Drug & supplement interaction

Rauvolfia Vomitoria + Chlorpromazine

Chlorpromazine brand names: Thorazine, Thorazine Spansules.

Major Interaction
The bottom line Major

Chlorpromazine falls into 3 drug categories that Rauvolfia Vomitoria can interact with; the most serious is rated major. Theoretically, concomitant use might increase the risk of adverse effects.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rauvolfia Vomitoria and Chlorpromazine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Rauvolfia Vomitoria interacts with whole categories of medication. Chlorpromazine falls into 3 of those categories, so it can interact with Rauvolfia Vomitoria in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

ANTIPSYCHOTIC DRUGS

1 of 3

Why this applies to Chlorpromazine

Chlorpromazine falls under ANTIPSYCHOTIC DRUGS — the group Rauvolfia Vomitoria interacts with.

Theoretically, concomitant use might increase the risk of adverse effects.
Concomitant use of neuroleptics with Rauvolfia vomitoria may potentiate the effects of these drugs and the rauwolfia alkaloids.
Severity Major 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 gist: both Rauvolfia vomitoria and chlorpromazine (Thorazine) push in the same direction on your brain and blood pressure. Chlorpromazine isn't a prodrug, so this isn't about one speeding up or slowing down the other. Instead, the reserpine in Rauvolfia depletes brain chemicals like dopamine, while chlorpromazine blocks them. Stack those effects and you can get more of the same: drowsiness, low blood pressure with dizziness or fainting when you stand, and a higher chance of movement problems like stiffness, tremor, or restlessness.

To be fair, this warning is theoretical, based on how these compounds work rather than firm studies. Still, the potential effects are serious enough that I wouldn't combine them on your own. Please check with your doctor or pharmacist before mixing the two.

References
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Moderate

CNS DEPRESSANTS

2 of 3

Chlorpromazine also falls under CNS DEPRESSANTS.

Theoretically, taking Rauvolfia vomitoria might cause additive sedative effects.
Rauvolfia vomitoria has sedative effects in animal research.
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 simple version: chlorpromazine (Thorazine) is already a pretty sedating medication. It can leave you feeling drowsy, foggy, lightheaded, or low on energy, and it can drop your blood pressure when you stand up. Rauvolfia vomitoria contains reserpine-like compounds that calm the nervous system and lower blood pressure too. So the worry is that the two together could pile on, leaving you more sleepy, dizzy, or unsteady than you'd expect from the medicine alone.

One honest note: this is a theoretical concern based on how these substances work and on animal studies, not strong human proof. Still, because rauvolfia is a potent plant and chlorpromazine is no lightweight, I'd play it safe. Please check with your doctor or pharmacist before combining them.

References
  1. Ekong MB, Peter AI, Edagha IA, et al. Rauwolfia vomitoria inhibits olfaction and modifies olfactory bulb cells. Brain Res Bull 2016;124:206-13. PubMed
  2. Amole OO, Yemitan OK, Oshikoya KA. Anticonvulsant activity of Rauvol?a Vomitoria (Afzel). Afr J Pharmacy Pharmacol 2009;3:319-322.
  3. Campbell JI, Mortensen A, Mølgaard P. Tissue lipid lowering-effect of a traditional Nigerian anti-diabetic infusion of Rauwolfia vomitoria foilage and Citrus aurantium fruit. J Ethnopharmacol 2006;104:379-86. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

3 of 3

Chlorpromazine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, Rauvolfia vomitoria might increase the levels and clinical effects of CYP2D6 substrates.
Rauvolfia vomitoria contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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 of it. Your body uses a liver enzyme called CYP2D6 to help clear chlorpromazine (Thorazine). Rauvolfia vomitoria contains a bit of yohimbine, and in lab studies yohimbine can slow that same enzyme down. If CYP2D6 is blocked, chlorpromazine may not break down as quickly, so its levels could creep up.

What that might look like in real life: more drowsiness, dizziness, a dip in blood pressure when you stand, dry mouth, or constipation. Keep in mind this is theoretical, based only on test-tube work, so we don't know how strong it is in people. Rauvolfia can also lower blood pressure on its own, which adds to the concern. Please loop in your pharmacist or doctor before combining them.

References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed

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

Rauvolfia Vomitoria Also Interacts With Other Medications

Rauvolfia Vomitoria has 229 major, 523 moderate, 87 minor known drug interactions in our database — the Chlorpromazine 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 Rauvolfia Vomitoria

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

From our Q&A

Questions About Rauvolfia Vomitoria or Chlorpromazine

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

This page covers Rauvolfia Vomitoria only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorpromazine page lists 211 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 17 major · 159 moderate · 35 minor.

Open the Chlorpromazine interaction page

One more smart check

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

We hold 17 real supplement products containing Rauvolfia Vomitoria, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauvolfia Vomitoria. Your product may carry other ingredients that interact with Chlorpromazine too, on top of Rauvolfia Vomitoria — 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 Rauvolfia Vomitoria and Chlorpromazine 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 Rauvolfia Vomitoria
Steady interest

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

29 days ago today
Medication Chlorpromazine
Steady interest

#1,833 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 Rauvolfia Vomitoria

What is Rauvolfia Vomitoria?

  • High blood pressure
  • Anxiety and agitation
  • Sleep problems
  • Mental health symptoms (traditional use)
  • Fever and general ailments

Rauvolfia vomitoria is an African shrub whose root contains powerful alkaloids, including reserpine, that have historically been used for high blood pressure and agitation. Because these compounds can strongly affect blood pressure, mood, and the nervous system, the plant can cause serious side effects and is not a casual supplement. Always talk to a doctor or pharmacist before using it.

Read the full Rauvolfia Vomitoria monograph & all interactions
Medication

About Chlorpromazine

What Is Chlorpromazine Used For?

Brand names: Thorazine, Thorazine Spansules

Chlorpromazine is used to manage psychotic disorders and treat schizophrenia. It also controls nausea and vomiting, relieves restlessness and apprehension before surgery, and controls the manic phase of manic-depressive illness. Other uses include relief of intractable hiccups, treatment of acute intermittent porphyria, and use as an adjunct in tetanus treatment.

In children ages 1 to 12, it is used for severe behavioral problems marked by explosive or combative behavior, and for short-term treatment of hyperactive children with conduct disorders. The oral forms are also approved for the management of manifestations of psychotic disorders broadly, in addition to the uses shared with the injection form.

See full Chlorpromazine drug information
Keep checking

Other Drugs & Rauvolfia Vomitoria

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

229Major
523Moderate
87Minor
1,990No known interaction
Major

229 interactions

Showing 60 of 229 major interactions — see all 229 on the Rauvolfia Vomitoria page.

Moderate

523 interactions

Showing 60 of 523 moderate interactions — see all 523 on the Rauvolfia Vomitoria page.

Minor

87 interactions

Showing 60 of 87 minor interactions — see all 87 on the Rauvolfia Vomitoria page.

No interaction 1,990 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 Rauvolfia Vomitoria and Chlorpromazine Together: Common Questions

Can you take Rauvolfia Vomitoria with Chlorpromazine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Rauvolfia Vomitoria and Chlorpromazine?
Chlorpromazine belongs to more than one drug category, and Rauvolfia Vomitoria 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 Rauvolfia Vomitoria and Chlorpromazine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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.