Drug & supplement interaction

Phellodendron + Treprostinil (Inh)

Treprostinil (Inh) brand name: Tyvaso.

Moderate Interaction
The bottom line Moderate

Treprostinil (Inh) falls into 2 drug categories that Phellodendron can interact with; the most serious is rated moderate. Theoretically, phellodendron might have additive effects with antihypertensive drugs.

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

Phellodendron and Treprostinil (Inh)

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

Why Are There 2 Interactions?

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

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Treprostinil (Inh)

Treprostinil (Inh) falls under ANTIHYPERTENSIVE DRUGS — the group Phellodendron interacts with.

Theoretically, phellodendron might have additive effects with antihypertensive drugs.
Phellodendron contains berberine. Animal research suggests that berberine can have hypotensive effects. Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. Theoretically, phellodendron might also reduce blood pressure.
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 for you. Inhaled treprostinil (Tyvaso) is a vasodilator, meaning it relaxes and widens blood vessels. Phellodendron contains berberine, which in animal studies and one small human study seemed to gently lower blood pressure on its own. So the concern here is additive: putting the two together could nudge your blood pressure down more than treprostinil alone.

If that happens, you might notice things like lightheadedness, dizziness, a flushed feeling, or a headache, especially when you stand up quickly. I'll be honest though, this is a theoretical concern based on how these work, not something proven with this exact combo. Since you're managing pulmonary hypertension, please loop in your doctor or pharmacist before adding phellodendron so they can keep an eye on your blood pressure.

References
  1. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  2. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  3. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Treprostinil (Inh) also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, phellodendron might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Phellodendron contains berberine. In vitro and in vivo research suggest that berberine can inhibit platelet aggregation. Theoretically, phellodendron might also inhibit platelet aggregation.
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 thing worth knowing: inhaled treprostinil (Tyvaso) doesn't just relax the blood vessels in your lungs, it also makes your platelets a little less sticky, so it has a mild blood-thinning effect of its own. Phellodendron contains berberine, and in lab and animal studies berberine also seems to slow platelet clumping. Stack those two together and, in theory, you could bruise or bleed a bit more easily.

I want to be honest that this is theoretical and only comes from lab and animal research, not from people, so it's not something to panic over. Still, if you notice easy bruising, nosebleeds, or bleeding gums, or you're on other blood thinners, please loop in your pharmacist or doctor before combining these.

References
  1. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  2. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.

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

Phellodendron Also Interacts With Other Medications

Phellodendron has 1,159 moderate known drug interactions in our database — the Treprostinil (Inh) one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Phellodendron

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

Everything else you take

See Every Supplement That Interacts With Treprostinil (Inh)

This page covers Phellodendron 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 Phellodendron as Part of a Dietary Supplement Product? Check It for Interactions

We hold 393 real supplement products containing Phellodendron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phellodendron. Your product may carry other ingredients that interact with Treprostinil (Inh) too, on top of Phellodendron — 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 Phellodendron 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 Phellodendron
Top 25%

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

29 days ago today
Medication Treprostinil (Inh)
Steady interest

#2,491 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 Phellodendron

What is Phellodendron?

Phellodendron
  • Digestive complaints and diarrhea
  • Inflammation and joint discomfort
  • Stress and weight management (in combination products)
  • Skin conditions (topical, traditional)
  • Antimicrobial support

Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evidence for most uses is limited, and it is often sold in combination with other herbs, making its individual effects hard to judge. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Phellodendron 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 & Phellodendron

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

0Major
1,159Moderate
0Minor
1,670No known interaction
Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Phellodendron page.

No interaction 1,670 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 Phellodendron and Treprostinil (Inh) Together: Common Questions

Can you take Phellodendron 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.
Why are there 2 interactions listed for Phellodendron and Treprostinil (Inh)?
Treprostinil (Inh) belongs to more than one drug category, and Phellodendron 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 Phellodendron 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.