Drug & supplement interaction

Sulforaphane + Macitentan

Macitentan brand name: Opsumit.

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

Sulforaphane has a moderate interaction with Macitentan. Theoretically, sulforaphane might increase the levels and effects of CYP3A4 substrates.

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

Sulforaphane and Macitentan

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Macitentan

Macitentan falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Sulforaphane interacts with.

Theoretically, sulforaphane might increase the levels and effects of CYP3A4 substrates.
Animal and in vitro research shows that sulforaphane inhibits CYP3A4 enzyme activity and downregulates its expression. This interaction has not been reported in humans.
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 relies on a liver enzyme called CYP3A4 to break down macitentan. In lab and animal studies, sulforaphane appears to slow that same enzyme down. If that held true in people, macitentan could clear a little more slowly and build up, which might mean stronger effects and more side effects like headache, low blood pressure, swelling, stuffy nose, or anemia.

The important part: this has only been seen in test tubes and animals, never confirmed in humans, so it's theoretical. Eating broccoli at meals is very unlikely to matter. A concentrated sulforaphane supplement is a different story, so check with your pharmacist or doctor before adding one. Please don't change your macitentan on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fimognari C, Lenzi M, Hrelia P. Interaction of the isothiocyanate sulforaphane with drug disposition and metabolism: pharmacological and toxicological implications. Curr Drug Metab. 2008;9(7):668-78. PubMed
  2. Mahéo K, Morel F, Langouët S, et al. Inhibition of cytochromes P-450 and induction of glutathione S-transferases by sulforaphane in primary human and rat hepatocytes. Cancer Res. 1997;57(17):3649-52.
  3. Yoxall V, Kentish P, Coldham N, Kuhnert N, Sauer MJ, Ioannides C. Modulation of hepatic cytochromes P450 and phase II enzymes by dietary doses of sulforaphane in rats: Implications for its chemopreventive activity. Int J Cancer. 2005;117(3):356-62. 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

Sulforaphane Also Interacts With Other Medications

Sulforaphane has 721 moderate known drug interactions in our database — the Macitentan one above is one of them. If you take anything else, check it against the full list below.

Moderate 721 No known interaction 2,109 (incl. Macitentan)
Taking anything else?

Check Another of Your Medications Against Sulforaphane

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

Everything else you take

See Every Supplement That Interacts With Macitentan

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

We hold 167 real supplement products containing Sulforaphane, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sulforaphane. Your product may carry other ingredients that interact with Macitentan too, on top of Sulforaphane — 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 Sulforaphane 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 Sulforaphane
Top 25%

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

29 days ago today
Medication Macitentan
Top 5%

#86 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 Sulforaphane

What is Sulforaphane?

  • Antioxidant support
  • General cellular health
  • Detoxification support
  • Inflammation
  • Skin and aging concerns

Sulforaphane is a natural compound found in broccoli and other cruciferous vegetables that has shown promising antioxidant and anti-inflammatory effects in lab studies, but strong human evidence for most specific health claims is still limited. It is generally well tolerated as part of a vegetable-rich diet, but if you take a concentrated supplement, talk to your pharmacist or doctor first.

Read the full Sulforaphane 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 & Sulforaphane

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

0Major
721Moderate
0Minor
2,108No known interaction
721 Moderate 2,108 No interaction
Moderate

721 interactions

Showing 60 of 721 moderate interactions — see all 721 on the Sulforaphane page.

No interaction 2,108 drugs checked — show the list

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

Showing the 60 most looked-up of 2,108 medications checked with no known interaction — see the full Sulforaphane list.

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

Can you take Sulforaphane with Macitentan?
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 Sulforaphane and Macitentan 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 Macitentan and Sulforaphane?

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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.