Drug & supplement interaction

Periwinkle + Aprocitentan

Aprocitentan brand name: Tryvio.

Moderate Interaction
The bottom line Moderate

Periwinkle has a moderate interaction with Aprocitentan. Theoretically, taking periwinkle may increase the effects of antihypertensive drugs due to the hypotensive activity of vincamine, a constituent of periwinkle.

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

Periwinkle and Aprocitentan

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Aprocitentan

Aprocitentan falls under ANTIHYPERTENSIVE DRUGS — the group Periwinkle interacts with.

Theoretically, taking periwinkle may increase the effects of antihypertensive drugs due to the hypotensive activity of vincamine, a constituent of periwinkle.
Severity Moderate Likelihood Probable Evidence D

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 situation with Tryvio (aprocitentan), which is a blood pressure medicine used for hard-to-control hypertension. Periwinkle contains a compound called vincamine that, at least on paper, can relax blood vessels and lower blood pressure on its own. So the concern isn't about how your body breaks the drug down. It's simpler than that: two blood-pressure-lowering effects could stack on top of each other.

If they add up too much, you might feel dizzy or lightheaded, tired, or even faint, especially when you stand up quickly. Keep in mind this warning is theoretical, based on how the plant behaves rather than solid human studies. Still, please don't add periwinkle without checking with your pharmacist or doctor first, and never stop your Tryvio on your own.

References
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Periwinkle Also Interacts With Other Medications

Periwinkle has 171 moderate known drug interactions in our database — the Aprocitentan 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 Periwinkle

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

Everything else you take

See Every Supplement That Interacts With Aprocitentan

This page covers Periwinkle only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aprocitentan page lists 189 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), Beer (major) and Siberian Cocklebur (major).

By severity: 7 major · 161 moderate · 21 minor.

From our pharmacist’s overview on the Aprocitentan page

“Aprocitentan (Tryvio) is prescribed when blood pressure stays high despite other medicines, so anything that pushes your pressure around cuts straight to why you take it. Most of the 189 ingredients here do exactly that: some add to the drop and can leave you dizzy or faint, while others, tyramine among them, push pressure back up and…”

Reviewed by 2 · Jul 18, 2026

Open the Aprocitentan interaction page

One more smart check

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

We hold 38 real supplement products containing Periwinkle, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Periwinkle. Your product may carry other ingredients that interact with Aprocitentan too, on top of Periwinkle — 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 Periwinkle and Aprocitentan 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 Periwinkle
Top half

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

29 days ago today
Medication Aprocitentan
Top half

#847 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 Periwinkle

What is Periwinkle?

  • Memory and cognitive support
  • Circulation problems
  • Dizziness and ringing in the ears
  • Minor wounds and sore throat (traditional)
  • High blood pressure (traditional)

Periwinkle (Vinca minor) is a flowering plant whose alkaloids are the source of vinpocetine, a compound marketed for memory and brain circulation. Evidence in humans is limited and mixed, and the plant contains potent compounds that can be toxic in larger amounts, so it should be used only with professional guidance. A closely related plant, Madagascar periwinkle, is the source of important cancer chemotherapy drugs but is not safe to use as a home remedy.

Read the full Periwinkle monograph & all interactions
Medication

About Aprocitentan

What Is Aprocitentan Used For?

Brand name: Tryvio

Tryvio is used to treat high blood pressure (hypertension) in adults who are already taking other blood pressure medications but still don't have their blood pressure under control. It is always used in combination with other antihypertensive (blood pressure-lowering) drugs — not on its own.

Lowering blood pressure reduces the risk of serious cardiovascular events, including strokes and heart attacks. Tryvio has not been shown in controlled trials to directly reduce those events itself, but blood pressure control overall does.

See full Aprocitentan drug information
Keep checking

Other Drugs & Periwinkle

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

0Major
171Moderate
0Minor
2,658No known interaction
Moderate

171 interactions

Showing 60 of 171 moderate interactions — see all 171 on the Periwinkle page.

No interaction 2,658 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 Periwinkle and Aprocitentan Together: Common Questions

Can you take Periwinkle with Aprocitentan?
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 Periwinkle and Aprocitentan 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.