Drug & supplement interaction

Rauvolfia Vomitoria + Ibuprofen, Pseudoephedrine

Ibuprofen, Pseudoephedrine brand name: Dristan.

Major Interaction
The bottom line Major

Ibuprofen, Pseudoephedrine falls into 2 drug categories that Rauvolfia Vomitoria can interact with; the most serious is rated major. Theoretically, concomitant use might cause additive effects.

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

Rauvolfia Vomitoria and Ibuprofen, Pseudoephedrine

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

Why Are There 2 Interactions?

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

Major

STIMULANT DRUGS

1 of 2

Why this applies to Ibuprofen, Pseudoephedrine

Ibuprofen, Pseudoephedrine falls under STIMULANT DRUGS — the group Rauvolfia Vomitoria interacts with.

Theoretically, concomitant use might cause additive effects.
Yohimbine, a constituent of Rauvolfia vomitoria, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking Rauvolfia vomitoria with stimulant drugs can have additive stimulant and hypertensive effects.
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 piece to watch with this combo: it's the pseudoephedrine part of your Dristan that matters most. Pseudoephedrine is a decongestant that mildly revs up your system, which can nudge your blood pressure and heart rate up a bit. Rauvolfia vomitoria contains yohimbine-like compounds that can do the same thing, so stacking them together could push those effects higher than either alone.

In real terms, that might mean a faster or pounding heartbeat, jitteriness, trouble sleeping, headache, or a noticeable bump in blood pressure. This concern is theoretical, based on how these compounds work rather than hard studies, so don't panic. The ibuprofen piece isn't the main issue here. Still, if you take anything with rauvolfia, please check with your pharmacist or doctor first, especially if you already have high blood pressure.

References
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9. PubMed
Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Ibuprofen, Pseudoephedrine also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, combining Rauvolfia vomitoria with antiplatelet or anticoagulant drugs might have additive effects.
Rauvolfia vomitoria contains small amounts of yohimbine. Research in healthy adults shows that taking yohimbine in doses of 8 mg or more seems to inhibit platelet aggregation in vitro by binding to the alpha-2 adrenoceptor. The effects of Rauvolfia vomitoria itself are unclear.
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 what's going on with this combo. Your Dristan product has two active pieces: ibuprofen, which on its own can mildly thin the blood and irritate the stomach, and pseudoephedrine, a decongestant that can raise blood pressure and heart rate. Rauvolfia vomitoria contains a small amount of yohimbine, which in lab studies seemed to make platelets a little less sticky. So in theory, stacking it on top of ibuprofen might add a touch to the blood-thinning effect.

Honestly, this is a weak, theory-only concern, and the real amount of yohimbine in this plant is unclear. The bigger flag for me is that rauvolfia strongly lowers blood pressure while pseudoephedrine raises it, so they fight each other. Please run this past your pharmacist before mixing them.

References
  1. Mustonen, P., Savola, J., and Lassila, R. Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine. Thromb.Res 8-1-2000;99(3):231-237.
  2. Berlin, I., Crespo-Laumonnier, B., Cournot, A., Landault, C., Aubin, F., Legrand, J. C., and Puech, A. J. The alpha 2-adrenergic receptor antagonist yohimbine inhibits epinephrine-induced platelet aggregation in healthy subjects. Clin Pharmacol.Ther. 199
  3. Braddock, L., Cowen, P. J., Elliott, J. M., Fraser, S., and Stump, K. Binding of yohimbine and imipramine to platelets in depressive illness. Psychol.Med 1986;16(4):765-773. PubMed
  4. Boon, N. A., Elliott, J. M., Grahame-Smith, D. G., John-Green, T., and Stump, K. A comparison of alpha 2-adrenoreceptor binding characteristics of intact human platelets identified by [3H]-yohimbine and [3H]- dihydroergocryptine. J Auton.Pharmacol 1983;3

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 Ibuprofen, Pseudoephedrine 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.

Everything else you take

See Every Supplement That Interacts With Ibuprofen, Pseudoephedrine

This page covers Rauvolfia Vomitoria only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibuprofen, Pseudoephedrine page lists 308 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Ephedra (major).

By severity: 11 major · 262 moderate · 35 minor.

Open the Ibuprofen, Pseudoephedrine 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 Ibuprofen, Pseudoephedrine 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 Ibuprofen, Pseudoephedrine 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
Top half

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

29 days ago today
Medication Ibuprofen, Pseudoephedrine
Steady interest

#1,759 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
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 Ibuprofen, Pseudoephedrine Together: Common Questions

Can you take Rauvolfia Vomitoria with Ibuprofen, Pseudoephedrine?
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 2 interactions listed for Rauvolfia Vomitoria and Ibuprofen, Pseudoephedrine?
Ibuprofen, Pseudoephedrine 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 Ibuprofen, Pseudoephedrine 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.