Drug & supplement interaction

Rauwolscine + Macitentan

Macitentan brand name: Opsumit.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Rauwolscine and Macitentan in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Rauwolscine and Macitentan

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Macitentan and Rauwolscine in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Rauwolscine safety at a glance

Rauwolscine overall Use caution It is a potent stimulant with limited human safety data and can affect heart rate and blood pressure.

Pregnancy Avoid Not enough safety data; avoid during pregnancy.

Breastfeeding Avoid Not enough safety data; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Macitentan and Rauwolscine? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Macitentan

Interactions in our licensed database are recorded against drug classes, not just single drug names. Macitentan is filed under 4 classifications — including antihypertensive drugs, hepatotoxic drugs, cytochrome p450 3a4 (cyp3a4) substrates. Rauwolscine has documented interactions with 6 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), calcium channel blockers (moderate) and clonidine (catapres) (moderate) — and none of Macitentan’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Rauwolscine Does Interact With Other Medications

Rauwolscine has 677 moderate known drug interactions in our database — Macitentan isn’t one of them. If you take anything else, check it against the full list below.

Moderate 677 No known interaction 2,153 (incl. Macitentan)

Taking anything else?

Check Another of Your Medications Against Rauwolscine

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

What to actually watch for

No Interaction Found — But Data Suggests Rauwolscine and Macitentan May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

An allergic reaction Worth acting on Additional detail
Rauwolscine
“Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. There is one report of a hypersensitivity reaction including fever, chills, malaise, itchy and scaly skin, progressive renal failure, and lupus-like syndrome associated with ingestion of a one-day dose of yohimbine.”

Rauwolscine · Natural Medicines adverse-effect record, reported in kidney failure.
1 source cited

6169. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed
Macitentan

Listed in the ADVERSE REACTIONS section of the FDA label for Macitentan. Read the label on DailyMed ›
Flushing / Headache Additional detail
Rauwolscine
“Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. Orally, yohimbine has been associated with reports of tremulousness, head twitching, seizures, loss of consciousness, enhanced brain norepinephrine release, decreased energy, dizziness, vertigo, headache, feeling cold, flushing, diaphoresis, and paralysis (11,18,3312,3971,17465,86786,86801,86804,8682…”

Rauwolscine · Natural Medicines adverse-effect record, reported in cluster headache.
6 sources cited

11. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

3312. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed

3971. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.

17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed

86786. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407. PubMed
Macitentan

Listed in the ADVERSE REACTIONS section of the FDA label for Macitentan. Read the label on DailyMed ›

Reported for Rauwolscine but not commonly for Macitentan: stomach upset, fainting, kidney problems and wheezing.

Effects for Macitentan come from the ADVERSE REACTIONS section of its FDA label; effects for Rauwolscine come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Macitentan

This page covers Rauwolscine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Macitentan page lists 253 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), Beer (major) and Grapefruit (major).

By severity: 9 major · 205 moderate · 39 minor.

From our pharmacist’s overview on the Macitentan page

“If you take macitentan (Opsumit) for pulmonary arterial hypertension, study this page rather than skim it. It lists 253 supplement and herbal ingredients, nine rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Macitentan interaction page

One more smart check

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

We hold 196 real supplement products containing Rauwolscine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauwolscine. Even though Rauwolscine itself has no known interaction with Macitentan, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Rauwolscine and Macitentan 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 Rauwolscine

Top 25%

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

29 days ago today

Medication Macitentan

Top 5%

#105 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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Rauwolscine reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Rauwolscine and Macitentan records this page draws on were last updated July 10, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Rauwolscine

What is Rauwolscine?

Fat loss and weight management
Bodybuilding and physique support
Energy and stimulant effects
Athletic performance
Libido support

Rauwolscine (alpha-yohimbine) is a stimulant alkaloid closely related to yohimbine that is marketed mainly in fat-burning and pre-workout supplements. Human evidence for its benefits is very limited, and it can raise heart rate and blood pressure and cause anxiety, so it should be used with caution and is not recommended for people with heart conditions, anxiety, or during pregnancy or breastfeeding.

Bark and roots (alkaloid extracted from plants such as Rauvolfia and Pausinystalia) · Capsules, tablets, powders (often in fat-burner and pre-workout blends)

An interaction check asks whether these two react with each other — it does not ask whether Rauwolscine is a good idea for someone in your situation. Here is what our Rauwolscine record says about it on its own.

Rauwolscine: dosing

There is no well-established or standardized dose for rauwolscine, and it has not been studied the way medicines are. Supplement products vary widely in how much they contain, and it is often combined with other stimulants.If you choose to use a product that contains it, follow the directions on the label, do not exceed the recommended amount, and consider starting with the lowest amount to see how you react.

From our Rauwolscine monograph — the full record covers uses, side effects and every documented interaction.

Read the full Rauwolscine monograph & all interactions

Medication

About Macitentan

What Is Macitentan Used For?

