Drug & supplement interaction

Puravive + Cilostazol

Cilostazol brand name: Pletal.

Moderate Interaction
Medically reviewed by · Updated February 2024
The bottom line Moderate

Cilostazol falls into 2 drug categories that Puravive can interact with; the most serious is rated moderate. Puravive, a dietary supplement, contains several ingredients that may interact with anticoagulant drugs due to their potential mild anticoagulant effects.

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

Puravive and Cilostazol

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

Why Are There 2 Interactions?

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

Moderate

Anticoagulant/Antiplatelet Drugs

1 of 2

Why this applies to Cilostazol

Cilostazol falls under Anticoagulant/Antiplatelet Drugs — the group Puravive interacts with.

Puravive, a dietary supplement, contains several ingredients that may interact with anticoagulant drugs due to their potential mild anticoagulant effects. These ingredients include Kudzu, Panax ginseng, Phellodendron, and Propolis. Ginsenosides in Panax ginseng may decrease platelet aggregation in lab studies, but human studies have not confirmed this effect. Animal studies suggest low oral bioavailability of certain compounds in ginseng, which could explain differences between lab and human research. Propolis water extract and caffeic acid phenethyl ester, found in propolis, have also been shown to inhibit platelet aggregation in lab studies. Additionally, in an animal model, propolis taken with warfarin reduced the effectiveness of warfarin, suggesting a potential interaction with anticoagulant drugs. Lastly, Phellodendron contains berberine, which studies show may inhibit platelet aggregation.
Severity Moderate Likelihood Possible Evidence C

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 Cilostazol (Pletal). This medicine is an antiplatelet, meaning it helps keep your platelets from clumping so blood flows more easily to your legs. A few ingredients in Puravive (ginseng, kudzu, propolis, and the berberine in phellodendron) have shown mild platelet-slowing effects in lab dishes. Stacking those on top of cilostazol could, in theory, nudge your bleeding risk up a bit, think easier bruising, nosebleeds, or bleeding gums that's slow to stop.

The honest part: this is mostly lab and animal data, not solid human proof, so I wouldn't lose sleep over it. Still, since both lean the same direction, please run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 3A4 (Cyp3A4) Substrates

2 of 2

Cilostazol also falls under Cytochrome P450 3A4 (Cyp3A4) Substrates.

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.
Severity Minor 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 deal with Pletal (cilostazol) and Puravive. Puravive contains Panax ginseng, which can nudge a liver enzyme called CYP3A4, and that's one of the enzymes your body uses to clear cilostazol. The tricky part is that ginseng has acted in opposite ways in different studies. In some cases it seems to block this enzyme (which could let cilostazol build up, raising the odds of headache, dizziness, a racing or pounding heartbeat, or loose stools). In others it seems to speed the enzyme up, which could make cilostazol work less well for your leg pain.

Honestly, this is a minor, mostly theoretical concern based on weak, mixed evidence, so I wouldn't panic. Still, since the direction isn't predictable, run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Puravive Also Interacts With Other Medications

Puravive has 356 moderate, 881 minor known drug interactions in our database — the Cilostazol one above is among them. If you take anything else, check it against the full list below.

Moderate 356 Minor 881 No known interaction 1,593 (incl. Cilostazol)
Taking anything else?

Check Another of Your Medications Against Puravive

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

From our Q&A

Questions About Puravive or Cilostazol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Puravive or Cilostazol, 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 Cilostazol

This page covers Puravive only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cilostazol page lists 286 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 41 minor.

Open the Cilostazol interaction page

How much people look this up

Where Puravive and Cilostazol 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 Puravive
Top half

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

29 days ago today
Medication Cilostazol
Steady interest

#1,423 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 Puravive

What is Puravive?

Puravive
  • Weight management
  • Metabolism support
  • Energy levels
  • General wellness
  • Stress and brain health

Puravive is a branded, multi-ingredient capsule marketed mainly for weight loss by claiming to boost brown fat activity, but there is no published, independent clinical research showing the product itself works for this purpose. Some individual ingredients have been studied in laboratory or small human studies, but those results do not prove the finished blend is safe or effective. Talk to a pharmacist or doctor before trying it, especially if you have health conditions or take medications.

Read the full Puravive monograph & all interactions
Medication

About Cilostazol

What Is Cilostazol Used For?

Brand name: Pletal

Cilostazol tablets are approved to reduce the symptoms of intermittent claudication (cramping leg pain that comes on during walking due to reduced blood flow in the arteries). The goal is to help you walk farther before pain forces you to stop.

See full Cilostazol drug information
Keep checking

Other Drugs & Puravive

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

0Major
356Moderate
881Minor
1,592No known interaction
356 Moderate 881 Minor 1,592 No interaction
Moderate

356 interactions

Showing 60 of 356 moderate interactions — see all 356 on the Puravive page.

Minor

881 interactions

Showing 60 of 881 minor interactions — see all 881 on the Puravive page.

No interaction 1,592 drugs checked — show the list

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

Showing the 60 most looked-up of 1,592 medications checked with no known interaction — see the full Puravive list.

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

Can you take Puravive with Cilostazol?
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 Puravive and Cilostazol?
Cilostazol belongs to more than one drug category, and Puravive 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 Puravive and Cilostazol 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 Cilostazol and Puravive?

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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.