a stimulant too. Stacking the two together could, in theory, add up and make those heart and nerve effects more noticeable.

The good news is this concern is theoretical, based on how these things work rather than strong human studies, and it mainly applies to large, concentrated amounts of guayusa. An occasional cup likely isn't a big deal. Still, if you notice a racing heart, tremor, or trouble sleeping, or you have any heart conditions, chat with your pharmacist or doctor before making guayusa a daily habit.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

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 Salmeterol 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 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 Salmeterol

This page covers Ilex Guayusa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Salmeterol page lists 141 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 7 major · 105 moderate · 29 minor.

From our pharmacist’s overview on the Salmeterol page

“Salmeterol (Serevent) is the long-acting inhaler taken twice daily for asthma or COPD, and its supplement list is one I would approach with real caution. Seven of the 141 ingredients on file rate major: grapefruit can raise salmeterol levels by blocking the enzyme that clears it, St.”

Reviewed by 2 · Jul 18, 2026

Open the Salmeterol interaction page

How much people look this up

Where Ilex Guayusa and Salmeterol 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

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

29 days ago today
Medication Salmeterol
Top half

#1,128 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 Salmeterol Oral Inhalation

What Is Salmeterol Oral Inhalation Used For?

Brand name: Serevent

Serevent Diskus (salmeterol inhalation powder) is used for three main purposes: treating asthma in patients aged 4 and older when used alongside an inhaled corticosteroid (ICS), preventing exercise-induced bronchospasm (EIB) in patients aged 4 and older, and maintaining treatment of bronchospasm in adults with COPD — including chronic bronchitis and emphysema.

Important: Serevent Diskus is not a rescue inhaler. It will not relieve sudden breathing problems. For asthma treatment, it must always be used together with an inhaled corticosteroid — never alone.

See full Salmeterol Oral Inhalation 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 Salmeterol Together: Common Questions

Can you take Ilex Guayusa with Salmeterol?
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 Ilex Guayusa and Salmeterol 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.