Brand name: Opsumit

Macitentan tablets — sold under the brand name Opsumit — are used to treat pulmonary arterial hypertension (PAH, WHO Group I), a serious condition where the blood pressure in the arteries supplying the lungs is abnormally high. The goal is to slow down how quickly the disease gets worse and to lower the chances of being hospitalized because of it.

In clinical studies, it was shown to be effective in adults with mostly moderate-to-severe PAH symptoms. Patients in those studies had PAH caused by unknown or inherited reasons, connective tissue disorders, or congenital heart disease with repaired heart shunts.

See full Macitentan drug information

Keep checking

Other Drugs & Rauwolscine

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

0Major

677Moderate

0Minor

2,152No known interaction

677 Moderate 2,152 No interaction

Moderate

677 interactions

Showing 60 of 677 moderate interactions — see all 677 on the Rauwolscine page.

No interaction 2,152 drugs checked — show the list

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

Showing the 60 most looked-up of 2,152 medications checked with no known interaction — see the full Rauwolscine list.

See the full Rauwolscine interactions page

See every supplement checked against Macitentan, ranked by severity

Evidence & sources

Rauwolscine References

The 28 references that drive our Rauwolscine monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed
Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
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
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.
Bagheri, H., Schmitt, L., Berlan, M., and Montastruc, J. L. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol 1992;34(6):555-558. PubMed
Swann, A. C., Birnbaum, D., Jagar, A. A., Dougherty, D. M., and Moeller, F. G. Acute yohimbine increases laboratory-measured impulsivity in normal subjects. Biol.Psychiatry 5-15-2005;57(10):1209-1211. PubMed
Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407. PubMed
Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829. PubMed
Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
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
Swann, A. C. Mechanisms of impulsivity in bipolar disorder and related illness. Epidemiol.Psichiatr.Soc. 2010;19(2):120-130.
Landis, E. and Shore, E. Yohimbine-induced bronchospasm. Chest 1989;96(6):1424. PubMed
Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363. PubMed
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
Charney, D. S., Heninger, G. R., and Sternberg, D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci 6-7-1982;30(23):2033-2041.
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
Riley AJ, Goodman R, Kellett JM, and et al. Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual Marital Ther 1989;4(1):17-26. DOI
Wylie KR. Yohimbine and sinusitis. Br J Psychiatry. 1996;169(3):384-5. PubMed
Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.
Godfraind T, Miller RC, Socrates Lima J. Effects of yohimbine, rauwolscine and corynanthine on contractions and calcium fluxes induced by depolarization and prostaglandin F2 alpha in rat aorta. Br J Pharmacol. 1983;80(1):115-21.
Shepperson NB, Duval N, Massingham R, Langer SZ. Pre- and postsynaptic alpha adrenoceptor selectivity studies with yohimbine and its two diastereoisomers rauwolscine and corynanthine in the anesthetized dog. J Pharmacol Exp Ther. 1981;219(2):540-6. DOI
Szabo B, Hedler L, Starke K. Peripheral presynaptic and central effects of clonidine, yohimbine and rauwolscine on the sympathetic nervous system in rabbits. Naunyn Schmiedebergs Arch Pharmacol. 1989;340(6):648-57. PubMed
Doxey JC, Lane AC, Roach AG, Virdee NK. Comparison of the alpha-adrenoceptor antagonist profiles of idazoxan (RX 781094), yohimbine, rauwolscine and corynanthine. Naunyn Schmiedebergs Arch Pharmacol. 1984;325(2):136-44.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Related: nutrient depletion

Macitentan Is Linked to Lower Levels of One Nutrient

Natural Medicines records Macitentan as a medicine that can lower these. This is not an interaction with Rauwolscine — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:

COENZYME Q10›

Read the full Macitentan nutrient depletion report ›

Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.

Pharmacist Counseling Corner

Taking Rauwolscine and Macitentan Together: Common Questions

Is it safe to take Rauwolscine with Macitentan?

We do not list a known interaction between Rauwolscine and Macitentan. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Do Rauwolscine and Macitentan have any of the same side effects?

Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.

How was the Rauwolscine and Macitentan combination checked?

Interactions in our licensed database are recorded against drug classes. Macitentan is filed under 4 classifications, and Rauwolscine has documented interactions with 6 drug classes — none of Macitentan's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.

Does Rauwolscine interact with any other medications?

Yes. Rauwolscine has 677 documented drug interactions in our database — Macitentan is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Does Macitentan interact with any supplements?

Yes. Macitentan has documented interactions with 253 supplements in our database — Rauwolscine is not one of them. The Macitentan interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Rauwolscine monograph Uses, safety profile, and every drug interaction in one place Macitentan drug information The full plain-English guide to this medication Macitentan supplement interactions Every supplement checked against Macitentan, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 28 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Macitentan and Rauwolscine?

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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.