Drug & supplement interaction

Rooibos + Cilostazol

Cilostazol brand name: Pletal.

Moderate Interaction
The bottom line Moderate

Cilostazol falls into 2 drug categories that Rooibos can interact with; the most serious is rated moderate. Theoretically, taking rooibos with CYP2C19 substrates may increase the effects of CYP2C19 substrates.

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

Rooibos and Cilostazol

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 2

Why this applies to Cilostazol

Cilostazol falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Rooibos interacts with.

Theoretically, taking rooibos with CYP2C19 substrates may increase the effects of CYP2C19 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems strongly inhibits CYP2C19 enzyme activity.
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 short version: your body uses a liver enzyme called CYP2C19 to help clear cilostazol. Lab studies hint that rooibos may slow that enzyme down. If that happens in real life, cilostazol could build up a bit more than usual, which might mean stronger effects and a higher chance of side effects like headache, dizziness, a racing or pounding heartbeat, diarrhea, or easier bruising.

Now the reassuring part: this concern comes only from test-tube research using concentrated rooibos extract, not from people. A normal cup or two of rooibos tea is very unlikely to cause trouble. If you drink it daily or use concentrated extracts, just mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cilostazol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, taking rooibos with CYP3A4 substrates may increase the effects of CYP3A4 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems strongly inhibits CYP3A4 enzyme activity.
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: your body relies on a liver enzyme called CYP3A4 to break down cilostazol (Pletal). Lab studies hint that concentrated rooibos extract may slow that enzyme down. If it does, cilostazol could clear more slowly and build up a bit in your system, which might mean stronger effects and a higher chance of side effects like headache, dizziness, a racing or pounding heartbeat, loose stools, or easier bruising.

I want to be straight with you though: this is based only on test-tube research, not real people, so it's mostly theoretical. A cup or two of rooibos tea is very unlikely to cause a problem. Concentrated extracts are the bigger question mark, so check with your pharmacist or doctor before using those.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.

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

Rooibos Also Interacts With Other Medications

Rooibos has 878 moderate known drug interactions in our database — the Cilostazol 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 Rooibos

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

From our Q&A

Questions About Rooibos or Cilostazol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rooibos or Cilostazol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Cilostazol

This page covers Rooibos only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cilostazol page lists 286 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 41 minor.

Open the Cilostazol interaction page

One more smart check

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

We hold 142 real supplement products containing Rooibos, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rooibos. Your product may carry other ingredients that interact with Cilostazol too, on top of Rooibos — 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 Rooibos and Cilostazol 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 Rooibos
Top half

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

29 days ago today
Medication Cilostazol
Steady interest

#1,565 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 Rooibos

What is Rooibos?

Rooibos
  • Caffeine-free beverage
  • Antioxidant support
  • Heart health
  • Blood sugar support
  • Digestive upset
  • General wellness

Rooibos is a caffeine-free herbal tea from South Africa that is rich in antioxidants and generally considered safe as a beverage. While lab and early studies suggest possible benefits for heart health, blood sugar, and inflammation, strong human evidence is lacking for most medical uses. Enjoy it as a tea, but talk to your pharmacist or doctor before using concentrated extracts for health reasons.

Read the full Rooibos monograph & all interactions
Medication

About Cilostazol

What Is Cilostazol Used For?

Brand name: Pletal

Cilostazol tablets are approved to reduce the symptoms of intermittent claudication (cramping leg pain that comes on during walking due to reduced blood flow in the arteries). The goal is to help you walk farther before pain forces you to stop.

See full Cilostazol drug information
Keep checking

Other Drugs & Rooibos

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

0Major
878Moderate
0Minor
1,951No known interaction
Moderate

878 interactions

Showing 60 of 878 moderate interactions — see all 878 on the Rooibos page.

No interaction 1,951 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 Rooibos and Cilostazol Together: Common Questions

Can you take Rooibos with Cilostazol?
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.
Why are there 2 interactions listed for Rooibos and Cilostazol?
Cilostazol belongs to more than one drug category, and Rooibos 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 Rooibos and Cilostazol 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 Cilostazol and Rooibos?

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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.