Drug & supplement interaction

Sesame + Riociguat

Riociguat brand name: Adempas.

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

Riociguat falls into 2 drug categories that Sesame can interact with; the most serious is rated moderate. Taking sesame oil with antihypertensive drugs might increase the risk of hypotension.

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

Sesame and Riociguat

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

Why Are There 2 Interactions?

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

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Riociguat

Riociguat falls under ANTIHYPERTENSIVE DRUGS — the group Sesame interacts with.

Taking sesame oil with antihypertensive drugs might increase the risk of hypotension.
Clinical research shows that replacing other cooking oil with sesame oil can lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with or without hypertension. There is also some evidence that sesame oil has additive effects in patients also taking atenolol, nifedipine, and/or hydrochlorothiazide. In patients using nifedipine, using a blend of sesame oil and rice bran oil for cooking reduces both SBP and DBP more than nifedipine alone.
Severity Moderate 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

Here's the simple version: riociguat (Adempas) works by relaxing your blood vessels to lower the high pressure in your lung arteries. One of its most common effects is lowering your overall blood pressure too, which can leave you feeling dizzy, lightheaded, or even faint. Sesame, especially as a regular cooking oil, may gently nudge blood pressure down on its own. Stacked together, the worry is that your pressure could drop a little lower than expected.

This concern is theoretical, based on how these two behave rather than direct studies with riociguat, so don't panic. A sprinkle of sesame seeds or a splash of oil in a meal is unlikely to cause trouble. If you're using concentrated sesame supplements or cooking with sesame oil daily, mention it to your pharmacist or doctor so they can keep an eye on your readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sankar, D., Sambandam, G., Ramakrishna, Rao M., and Pugalendi, K. V. Modulation of blood pressure, lipid profiles and redox status in hypertensive patients taking different edible oils. Clin Chim Acta 2005;355(1-2):97-104. PubMed
  2. Sankar, D., Rao, M. R., Sambandam, G., and Pugalendi, K. V. A pilot study of open label sesame oil in hypertensive diabetics. J Med Food 2006;9(3):408-412. PubMed
  3. Sankar, D., Rao, M. R., Sambandam, G., and Pugalendi, K. V. Effect of sesame oil on diuretics or Beta-blockers in the modulation of blood pressure, anthropometry, lipid profile, and redox status. Yale J Biol.Med. 2006;79(1):19-26.
  4. Khosravi-Boroujeni H, Nikbakht E, Natanelov E, Khalesi S. Can sesame consumption improve blood pressure? A systematic review and meta-analysis of controlled trials. J Sci Food Agric. 2017;97(10):3087-3094. PubMed
  5. Devarajan S, Singh R, Chatterjee B, Zhang B, Ali A. A blend of sesame oil and rice bran oil lowers blood pressure and improves the lipid profile in mild-to-moderate hypertensive patients. J Clin Lipidol. 2016;10(2):339-49. PubMed
  6. Atefi M, Entezari MH, Vahedi H, Hassanzadeh A. The effects of sesame oil on metabolic biomarkers: a systematic review and meta-analysis of clinical trials. J Diabetes Metab Disord 2022;21(1):1065-1080. PubMed
  7. Huang H, Zhou G, Pu R, Cui Y, Liao D. Clinical evidence of dietary supplementation with sesame on cardiovascular risk factors: An updated meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2022;62(20):5592-5602. PubMed
Minor

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Riociguat also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, sesame might alter the transport of P-glycoprotein substrates.
In vitro research suggests that sesamin, a constituent of sesame, can inhibit the multi-drug transporter protein, P-glycoprotein. However, this interaction has not been reported in humans.
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 simple version: your body uses a sort of cellular bouncer called P-glycoprotein to help move certain drugs, including riociguat (Adempas), out of cells and tissues. A natural compound in sesame, called sesamin, has been shown in lab dishes to slow that bouncer down. If that happened in people, slightly more riociguat could stick around, which in theory might nudge up its blood-pressure-lowering effects, like dizziness, lightheadedness, headache, or feeling faint when you stand up.

