Terminalia + Aspirin, Omeprazole
Aspirin, Omeprazole brand name: Yosprala.
Aspirin, Omeprazole falls into 4 drug categories that Terminalia can interact with; the most serious is rated moderate. Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
Read the full interaction reportTerminalia and Aspirin, Omeprazole
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Terminalia interacts with whole categories of medication. Aspirin, Omeprazole falls into 4 of those categories, so it can interact with Terminalia in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
1 of 4Why this applies to Aspirin, Omeprazole
Aspirin, Omeprazole falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Terminalia interacts with.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.
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 for your Yosprala (the aspirin plus omeprazole combo): lab studies suggest Terminalia arjuna may slow down a liver enzyme called CYP2C9. Both pieces of your medicine lean on that enzyme to be cleared. If it's blocked, levels could drift a little higher. For the aspirin part, that mostly means a bit more chance of stomach upset or bleeding signs (think dark stools, easy bruising, or stomach pain). For omeprazole, it usually just means more of its acid-blocking effect.
That said, this is theoretical, based only on test-tube work, not real people. I wouldn't lose sleep over it, but because aspirin already nudges bleeding risk, run it past your pharmacist or doctor before adding Terminalia.
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 4Aspirin, Omeprazole also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that Terminalia arjuna extract inhibits CYP3A4 enzymes and reduces CYP3A4 substrate metabolism.
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 Yosprala (the aspirin plus omeprazole combo) and Terminalia. In lab studies, Terminalia arjuna seems to slow down a liver enzyme called CYP3A4, which is one pathway your body uses to clear omeprazole. If that enzyme is blocked, omeprazole could build up a bit, which might mean slightly stronger acid-lowering effects or a touch more chance of side effects like headache, nausea, or stomach upset. The aspirin portion isn't really cleared this way, so it's mostly the omeprazole side we're thinking about.
The good news: this is theoretical, based only on test-tube research, not real people. So I wouldn't lose sleep over it. Still, if you have a heart condition and want to try Terminalia, please run it by your pharmacist or doctor first.
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
ANTICOAGULANT/ANTIPLATELET DRUGS
3 of 4Aspirin, Omeprazole also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.
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 thing to keep in mind with this combo. The aspirin in Yosprala already works by making your platelets less sticky so they don't form clots. Terminalia arjuna appears to do something similar, at least in lab studies, by slowing down platelet clumping. Stack the two together and, in theory, you could nudge your bleeding risk a little higher. That might show up as easier bruising, nosebleeds, bleeding gums, or in rare cases stomach bleeding.
I want to be honest about the evidence here: this is based only on test-tube and animal data, not real patient studies, so it's more of a caution than a proven problem. The omeprazole side of your pill isn't really involved. Still, since you're already on aspirin for your heart, please run Terminalia by your pharmacist or doctor before adding it.
- Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.
OMEPRAZOLE (Prilosec)
4 of 4Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of omeprazole increases blood levels of omeprazole and decreases omeprazole clearance. It is speculated that Terminalia chebula reduces the metabolism of omeprazole by inhibiting cytochrome P450 2C19.
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 for your Yosprala, which combines aspirin and omeprazole. The interaction on file involves the omeprazole half. Your body normally clears omeprazole using a liver enzyme called CYP2C19. Lab and animal research suggests one type of Terminalia (Terminalia chebula) may slow that enzyme down, which could let omeprazole build up a bit higher than usual.
In real life, higher omeprazole levels mostly just mean a stronger acid-blocking effect, which is generally well tolerated. The aspirin part isn't really affected here. I'll be honest though: this is theoretical, based only on animal data, so I wouldn't lose sleep over it. Still, before adding any Terminalia supplement, run it past your pharmacist or doctor, especially since you have heart concerns.
- Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
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.
Terminalia Also Interacts With Other Medications
Terminalia has 932 moderate known drug interactions in our database — the Aspirin, Omeprazole one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Terminalia
We haven’t checked that one against Terminalia yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Terminalia. Pick one to open its full report.
See Every Supplement That Interacts With Aspirin, Omeprazole
This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Omeprazole page lists 318 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Grapefruit (major).
By severity: 9 major · 256 moderate · 53 minor.
From our pharmacist’s overview on the Aspirin, Omeprazole page
“Yosprala pairs aspirin, a blood thinner, with omeprazole, an acid reducer whose job is to shield the stomach from that aspirin, so this list carries real weight and warrants genuine care. Of the 318 supplements and herbs on file, nine are rated major, and understanding those first matters more than reading the rest.”
Reviewed by 2 · Jul 18, 2026
Taking Terminalia as Part of a Dietary Supplement Product? Check It for Interactions
We hold 306 real supplement products containing Terminalia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Terminalia. Your product may carry other ingredients that interact with Aspirin, Omeprazole too, on top of Terminalia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Terminalia and Aspirin, Omeprazole 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.
#316 of 1,452 supplements looked up here in the last 7 days
#498 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 Terminalia
What is Terminalia?
- Heart health and circulation
- Digestive problems (constipation, diarrhea)
- Cholesterol support
- Antioxidant and anti-inflammatory support
- Immune support
Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible benefits for heart and cholesterol health, but the evidence is limited and not strong enough to recommend it as a treatment. Talk to your pharmacist or doctor before using it, especially if you have a heart condition.
Other Drugs & Terminalia
Browse every other medication we’ve checked against Terminalia — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
932 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ketoprofen ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
Showing 60 of 932 moderate interactions — see all 932 on the Terminalia page.
No interaction 1,897 drugs checked — show the list
We also checked Terminalia against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Acetaminophen ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Bupropion ›
- Amoxicillin ›
- Lisinopril ›
- Acyclovir ›
- Bendamustine ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Spironolactone ›
- Factor 7a ›
- Phentermine, Topiramate ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Minoxidil ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Phenylephrine ›
- Vancomycin ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Pentobarbitone ›
- Bentoquatam ›
- Procainamide ›
- Hydroxychloroquine ›
- Amoxicillin, Clavulanate Potassium ›
- Azelaic Acid ›
- Digoxin ›
- Triptorelin ›
Showing the 60 most looked-up of 1,897 medications checked with no known interaction — see the full Terminalia 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
Aspirin, Omeprazole Is Linked to Lower Levels of One Nutrient
Natural Medicines records Aspirin, Omeprazole as a medicine that can lower these. This is not an interaction with Terminalia — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Aspirin, Omeprazole nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Terminalia and Aspirin, Omeprazole Together: Common Questions
Can you take Terminalia with Aspirin, Omeprazole?
Why are there 4 interactions listed for Terminalia and Aspirin, Omeprazole?
How serious is the Terminalia and Aspirin, Omeprazole interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Aspirin, Omeprazole and Terminalia?
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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.