Drug & supplement interaction

Strawberry + Riociguat

Riociguat brand name: Adempas.

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

Strawberry has a moderate interaction with Riociguat. In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.

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

Strawberry and Riociguat

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

Why this applies to Riociguat

Riociguat falls under P-GLYCOPROTEIN SUBSTRATES — the group Strawberry interacts with.

In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
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 for riociguat (Adempas). This medicine is moved around your body partly by a transporter called P-glycoprotein, which helps pump it out of cells. In a lab dish, strawberry extract slowed that pump down. If the pump works less well, a bit more riociguat could stay in your system, which in theory might nudge its effects up. With riociguat that mainly means lower blood pressure, so you could feel more lightheaded, dizzy, headachy, or notice an upset stomach.

Now the reassuring part: this is only test-tube evidence, not something seen in real patients, and everyday strawberries on your cereal are very unlikely to matter. Concentrated strawberry supplements are the bigger question mark. Riociguat is a sensitive blood pressure medicine, so before adding any strawberry supplement, run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Van Gelder, J., Deferme, S., Naesens, L., De Clercq, E., van den, Mooter G., Kinget, R., and Augustijns, P. Intestinal absorption enhancement of the ester prodrug tenofovir disoproxil fumarate through modulation of the biochemical barrier by defined este
  2. Deferme, S., Van Gelder, J., and Augustijns, P. Inhibitory effect of fruit extracts on P-glycoprotein-related efflux carriers: an in-vitro screening. J Pharm Pharmacol 2002;54(9):1213-1219.

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

Strawberry Also Interacts With Other Medications

Strawberry has 315 moderate known drug interactions in our database — the Riociguat one above is one of them. If you take anything else, check it against the full list below.

Moderate 315 No known interaction 2,515 (incl. Riociguat)
Taking anything else?

Check Another of Your Medications Against Strawberry

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

Everything else you take

See Every Supplement That Interacts With Riociguat

This page covers Strawberry 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 Strawberry as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,806 real supplement products containing Strawberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Strawberry. Your product may carry other ingredients that interact with Riociguat too, on top of Strawberry — 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 Strawberry 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 Strawberry
Top 10%

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

29 days ago today
Medication Riociguat
Steady interest

#1,638 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 Strawberry

What is Strawberry?

  • General antioxidant support
  • Heart and blood vessel health
  • Blood sugar support
  • Skin and oral health
  • Source of vitamin C and fiber

Strawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but concentrated supplement forms have only limited research behind specific health claims. If you have allergies or take it as a supplement, check with your pharmacist or doctor.

Read the full Strawberry 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 & Strawberry

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

0Major
315Moderate
0Minor
2,514No known interaction
315 Moderate 2,514 No interaction
Moderate

315 interactions

Showing 60 of 315 moderate interactions — see all 315 on the Strawberry page.

No interaction 2,514 drugs checked — show the list

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

Showing the 60 most looked-up of 2,514 medications checked with no known interaction — see the full Strawberry list.

See the full Strawberry 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
Strawberry 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 Strawberry and Riociguat Together: Common Questions

Can you take Strawberry 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.
How serious is the Strawberry 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 Strawberry?

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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.