Drug & supplement interaction

Indian Snakeroot + Treprostinil (Oral)

Treprostinil (Oral) brand names: Remodulin, Orenitram.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Treprostinil (Oral) falls into 2 drug categories that Indian Snakeroot can interact with; the most serious is rated moderate. Theoretically, concomitant use of Indian snakeroot and antihypertensive drugs might increase the risk of hypotension.

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

Indian Snakeroot and Treprostinil (Oral)

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

Why Are There 2 Interactions?

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

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Treprostinil (Oral)

Treprostinil (Oral) falls under ANTIHYPERTENSIVE DRUGS — the group Indian Snakeroot interacts with.

Theoretically, concomitant use of Indian snakeroot and antihypertensive drugs might increase the risk of hypotension.
Indian snakeroot, which contains reserpine, can reduce both systolic and diastolic blood pressure.
Severity Moderate Likelihood Possible Evidence B

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 thing to keep in mind: oral treprostinil (Remodulin) already widens your blood vessels to ease the strain on your heart and lungs, and one of its built-in effects is lowering blood pressure. Indian snakeroot contains reserpine, which also brings blood pressure down. Stack the two together and those effects can add up, leaving you with pressure that drops too far.

What that might feel like is dizziness, lightheadedness, headache, flushing, or feeling faint when you stand up, all of which overlap with treprostinil's own common side effects. This concern is mostly theoretical, but reserpine is genuinely potent, so please don't pair these without looping in your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
  2. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
  3. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Treprostinil (Oral) also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, taking Indian snakeroot might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits platelet aggregation.
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 connection worth knowing about. Oral treprostinil (Remodulin) is used for pulmonary arterial hypertension, and one of the ways it works is by relaxing blood vessels and slightly reducing how easily platelets clump together. Indian snakeroot contains tiny amounts of a compound (yohimbine) that, in lab tests only, also seemed to slow platelet clumping. Put the two together and the theory is that bleeding or easy bruising could become a little more likely.

I want to be honest about how soft this evidence is: it comes from test-tube research, not real patients, so we don't truly know if it matters in everyday use. Still, since snakeroot also drops blood pressure on its own (something treprostinil already does), please loop in your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mustonen, P., Savola, J., and Lassila, R. Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine. Thromb.Res 8-1-2000;99(3):231-237.
  2. Berlin, I., Crespo-Laumonnier, B., Cournot, A., Landault, C., Aubin, F., Legrand, J. C., and Puech, A. J. The alpha 2-adrenergic receptor antagonist yohimbine inhibits epinephrine-induced platelet aggregation in healthy subjects. Clin Pharmacol.Ther. 199
  3. Braddock, L., Cowen, P. J., Elliott, J. M., Fraser, S., and Stump, K. Binding of yohimbine and imipramine to platelets in depressive illness. Psychol.Med 1986;16(4):765-773. PubMed
  4. Boon, N. A., Elliott, J. M., Grahame-Smith, D. G., John-Green, T., and Stump, K. A comparison of alpha 2-adrenoreceptor binding characteristics of intact human platelets identified by [3H]-yohimbine and [3H]- dihydroergocryptine. J Auton.Pharmacol 1983;3

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

Indian Snakeroot Also Interacts With Other Medications

Indian Snakeroot has 83 major, 759 moderate known drug interactions in our database — the Treprostinil (Oral) one above is among them. If you take anything else, check it against the full list below.

Major 83 Moderate 759 No known interaction 1,988 (incl. Treprostinil (Oral))
Taking anything else?

Check Another of Your Medications Against Indian Snakeroot

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

Everything else you take

See Every Supplement That Interacts With Treprostinil (Oral)

This page covers Indian Snakeroot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil (Oral) page lists 291 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), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Treprostinil (Oral) page

“With treprostinil (Orenitram), a medicine that opens narrowed lung arteries in pulmonary arterial hypertension, supplements deserve more scrutiny than usual. The drug widens blood vessels and dampens platelet clumping, and nearly everything on this list leans on one of those two levers.”

Reviewed by 2 · Jul 18, 2026

Open the Treprostinil (Oral) interaction page

One more smart check

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

We hold 70 real supplement products containing Indian Snakeroot, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Snakeroot. Your product may carry other ingredients that interact with Treprostinil (Oral) too, on top of Indian Snakeroot — 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 Indian Snakeroot and Treprostinil (Oral) 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 Indian Snakeroot
Top half

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

29 days ago today
Medication Treprostinil (Oral)
Top half

#836 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 Indian Snakeroot

What is Indian Snakeroot?

Indian Snakeroot
  • High blood pressure
  • Anxiety and stress
  • Insomnia
  • Agitation
  • Fever (traditional use)

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious side effects like depression and very low blood pressure, it should never be used without medical supervision. It is not a safe or simple home remedy, and many countries restrict its use.

Read the full Indian Snakeroot monograph & all interactions
Medication

About Treprostinil

What Is Treprostinil Used For?

Brand names: Remodulin, Orenitram

Treprostinil treats pulmonary arterial hypertension (PAH; WHO Group 1) — high blood pressure in the arteries of the lungs. Depending on the product and route, it is used to improve exercise ability, delay disease progression, or reduce symptoms tied to physical activity. Remodulin and treprostinil injection products are also indicated for patients who need to transition away from another PAH medicine called epoprostenol.

Tyvaso, Tyvaso DPI, and Yutrepia (inhaled forms) are additionally approved to treat pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) — lung-pressure problems caused by scarring or inflammation in the lung tissue itself. Orenitram (extended-release oral tablet) is specifically indicated to delay disease progression and improve exercise capacity in PAH.

See full Treprostinil drug information
Keep checking

Other Drugs & Indian Snakeroot

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

83Major
759Moderate
0Minor
1,987No known interaction
83 Major 759 Moderate 1,987 No interaction
Major

83 interactions

Showing 60 of 83 major interactions — see all 83 on the Indian Snakeroot page.

Moderate

759 interactions

Showing 60 of 759 moderate interactions — see all 759 on the Indian Snakeroot page.

No interaction 1,987 drugs checked — show the list

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

Showing the 60 most looked-up of 1,987 medications checked with no known interaction — see the full Indian Snakeroot list.

See the full Indian Snakeroot interactions page
See every supplement checked against Treprostinil (Oral), ranked by severity
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

Keep exploring
Indian Snakeroot monograph › Uses, safety, and every drug interaction in one place Treprostinil (Oral) supplement interactions › Every supplement checked against Treprostinil (Oral), ranked by severity Treprostinil drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Indian Snakeroot and Treprostinil (Oral) Together: Common Questions

Can you take Indian Snakeroot with Treprostinil (Oral)?
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 Indian Snakeroot and Treprostinil (Oral)?
Treprostinil (Oral) belongs to more than one drug category, and Indian Snakeroot 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 Indian Snakeroot and Treprostinil (Oral) 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.