Drug & supplement interaction

Moringa + Riociguat

Riociguat brand name: Adempas.

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

Riociguat falls into 2 drug categories that Moringa can interact with; the most serious is rated moderate. Theoretically, moringa might increase or decrease levels of CYP3A4 substrates.

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

Moringa and Riociguat

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Riociguat

Riociguat falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Moringa interacts with.

Theoretically, moringa might increase or decrease levels of CYP3A4 substrates.
Some in vitro research suggests that moringa inhibits cytochrome P450 3A4 (CYP3A4). However, other in vitro research suggests that moringa extract induces CYP3A4 enzymes. A pharmacokinetic study in patients with HIV shows no change in the pharmacokinetics of nevirapine, which is partially metabolized by CYP3A4, when administered concomitantly with moringa leaf powder 1.85 grams daily for 14 days.
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 situation with moringa and your Adempas (riociguat). Your body clears riociguat mainly using a liver enzyme called CYP3A4. In lab dishes, moringa has gone both ways: some studies suggest it slows this enzyme down, others suggest it speeds it up. So we honestly can't say for sure which direction it would push your drug levels.

If moringa slowed that enzyme, riociguat could build up and cause more low blood pressure, dizziness, headache, or fainting. If it sped it up, the drug might work less well for your lung pressure. The good news: this is theoretical, based only on lab and animal data, and a human study with another CYP3A4 drug showed no change. Food amounts in cooking are unlikely to matter, but before using concentrated moringa supplements, please check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Monera TG, Wolfe AR, Maponga CC, et al. Moringa oleifera leaf extracts inhibit 6beta-hydroxylation of testosterone by CYP3A4. J Infect Dev Ctries 2008;2:379-83.
  2. Monera-Penduka TG, Maponga CC, Wolfe AR, Wiesner L, Morse GD, Nhachi CF. Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study. AIDS Res Ther. 2017;14:12. doi: 10.1186/s1 PubMed
  3. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
Moderate

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Riociguat also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, moringa leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that moringa leaf extract inhibits renal P-glycoprotein transport activity. So far, this reaction has not been reported in humans.
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 gist with moringa and your Riociguat (Adempas). Your body uses a kind of cellular pump called P-glycoprotein to move certain drugs around and help clear them. In lab dishes, moringa leaf extract appears to slow that pump down. In theory, a slower pump could let a little more Riociguat hang around in your body, which might nudge its effects up.

Since Riociguat relaxes blood vessels, the main thing to watch for would be its dose-related effects: low blood pressure, dizziness, lightheadedness, headache, or feeling faint. I want to be straight with you, though, this is only test-tube evidence and hasn't been seen in real people. Occasional moringa in food is unlikely to matter, but concentrated supplements are worth running past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Amaeze O, Marques ES, Wei W, et al. Evaluation of Nigerian Medicinal Plants Extract on Human P-glycoprotein and Cytochrome P450 Enzyme Induction: Implications for Herb-drug Interaction. Curr Drug Metab. 2021;22(14):1103-1113. 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

Moringa Also Interacts With Other Medications

Moringa has 716 moderate, 152 minor known drug interactions in our database — the Riociguat one above is among them. If you take anything else, check it against the full list below.

Moderate 716 Minor 152 No known interaction 1,962 (incl. Riociguat)
Taking anything else?

Check Another of Your Medications Against Moringa

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

From our Q&A

Questions About Moringa or Riociguat

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Moringa or Riociguat, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Riociguat

This page covers Moringa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Riociguat page lists 230 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), Grapefruit (major) and St. John's Wort (major).

By severity: 6 major · 187 moderate · 37 minor.

From our pharmacist’s overview on the Riociguat page

“Riociguat (Adempas) works by relaxing the blood vessels in your lungs, which also lowers blood pressure, so I read this list of 230 supplements and herbs with real concern, and the six rated major are what to understand first. Grapefruit can push riociguat levels up and intensify its effect, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Riociguat interaction page

One more smart check

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

We hold 738 real supplement products containing Moringa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Moringa. Your product may carry other ingredients that interact with Riociguat too, on top of Moringa — 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 Moringa and Riociguat 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 Moringa
Top 25%

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

29 days ago today
Medication Riociguat
Steady interest

#1,467 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 Moringa

What is Moringa?

  • Nutritional supplement
  • Blood sugar support
  • Cholesterol support
  • Inflammation
  • Skin conditions

Moringa is a nutrient-rich plant whose leaves are widely used as a food and supplement, especially in parts of the world where malnutrition is common. Early research hints at possible benefits for blood sugar, cholesterol, and inflammation, but the human evidence is limited and not strong enough to recommend it as a treatment. Talk with your pharmacist or doctor before using moringa, especially if you are pregnant, breastfeeding, or taking medications.

Read the full Moringa monograph & all interactions
Medication

About Riociguat

What Is Riociguat Used For?

Brand name: Adempas

Riociguat tablets — sold under the brand names Adempas and Riociguat — are approved for adults with two types of high blood pressure in the lungs. The first is chronic thromboembolic pulmonary hypertension (CTEPH), a condition caused by blood clots that have blocked or narrowed the arteries in the lungs. Riociguat is used when surgery has not fully fixed the problem, or when surgery is not an option.

The second is pulmonary arterial hypertension (PAH), a progressive disease where the arteries in the lungs become stiff and narrowed. In PAH, riociguat helps improve exercise ability, functional class (how well you can get around day-to-day), and slows disease worsening. It can be used alone or combined with other PAH medicines called endothelin receptor antagonists or prostanoids.

See full Riociguat drug information
Keep checking

Other Drugs & Moringa

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

0Major
716Moderate
152Minor
1,961No known interaction
716 Moderate 152 Minor 1,961 No interaction
Moderate

716 interactions

Showing 60 of 716 moderate interactions — see all 716 on the Moringa page.

Minor

152 interactions

Showing 60 of 152 minor interactions — see all 152 on the Moringa page.

No interaction 1,961 drugs checked — show the list

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

Showing the 60 most looked-up of 1,961 medications checked with no known interaction — see the full Moringa list.

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

Can you take Moringa with Riociguat?
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 Moringa and Riociguat?
Riociguat belongs to more than one drug category, and Moringa 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 Moringa and Riociguat 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 Riociguat and Moringa?

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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.