The honest truth, though, is this comes only from test-tube research and has never been seen in real patients. Everyday sesame on your food is very unlikely to matter. Still, since riociguat affects blood pressure, it's worth a quick word with your pharmacist or doctor before using concentrated sesame supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Okura, T., Ibe, M., Umegaki, K., Shinozuka, K., and Yamada, S. Effects of dietary ingredients on function and expression of P-glycoprotein in human intestinal epithelial cells. Biol Pharm Bull 2010;33(2):255-259. PubMed
  2. Nabekura, T., Yamaki, T., Ueno, K., and Kitagawa, S. Inhibition of P-glycoprotein and multidrug resistance protein 1 by dietary phytochemicals. Cancer Chemother Pharmacol 2008;62(5):867-873. 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

Sesame Also Interacts With Other Medications

Sesame has 342 moderate, 185 minor known drug interactions in our database — the Riociguat one above is among them. If you take anything else, check it against the full list below.

Moderate 342 Minor 185 No known interaction 2,303 (incl. Riociguat)
Taking anything else?

Check Another of Your Medications Against Sesame

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

Everything else you take

See Every Supplement That Interacts With Riociguat

This page covers Sesame only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Riociguat page lists 230 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), Grapefruit (major) and St. John's Wort (major).

By severity: 6 major · 187 moderate · 37 minor.

From our pharmacist’s overview on the Riociguat page

“Riociguat (Adempas) works by relaxing the blood vessels in your lungs, which also lowers blood pressure, so I read this list of 230 supplements and herbs with real concern, and the six rated major are what to understand first. Grapefruit can push riociguat levels up and intensify its effect, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Riociguat interaction page

One more smart check

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

We hold 434 real supplement products containing Sesame, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sesame. Your product may carry other ingredients that interact with Riociguat too, on top of Sesame — 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 Sesame and Riociguat 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 Sesame
Top half

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

29 days ago today
Medication Riociguat
Steady interest

#1,675 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 Sesame

What is Sesame?

  • Heart and cholesterol health
  • Blood pressure support
  • Source of healthy fats and minerals
  • Skin and hair care (topical oil)
  • Antioxidant support
  • Cooking and nutrition

Sesame is a nutritious seed and oil widely used in cooking and traditional medicine, and it provides healthy fats, fiber, and antioxidant compounds called lignans. Some early research suggests sesame may modestly help with cholesterol and blood pressure, but the evidence is limited. Sesame is also a common, sometimes serious, food allergen, so people with seed allergies should be careful.

Read the full Sesame monograph & all interactions
Medication

About Riociguat

What Is Riociguat Used For?

Brand name: Adempas

Riociguat tablets — sold as Adempas and under the generic name Riociguat — are used to treat adults with two types of pulmonary hypertension (high blood pressure in the lungs).

The first is chronic thromboembolic pulmonary hypertension (CTEPH), a condition caused by blood clots in the lung arteries, either after surgery or when surgery is not an option. The second is pulmonary arterial hypertension (PAH), where the arteries carrying blood to the lungs are narrowed or blocked. In both conditions, riociguat helps improve exercise ability and functional status, and in PAH it also helps slow the disease from getting worse.

See full Riociguat drug information
Keep checking

Other Drugs & Sesame

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

0Major
342Moderate
185Minor
2,302No known interaction
342 Moderate 185 Minor 2,302 No interaction
Moderate

342 interactions

Showing 60 of 342 moderate interactions — see all 342 on the Sesame page.

Minor

185 interactions

Showing 60 of 185 minor interactions — see all 185 on the Sesame page.

No interaction 2,302 drugs checked — show the list

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

Showing the 60 most looked-up of 2,302 medications checked with no known interaction — see the full Sesame list.

See the full Sesame interactions page
See every supplement checked against Riociguat, 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
Sesame monograph › Uses, safety, and every drug interaction in one place Riociguat supplement interactions › Every supplement checked against Riociguat, ranked by severity Riociguat 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 Sesame and Riociguat Together: Common Questions

Can you take Sesame with Riociguat?
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 Sesame and Riociguat?
Riociguat belongs to more than one drug category, and Sesame 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 Sesame and Riociguat 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 Riociguat and Sesame?

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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.