Drug & supplement interaction

Rauvolfia Vomitoria + Inotersen

Inotersen brand name: Tegsedi.

Minor Interaction
The bottom line Minor

Rauvolfia Vomitoria has a minor interaction with Inotersen. Theoretically, combining Rauvolfia vomitoria with antiplatelet or anticoagulant drugs might have additive effects.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Rauvolfia Vomitoria and Inotersen

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

Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Inotersen

Inotersen falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Rauvolfia Vomitoria interacts with.

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 the short version: this is a very theoretical, low-level concern. Inotersen (Tegsedi) is an injectable medicine used for a rare condition called hereditary transthyretin amyloidosis. One of its known side effects is a drop in platelets (the cells that help your blood clot), which can raise bleeding risk on its own.

Rauvolfia vomitoria contains a small amount of yohimbine, and in lab studies high doses of yohimbine slowed platelet clumping. So in theory, layering it on top of Inotersen could nudge your bleeding risk a bit higher. But this is based on pharmacology and test-tube data, not real patient cases, and the effect of the plant itself is unclear. Still, because Inotersen already affects platelets, I'd run any use of this supplement past your doctor or pharmacist first, and report easy bruising or unusual bleeding.

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 230 major, 523 moderate, 86 minor known drug interactions in our database — the Inotersen one above is one of 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 Inotersen

This page covers Rauvolfia Vomitoria only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Inotersen page lists 208 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Danshen (major), Piracetam (major), Siberian Cocklebur (major) and Aconite (moderate).

By severity: 4 major · 186 moderate · 18 minor.

From our pharmacist’s overview on the Inotersen page

“Danshen is the entry I would flag first for anyone taking inotersen (Tegsedi). Inotersen can drive platelet counts dangerously low, and 202 of the 208 supplements on this page add some blood-thinning or antiplatelet effect on top of that.”

Reviewed by 2 · Jul 18, 2026

Open the Inotersen 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 Inotersen 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 Inotersen 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

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

29 days ago today
Medication Inotersen
Steady interest

#2,568 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.

230Major
523Moderate
86Minor
1,990No known interaction
Major

230 interactions

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

Moderate

523 interactions

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

Minor

86 interactions

Showing 60 of 86 minor interactions — see all 86 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

Keep exploring
Pharmacist Counseling Corner

Taking Rauvolfia Vomitoria and Inotersen Together: Common Questions

Can you take Rauvolfia Vomitoria with Inotersen?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Rauvolfia Vomitoria and Inotersen interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Inotersen and Rauvolfia Vomitoria?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.