Drug & supplement interaction

Periwinkle + Hydroflumethiazide, Reserpine

Hydroflumethiazide, Reserpine brand names: Salutensin-Demi, Salutensin.

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

Periwinkle has a moderate interaction with Hydroflumethiazide, Reserpine. 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 Hydroflumethiazide, Reserpine

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Hydroflumethiazide, Reserpine

Hydroflumethiazide, Reserpine 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

Salutensin combines two blood pressure lowering medicines: hydroflumethiazide (a water pill) and reserpine (which relaxes blood vessels and slows the heart). Periwinkle contains vincamine, a compound that lab studies suggest may also gently widen blood vessels and nudge blood pressure down. So in theory, pairing the two could stack their effects and push your pressure lower than intended.

What that might feel like: dizziness, lightheadedness (especially when standing up), tiredness, or even faintness. I want to be honest, though: this concern is theoretical, based on how vincamine behaves, not on solid human studies. Still, if you take Salutensin and are considering periwinkle, please check in with your pharmacist or doctor first rather than starting it on your own.

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

Moderate 171 No known interaction 2,659 (incl. Hydroflumethiazide, Reserpine)
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 Hydroflumethiazide, Reserpine

This page covers Periwinkle only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydroflumethiazide, Reserpine page lists 228 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), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 193 moderate · 25 minor.

From our pharmacist’s overview on the Hydroflumethiazide, Reserpine page

“American hellebore tops this list because even small doses lower blood pressure and slow the heart, a dangerous match for Salutensin (hydroflumethiazide with reserpine), a combination pill built to pull blood pressure down. The list as a whole warrants real care.”

Reviewed by 2 · Jul 18, 2026

Open the Hydroflumethiazide, Reserpine 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 Hydroflumethiazide, Reserpine 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 Hydroflumethiazide, Reserpine 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

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

29 days ago today
Medication Hydroflumethiazide, Reserpine
Steady interest

#2,406 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
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
171 Moderate 2,658 No 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

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

Showing the 60 most looked-up of 2,658 medications checked with no known interaction — see the full Periwinkle list.

See the full Periwinkle interactions page
See every supplement checked against Hydroflumethiazide, Reserpine, 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
Periwinkle monograph › Uses, safety, and every drug interaction in one place Hydroflumethiazide, Reserpine supplement interactions › Every supplement checked against Hydroflumethiazide, Reserpine, 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 Periwinkle and Hydroflumethiazide, Reserpine Together: Common Questions

Can you take Periwinkle with Hydroflumethiazide, Reserpine?
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 Hydroflumethiazide, Reserpine 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 Hydroflumethiazide, Reserpine and Periwinkle?

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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.