Drug & supplement interaction

Khat + Epoprostenol

Epoprostenol brand name: Flolan.

Moderate Interaction
The bottom line Moderate

Khat has a moderate interaction with Epoprostenol. Human research shows that khat and its constituent, cathinone, can increase blood pressure.

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

Khat and Epoprostenol

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Epoprostenol

Epoprostenol falls under ANTIHYPERTENSIVE DRUGS — the group Khat interacts with.

Human research shows that khat and its constituent, cathinone, can increase blood pressure. Theoretically, khat might reduce the effect of antihypertensive drug therapy. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
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

Epoprostenol (Flolan) is a powerful medicine given by continuous IV infusion to relax blood vessels and lower the dangerously high pressures in the lungs of people with pulmonary arterial hypertension. It also tends to lower overall blood pressure. Khat does the opposite. Its stimulant chemicals, mainly cathinone, push blood pressure up and put extra strain on the heart, so it could work against what your epoprostenol is trying to do.

On top of that, khat is illegal in the U.S. and stresses the heart, which is the last thing someone with serious heart and lung disease needs. The evidence here is limited, but the risk is real. Please don't change anything on your own. Talk with your doctor or pharmacist about any stimulant use.

References
  1. Hassan, N. A., Gunaid, A. A., Abdo-Rabbo, A. A., Abdel-Kader, Z. Y., al Mansoob, M. A., Awad, A. Y., and Murray-Lyon, I. M. The effect of Qat chewing on blood pressure and heart rate in healthy volunteers. Trop.Doct. 2000;30(2):107-108. PubMed
  2. Hassan, N. A., Gunaid, A. A., El Khally, F. M., Al Noami, M. Y., and Murray-Lyon, I. M. Khat chewing and arterial blood pressure. A randomized controlled clinical trial of alpha-1 and selective beta-1 adrenoceptor blockade. Saudi.Med J 2005;26(4):537-541 DOI
  3. Brenneisen, R., Fisch, H. U., Koelbing, U., Geisshusler, S., and Kalix, P. Amphetamine-like effects in humans of the khat alkaloid cathinone. Br.J.Clin.Pharmacol. 1990;30(6):825-828. PubMed

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

Khat Also Interacts With Other Medications

Khat has 4 major, 400 moderate known drug interactions in our database — the Epoprostenol 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 Khat

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

Everything else you take

See Every Supplement That Interacts With Epoprostenol

This page covers Khat only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epoprostenol page lists 136 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), Tyramine (major) and Adrafinil (moderate).

By severity: 4 major · 111 moderate · 21 minor.

From our pharmacist’s overview on the Epoprostenol page

“American hellebore tops my concerns for anyone on epoprostenol (Flolan), the continuous infusion that opens blood vessels in the lungs to treat pulmonary arterial hypertension. The herb lowers blood pressure even in small doses, and stacked on a medicine that already relaxes those vessels, the drop can be dangerous.”

Reviewed by 2 · Jul 18, 2026

Open the Epoprostenol interaction page

How much people look this up

Where Khat and Epoprostenol 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 Khat
Top half

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

29 days ago today
Medication Epoprostenol
Steady interest

#2,404 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 Khat

What is Khat?

Khat
  • Stimulant for energy and alertness
  • Euphoria and mood elevation
  • Reducing fatigue
  • Appetite suppression
  • Social and traditional ceremonies

Khat is a plant chewed for its amphetamine-like stimulant effects, but it carries serious risks including high blood pressure, heart problems, mental health effects, and dependence. It is a controlled substance and illegal in the United States and many other countries, so it should not be used.

Read the full Khat monograph & all interactions
Medication

About Epoprostenol

What Is Epoprostenol Used For?

Brand name: Flolan

Epoprostenol treats pulmonary arterial hypertension (PAH) (WHO Group 1), which is high blood pressure in the arteries of the lungs. It is used to improve exercise capacity.

Both Veletri and Epoprostenol for injection are approved for this use. Studies included mostly people with NYHA Functional Class III–IV symptoms (moderate to severe limits on activity). The causes were mainly idiopathic or heritable PAH, or PAH linked to connective tissue diseases.

See full Epoprostenol drug information
Keep checking

Other Drugs & Khat

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

4Major
400Moderate
0Minor
2,425No known interaction
Major

4 interactions

Moderate

400 interactions

Showing 60 of 400 moderate interactions — see all 400 on the Khat page.

No interaction 2,425 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 Khat and Epoprostenol Together: Common Questions

Can you take Khat with Epoprostenol?
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 Khat and Epoprostenol 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.