Drug & supplement interaction

Japanese Persimmon + Treprostinil

Moderate Interaction
The bottom line Moderate

Treprostinil falls into 2 drug categories that Japanese Persimmon can interact with; the most serious is rated moderate. Japanese persimmon is thought to have hypotensive effects.

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

Japanese Persimmon and Treprostinil

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

Why Are There 2 Interactions?

Japanese Persimmon interacts with whole categories of medication. Treprostinil falls into 2 of those categories, so it can interact with Japanese Persimmon 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

Treprostinil falls under ANTIHYPERTENSIVE DRUGS — the group Japanese Persimmon interacts with.

Japanese persimmon is thought to have hypotensive effects. Theoretically, concurrent use might increase risk of hypotension with drugs that lower blood pressure. These include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
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 thing with treprostinil (Orenitram): it's a powerful blood vessel widener used for pulmonary arterial hypertension, and one of its main known effects is lowering blood pressure. Japanese persimmon, especially in concentrated supplement or leaf-extract form, is also thought to nudge blood pressure down. Stack the two together and you could end up lower than you'd like.

What that can feel like is dizziness, lightheadedness, headache, flushing, or feeling faint when you stand up, which are already common with treprostinil. I'd note this is mostly theoretical and the persimmon effect is mild, so eating the fruit as a normal food is unlikely to be a problem. It's the concentrated products that matter more. Before adding any persimmon supplement, please check with your doctor or pharmacist.

References
  1. Hibino G, Nadamoto T, Fujisawa F, Fushiki T. Regulation of the peripheral body temperature by foods: a temperature decrease induced by the Japanese persimmon (kaki, Diospyros kaki). Biosci Biotechnol Biochem 2003;67:23-8. .
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Treprostinil also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

There is concern that Japanese persimmon leaf constituents might potentiate effects of anticoagulant and antiplatelet drugs. In vitro research shows that certain Japanese persimmon leaf extract protein fractions have anticoagulant activity. These fractions are thought to bind fibrinogen leading to thrombin inactivation. This effect has not been shown in humans.
Some anticoagulant and antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), and others.
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 thing to know about Treprostinil (Orenitram): it's used for pulmonary arterial hypertension, and besides relaxing blood vessels it also makes platelets less sticky, so it has a mild blood-thinning side to it. Japanese persimmon comes into play because lab studies suggest compounds in the leaf (not the everyday fruit) may have their own anticoagulant activity. Stacked together, the theory is you could bleed or bruise a little more easily.

But take this with a grain of salt. This concern is purely theoretical, based on test-tube research, and has never been shown in people. Eating persimmon fruit as food is very unlikely to matter. Concentrated leaf extracts are the real question, so check with your pharmacist or doctor before adding one.

References
  1. Sa YS, Kim SJ, Choi HS. The anticoagulant fraction from the leaves of Diospyros kaki L. has an antithrombotic activity. Arch Pharm Res. 2005;28(6):667-74.

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

Japanese Persimmon Also Interacts With Other Medications

Japanese Persimmon has 288 moderate known drug interactions in our database — the Treprostinil 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 Japanese Persimmon

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

Everything else you take

See Every Supplement That Interacts With Treprostinil

This page covers Japanese Persimmon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil 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.

Open the Treprostinil interaction page

One more smart check

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

We hold 1 real supplement products containing Japanese Persimmon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Japanese Persimmon. Your product may carry other ingredients that interact with Treprostinil too, on top of Japanese Persimmon — 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 Japanese Persimmon and Treprostinil 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 Japanese Persimmon
Steady interest

#1,448 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Treprostinil
Steady interest

#2,602 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 Japanese Persimmon

What is Japanese Persimmon?

  • High blood pressure
  • Cough and hiccups (traditional use)
  • Antioxidant support
  • Digestive health and fiber
  • Skin and general wellness

Japanese persimmon is a nutritious fruit rich in fiber, vitamins, and antioxidant plant compounds, and its leaves and calyx are used in traditional medicine. While eating the fruit as food is generally safe and healthy, the evidence for concentrated supplements or leaf extracts treating specific conditions is limited. Talk to your pharmacist or doctor before using persimmon products medicinally.

Read the full Japanese Persimmon monograph & all interactions
Medication

About Treprostinil

What Is Treprostinil Used For?

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 & Japanese Persimmon

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

0Major
288Moderate
0Minor
2,541No known interaction
Moderate

288 interactions

Showing 60 of 288 moderate interactions — see all 288 on the Japanese Persimmon page.

No interaction 2,541 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 Japanese Persimmon and Treprostinil Together: Common Questions

Can you take Japanese Persimmon with Treprostinil?
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 Japanese Persimmon and Treprostinil?
Treprostinil belongs to more than one drug category, and Japanese Persimmon 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 Japanese Persimmon and Treprostinil 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.