Drug & supplement interaction

Syrian Rue + Disopyramide Phosphate

Disopyramide Phosphate brand names: Norpace CR, Norpace.

Moderate Interaction
The bottom line Moderate

Disopyramide Phosphate falls into 2 drug categories that Syrian Rue can interact with; the most serious is rated moderate. Theoretically, Syrian rue might increase the levels and clinical effects of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Syrian Rue and Disopyramide Phosphate

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

Why Are There 2 Interactions?

Syrian Rue interacts with whole categories of medication. Disopyramide Phosphate falls into 2 of those categories, so it can interact with Syrian Rue 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 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Disopyramide Phosphate

Disopyramide Phosphate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Syrian Rue interacts with.

Theoretically, Syrian rue might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Syrian rue contains beta-carboline alkaloids, including harmine, harmol, and harmane. In vitro research suggests that these beta-carboline alkaloids competitively inhibit CYP3A4 enzymes.
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 disopyramide (Norpace). Your body relies on a liver enzyme called CYP3A4 to clear this medicine out. Lab studies suggest the harmala alkaloids in Syrian Rue can slow that same enzyme down. If that happens, disopyramide could build up higher than expected in your blood.

Disopyramide is an antiarrhythmic with a fairly narrow safety window, so higher levels matter. Too much can cause dry mouth, blurry vision, trouble urinating, low blood pressure, or even worsen heart rhythm problems. To be fair, this is a theoretical concern from test-tube data, not proven in people. Still, given the heart's involvement, please check with your pharmacist or doctor before combining these.

References
  1. Zhao, T., He, Y. Q., Wang, J., Ding, K. M., Wang, C. H., and Wang, Z. T. Inhibition of human cytochrome P450 enzymes 3A4 and 2D6 by β-carboline alkaloids, harmine derivatives. Phytother Res 2011;25(11):1671-1677.
Moderate

ANTICHOLINERGIC DRUGS

2 of 2

Disopyramide Phosphate also falls under ANTICHOLINERGIC DRUGS.

Theoretically, Syrian rue might decrease the effects of anticholinergic drugs.
Syrian rue contains harmine. Animal research suggests that intravenous administration of harmine potentiates the effects of acetylcholine or increases acetylcholine levels.
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 basics of what we're looking at. Disopyramide (Norpace) is a heart rhythm medication that also has strong anticholinergic activity, meaning it blocks acetylcholine. That's why it often causes dry mouth, blurry vision, constipation, and trouble urinating. Syrian Rue contains harmine, which in animal studies seemed to nudge acetylcholine levels up, the opposite direction. So in theory, the rue could blunt disopyramide's effects a little.

I want to be straight with you, though: this is purely theoretical and based on animal lab work, not on people taking these together. Since disopyramide controls a serious problem (your heart rhythm), even small shifts deserve respect. Please loop in your doctor or pharmacist before mixing these, especially given Syrian Rue's own toxicity risks.

References
  1. Slotkin, T. A. and DiStefano, V. Cardiovascular and respiratory effects of harmine. Proc Soc Exp Biol Med 1970;133(2):662-664. PubMed
  2. Javoy, F., Euvrard, C., Herbet, A., Bockaert, J., Enjalbert, A., Agid, Y., and Glowinski, J. Lack of involvement of dopaminergic and GABA neurones in the inhbitory effect of harmaline on the activity of striatal cholinergic neurones in the rat. Naunyn Sch

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

Syrian Rue Also Interacts With Other Medications

Syrian Rue has 1,121 moderate known drug interactions in our database — the Disopyramide Phosphate 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 Syrian Rue

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

Everything else you take

See Every Supplement That Interacts With Disopyramide Phosphate

This page covers Syrian Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Disopyramide Phosphate page lists 169 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 10 major · 117 moderate · 42 minor.

From our pharmacist’s overview on the Disopyramide Phosphate page

“Grapefruit is the first thing I would set aside on disopyramide phosphate (Norpace), a medicine that steadies dangerous heart rhythms, because grapefruit juice can push the drug's blood level up. That pattern dominates the page, since 121 of the 169 flagged ingredients act on the same liver enzyme, CYP3A4, raising the drug's level or,…”

Reviewed by 2 · Jul 18, 2026

Open the Disopyramide Phosphate interaction page

How much people look this up

Where Syrian Rue and Disopyramide Phosphate 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 Syrian Rue
Steady interest

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

29 days ago today
Medication Disopyramide Phosphate
Steady interest

#1,830 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 Syrian Rue

What is Syrian Rue?

  • Traditional remedy for digestive complaints
  • Used as a sedative or for mood
  • Antimicrobial and antiparasitic folk use
  • Used as a dye and incense
  • Recreational psychoactive use

Syrian Rue (Peganum harmala) is a traditional plant whose seeds contain potent compounds called harmala alkaloids, including MAO-inhibiting harmine and harmaline. There is little reliable human evidence that it safely treats any condition, and it carries real risks of toxicity, so it is not recommended for self-treatment. Talk to a pharmacist or doctor before considering it.

Read the full Syrian Rue monograph & all interactions
Medication

About Disopyramide

What Is Disopyramide Used For?

Brand names: Norpace CR, Norpace

Disopyramide — available as Disopyramide Phosphate, Norpace, and Norpace CR — is indicated for the treatment of documented ventricular arrhythmias, such as sustained ventricular tachycardia (a fast, dangerous heart rhythm), that a physician judges to be life-threatening.

Because this drug can itself cause arrhythmias, it is not recommended for minor or symptom-free arrhythmias. Treatment is started in a hospital setting so the heart can be closely monitored. Antiarrhythmic drugs like disopyramide have not been shown to improve survival in patients with ventricular arrhythmias.

See full Disopyramide drug information
Keep checking

Other Drugs & Syrian Rue

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

0Major
1,121Moderate
0Minor
1,708No known interaction
Moderate

1,121 interactions

Showing 60 of 1,121 moderate interactions — see all 1,121 on the Syrian Rue page.

No interaction 1,708 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 Syrian Rue and Disopyramide Phosphate Together: Common Questions

Can you take Syrian Rue with Disopyramide Phosphate?
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 Syrian Rue and Disopyramide Phosphate?
Disopyramide Phosphate belongs to more than one drug category, and Syrian Rue 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 Syrian Rue and Disopyramide Phosphate 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 Disopyramide Phosphate and Syrian Rue?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.