Drug & supplement interaction

Rauvolfia Vomitoria + Epoprostenol

Epoprostenol brand name: Flolan.

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

Rauvolfia Vomitoria has a moderate interaction with Epoprostenol. Theoretically, Rauvolfia vomitoria might increase the risk of hypotension.

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

Rauvolfia Vomitoria and Epoprostenol

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Epoprostenol

Epoprostenol falls under ANTIHYPERTENSIVE DRUGS — the group Rauvolfia Vomitoria interacts with.

Theoretically, Rauvolfia vomitoria might increase the risk of hypotension.
Rauvolfia vomitoria contains a very small amount of the drug reserpine. Reserpine can reduce both systolic and diastolic 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: Epoprostenol (Flolan) is a continuous IV medicine used for pulmonary hypertension, and one of its main jobs is to relax and open up blood vessels. That naturally lowers blood pressure. Rauvolfia vomitoria contains a small amount of reserpine, which also pushes blood pressure down by lowering certain nerve messengers. Stack the two together and you could, in theory, end up with blood pressure that drops too far.

If that happened, you might feel dizzy, lightheaded, flushed, or faint, especially when standing up. To be fair, this warning is based on how these compounds work, not on solid studies, so it's more of a heads-up than a proven problem. Still, since Epoprostenol is a powerful drug, please loop in your doctor or pharmacist before adding this herb.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
  2. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.

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 230 major, 522 moderate, 87 minor known drug interactions in our database — the Epoprostenol one above is one of them. If you take anything else, check it against the full list below.

Major 230 Moderate 522 Minor 87 No known interaction 1,991 (incl. Epoprostenol)
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.

Everything else you take

See Every Supplement That Interacts With Epoprostenol

This page covers Rauvolfia Vomitoria only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epoprostenol page lists 136 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), Tyramine (major) and Adrafinil (moderate).

By severity: 4 major · 111 moderate · 21 minor.

From our pharmacist’s overview on the Epoprostenol page

“American hellebore tops my concerns for anyone on epoprostenol (Flolan), the continuous infusion that opens blood vessels in the lungs to treat pulmonary arterial hypertension. The herb lowers blood pressure even in small doses, and stacked on a medicine that already relaxes those vessels, the drop can be dangerous.”

Reviewed by 2 · Jul 18, 2026

Open the Epoprostenol 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 Epoprostenol 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 Epoprostenol 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

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

29 days ago today
Medication Epoprostenol
Top half

#1,009 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 Epoprostenol

What Is Epoprostenol Used For?

Brand name: Flolan

Epoprostenol (available as the brands Epoprostenol, Flolan, and Veletri) is used to treat pulmonary arterial hypertension (PAH) — WHO Group 1, a type of high blood pressure in the arteries of the lungs. The goal is to improve how much physical activity patients can handle.

The clinical studies that established its effectiveness included mainly patients with moderate-to-severe symptoms (NYHA Functional Class III–IV) whose PAH was idiopathic (no known cause), heritable (genetic), or related to connective tissue diseases such as scleroderma.

See full Epoprostenol 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.

230Major
522Moderate
87Minor
1,990No known interaction
230 Major 522 Moderate 87 Minor 1,990 No interaction
Major

230 interactions

Showing 60 of 230 major interactions — see all 230 on the Rauvolfia Vomitoria page.

Moderate

522 interactions

Showing 60 of 522 moderate interactions — see all 522 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

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

Showing the 60 most looked-up of 1,990 medications checked with no known interaction — see the full Rauvolfia Vomitoria list.

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

Can you take Rauvolfia Vomitoria with Epoprostenol?
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 Rauvolfia Vomitoria and Epoprostenol 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 Epoprostenol and Rauvolfia Vomitoria?

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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.