Drug & supplement interaction

Rauvolfia Vomitoria + Oxymetazoline Hydrochloride

Oxymetazoline Hydrochloride brand names: Afrin, Rhofade, Upneeq.

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

Rauvolfia Vomitoria has a major interaction with Oxymetazoline Hydrochloride. Theoretically, concomitant use might cause additive effects.

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

Rauvolfia Vomitoria and Oxymetazoline Hydrochloride

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

Major

STIMULANT DRUGS

Why this applies to Oxymetazoline Hydrochloride

Oxymetazoline Hydrochloride 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

Oxymetazoline is a vasoconstrictor, meaning it narrows blood vessels. When you use it for rosacea (Rhofade) or in a nasal spray (Afrin), most of it works right where you put it, but some can still get into your bloodstream. Rauvolfia vomitoria contains stimulant-type compounds like yohimbine that can raise blood pressure on their own. In theory, combining the two could add up, nudging your blood pressure higher or causing a faster, pounding heartbeat, jitteriness, or headache.

I'll be honest: this concern is based on pharmacology and theory, not solid studies, and a dab of skin cream is far less likely to matter than a strong oral dose of the herb. Still, since Rauvolfia is potent and unpredictable, please check with your pharmacist or doctor before using them together, especially if you have heart or blood pressure issues.

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

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 Oxymetazoline Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Major 229 Moderate 523 Minor 87 No known interaction 1,991 (incl. Oxymetazoline Hydrochloride)
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 Oxymetazoline Hydrochloride

This page covers Rauvolfia Vomitoria only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Oxymetazoline Hydrochloride page lists 48 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Ephedra (major), Peyote (major), Sida Cordifolia (major), 1,3-dmaa (moderate) and 1,3-dmba (moderate).

By severity: 4 major · 39 moderate · 5 minor.

Open the Oxymetazoline Hydrochloride 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 Oxymetazoline Hydrochloride 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 Oxymetazoline Hydrochloride 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

#1,013 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Oxymetazoline Hydrochloride
Top half

#1,291 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 Oxymetazoline Topical

What Is Oxymetazoline Topical Used For?

Brand names: Afrin, Rhofade, Upneeq

Rhofade (oxymetazoline hydrochloride cream, 1%) is approved to treat persistent facial erythema (redness) associated with rosacea in adults. It is applied directly to the face once daily.

Other oxymetazoline topical products — including Afrin spray and Medix Nasal Decongestant Oxymetazoline Hydrochloride and Tukol Max Action solutions — are available for nasal use. Uses for those products are not covered in the current prescribing information provided here.

See full Oxymetazoline Topical 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
229 Major 523 Moderate 87 Minor 1,990 No 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

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 Oxymetazoline Hydrochloride, 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 Oxymetazoline Hydrochloride supplement interactions › Every supplement checked against Oxymetazoline Hydrochloride, ranked by severity Oxymetazoline Topical 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 Oxymetazoline Hydrochloride Together: Common Questions

Can you take Rauvolfia Vomitoria with Oxymetazoline Hydrochloride?
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.
How serious is the Rauvolfia Vomitoria and Oxymetazoline Hydrochloride 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

Still Have a Question About Oxymetazoline Hydrochloride 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.