Drug & supplement interaction

Khat + Guanethidine Monosulfate

Guanethidine Monosulfate brand names: Ismelin, Isimil.

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

Khat has a moderate interaction with Guanethidine Monosulfate. 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 Guanethidine Monosulfate

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Guanethidine Monosulfate

Guanethidine Monosulfate 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

Here's the short version: guanethidine works by lowering the activity of certain nerves that drive up your blood pressure. Khat does the opposite. Its main stimulant chemical, cathinone, acts a lot like an amphetamine and pushes your blood pressure and heart rate up. So the two are essentially tugging in opposite directions, and khat could blunt how well guanethidine controls your numbers.

In real terms, that might mean your blood pressure creeps back up even while you're taking your medicine. The evidence here is moderate and partly theoretical, but the conflict makes sense. On top of that, khat is a controlled substance and isn't legal here, so it really shouldn't be used. If you have any concerns about your blood pressure, please talk with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Guanethidine Monosulfate one above is one of them. If you take anything else, check it against the full list below.

Major 4 Moderate 400 No known interaction 2,426 (incl. Guanethidine Monosulfate)
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 Guanethidine Monosulfate

This page covers Khat only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guanethidine Monosulfate page lists 137 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 · 112 moderate · 21 minor.

From our pharmacist’s overview on the Guanethidine Monosulfate page

“Guanethidine monosulfate (Ismelin) is a forceful older drug for severe high blood pressure, and its interaction list warrants genuine care. Nearly all 137 supplements and herbs on file pull blood pressure one way or the other, either adding to the drug's effect and risking dizziness and faints, or pushing pressure back up and undoing t…”

Reviewed by 2 · Jul 18, 2026

Open the Guanethidine Monosulfate interaction page

How much people look this up

Where Khat and Guanethidine Monosulfate 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

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

29 days ago today
Medication Guanethidine Monosulfate
Steady interest

#1,637 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
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
4 Major 400 Moderate 2,425 No 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

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

Showing the 60 most looked-up of 2,425 medications checked with no known interaction — see the full Khat list.

See the full Khat interactions page
See every supplement checked against Guanethidine Monosulfate, 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
Khat monograph › Uses, safety, and every drug interaction in one place Guanethidine Monosulfate supplement interactions › Every supplement checked against Guanethidine Monosulfate, ranked by severity 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 Khat and Guanethidine Monosulfate Together: Common Questions

Can you take Khat with Guanethidine Monosulfate?
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 Guanethidine Monosulfate 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

Still Have a Question About Guanethidine Monosulfate and Khat?

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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.