Sage + Olodaterol Hydrochloride, Tiotropium Bromide
Olodaterol Hydrochloride, Tiotropium Bromide brand name: Stiolto Respimat.
Olodaterol Hydrochloride, Tiotropium Bromide falls into 3 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, sage might increase levels of drugs transported by P-glycoprotein.
Read the full interaction reportSage and Olodaterol Hydrochloride, Tiotropium Bromide
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Sage interacts with whole categories of medication. Olodaterol Hydrochloride, Tiotropium Bromide falls into 3 of those categories, so it can interact with Sage in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
P-GLYCOPROTEIN SUBSTRATES
1 of 3Why this applies to Olodaterol Hydrochloride, Tiotropium Bromide
Olodaterol Hydrochloride, Tiotropium Bromide falls under P-GLYCOPROTEIN SUBSTRATES — the group Sage interacts with.
In vitro research suggests that common sage (Salvia officinalis) can inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.
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.
Here's the gist with Stiolto Respimat (olodaterol and tiotropium). One of its ingredients, tiotropium, is moved around the body by a transporter called P-glycoprotein. In lab dish studies, sage seemed to slow that transporter down. If that happened in real life, a bit more tiotropium could stay in your system, which might mean more of its usual side effects like dry mouth, constipation, blurry vision, or trouble urinating.
But I want to keep this in perspective. This is only a theoretical concern from test-tube research, and it hasn't been seen in people. Sprinkling sage on dinner is very unlikely to matter. Concentrated sage extracts or oils are a bigger question mark, so check with your pharmacist or doctor before using them.
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Olodaterol Hydrochloride, Tiotropium Bromide also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.
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.
Here's the gist with your Stiolto Respimat inhaler (which contains olodaterol and tiotropium): one of those ingredients, olodaterol, is partly broken down by a liver enzyme called CYP3A4. Lab tests suggest sage may slow that enzyme down a bit. In theory, that could let a little more olodaterol linger in your body, which might nudge up the typical side effects of that drug class, things like a faster or pounding heartbeat, jitteriness, tremor, or a headache.
I want to keep this in perspective. This is only test-tube evidence and hasn't actually been seen in real people. Cooking with sage is very unlikely to cause any trouble. Concentrated sage extracts or the essential oil are where I'd be more cautious. If you're considering a sage supplement, just run it by your pharmacist or doctor first.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
ANTICHOLINERGIC DRUGS
3 of 3Olodaterol Hydrochloride, Tiotropium Bromide also falls under ANTICHOLINERGIC DRUGS.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.
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.
Let me walk you through this one. Stiolto Respimat is an inhaler that pairs olodaterol with tiotropium. The tiotropium part is the piece we care about here. It's an anticholinergic, meaning it works by blocking the chemical messenger acetylcholine in your airways, which helps relax and open them up so you can breathe easier.
The theory is that sage may nudge acetylcholine levels up by slowing the enzyme that breaks it down. In plain terms, sage could work in the opposite direction of your inhaler and slightly blunt how well it opens your airways. That said, this is only lab-dish evidence, not seen in real patients, and normal cooking amounts of sage almost certainly won't matter. Concentrated sage extracts or oils are where I'd be more cautious. If you use those regularly, mention it to your pharmacist or doctor.
- Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
- Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
- Savelev, S. U., Okello, E. J., and Perry, E. K. Butyryl- and acetyl-cholinesterase inhibitory activities in essential oils of Salvia species and their constituents. Phytother Res 2004;18(4):315-324.
- Kennedy, D. O., Pace, S., Haskell, C., Okello, E. J., Milne, A., and Scholey, A. B. Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology 2006;31(4):84 PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Sage Also Interacts With Other Medications
Sage has 1,295 moderate known drug interactions in our database — the Olodaterol Hydrochloride, Tiotropium Bromide one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Sage
We haven’t checked that one against Sage yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Sage. Pick one to open its full report.
See Every Supplement That Interacts With Olodaterol Hydrochloride, Tiotropium Bromide
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Olodaterol Hydrochloride, Tiotropium Bromide page lists 171 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: American Hellebore (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).
By severity: 9 major · 133 moderate · 29 minor.
Open the Olodaterol Hydrochloride, Tiotropium Bromide interaction page
Taking Sage as Part of a Dietary Supplement Product? Check It for Interactions
We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Your product may carry other ingredients that interact with Olodaterol Hydrochloride, Tiotropium Bromide too, on top of Sage — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Sage and Olodaterol Hydrochloride, Tiotropium Bromide 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.
#243 of 1,452 supplements looked up here in the last 7 days
#2,031 of 2,830 medications looked up here in the last 7 days
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.
About Sage
What is Sage?
- Sore throat and mouth irritation
- Digestive upset
- Excessive sweating
- Memory and thinking
- Menopause symptoms (hot flashes)
- General antioxidant support
Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.
Other Drugs & Sage
Browse every other medication we’ve checked against Sage — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,295 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Glycopyrrolate ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
Showing 60 of 1,295 moderate interactions — see all 1,295 on the Sage page.
No interaction 1,534 drugs checked — show the list
We also checked Sage against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Amoxicillin ›
- Bupropion ›
- Methotrexate ›
- Bendamustine ›
- Acyclovir ›
- Isotretinoin ›
- Azithromycin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Amoxicillin, Clavulanate Potassium ›
- Ezetimibe ›
- Levothyroxine Sodium ›
- Pegunigalsidase Alfa-iwxj ›
- Dexmethylphenidate ›
- Daptomycin ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Mitomycin ›
- Hexobarbitone ›
- Acetylsalicylic Acid ›
- Levodopa ›
- Factor 7a ›
- Hethylphenidate Hcl ›
- Bentoquatam ›
- Cefaclor ›
- Azelaic Acid ›
- Lenvatinib ›
- Pizotifen ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Ribavirin Aerosol ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Flutemetamol F-18 ›
- Vancomycin ›
- Tenecteplase ›
- Triptorelin ›
- Dirithromycin ›
- Ropinirole ›
- Rocuronium ›
- Tocainide ›
- Magnesium Hydroxide (otc Drug) ›
- Dextrothyroxine ›
- Ferric Derisomaltose ›
- Mitomycin C ›
- Gestodene ›
- Birth Control Pills ›
Showing the 60 most looked-up of 1,534 medications checked with no known interaction — see the full Sage list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Taking Sage and Olodaterol Hydrochloride, Tiotropium Bromide Together: Common Questions
Can you take Sage with Olodaterol Hydrochloride, Tiotropium Bromide?
Why are there 3 interactions listed for Sage and Olodaterol Hydrochloride, Tiotropium Bromide?
How serious is the Sage and Olodaterol Hydrochloride, Tiotropium Bromide interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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