Drug & supplement interaction

Periwinkle + Treprostinil (Inh)

Treprostinil (Inh) brand name: Tyvaso.

Moderate Interaction
The bottom line Moderate

Periwinkle has a moderate interaction with Treprostinil (Inh). 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 Treprostinil (Inh)

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Treprostinil (Inh)

Treprostinil (Inh) 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 thing to keep in mind if you're using inhaled treprostinil (Tyvaso) for your lung-related high blood pressure. Treprostinil is already a vasodilator, meaning it relaxes and widens blood vessels. Periwinkle contains vincamine, which may also lower blood pressure. So on paper, layering the two could nudge your blood pressure down a little more than expected, potentially bringing on lightheadedness, dizziness, flushing, headache, or feeling faint when you stand up.

I want to be honest about the strength of this one: it's based on how these compounds behave in theory and in lab work, not on solid human studies. Treprostinil isn't a prodrug, so this is about added blood-pressure lowering, not changed activation. Still, before adding any periwinkle product, please check with your pharmacist or your PAH specialist first.

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 Treprostinil (Inh) 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 Treprostinil (Inh)

This page covers Periwinkle only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil (Inh) page lists 275 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), American Mistletoe (major), Danshen (major), Piracetam (major) and Tyramine (major).

By severity: 5 major · 251 moderate · 19 minor.

From our pharmacist’s overview on the Treprostinil (Inh) page

“Inhaled treprostinil (Tyvaso) relaxes blood vessels in the lungs to treat pulmonary hypertension, and it also blunts platelet clotting, which is why this list of 275 ingredients warrants real vigilance rather than a shrug. Two themes cover almost everything.”

Reviewed by 2 · Jul 18, 2026

Open the Treprostinil (Inh) 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 Treprostinil (Inh) 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 Treprostinil (Inh) 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
Steady interest

#1,085 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Treprostinil (Inh)
Steady interest

#2,473 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 Treprostinil Oral Inhalation

What Is Treprostinil Oral Inhalation Used For?

Brand name: Tyvaso

Treprostinil oral inhalation is used to treat two serious lung conditions that raise pressure in the blood vessels of the lungs. It helps improve how much physical activity you can do.

Tyvaso inhalation solution and Tyvaso DPI are both indicated to treat pulmonary arterial hypertension (PAH; WHO Group 1) and pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3). Clinical studies establishing effectiveness in PAH primarily included patients with moderate symptoms (NYHA Class III) whose PAH was idiopathic, heritable, or related to connective tissue disease. Studies in PH-ILD primarily included patients with idiopathic interstitial pneumonia, combined pulmonary fibrosis and emphysema, or connective tissue disease-related lung disease.

See full Treprostinil Oral Inhalation 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 Treprostinil (Inh) Together: Common Questions

Can you take Periwinkle with Treprostinil (Inh)?
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 Treprostinil (Inh) 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.