Terminalia - Plavix (Clopidogrel) Interaction
Herbal: Terminalia
Also Known As: Terminalia arjuna, Abhaya, Amandier Indien, Arale, Arjuna, Axjun Argun, Badamier, Badamier chebule, Badamier Géant, Baheda, Bahera, Bahira, Bala Harade, Balera, Behada, Belleric Myrobalan, Belliric Myrobalan, Bhibitaki, Bibhitak, Bibitaki, Bihara, Black myrobalan
Drug: Clopidogrel
Brand names:
Plavix
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 25, 2025
Interaction Details
Clopidogrel is classified as belonging to the following category: Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.
Interaction Rating
Likelihood of Occurrence
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
References
- 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.
Interaction Details
Clopidogrel is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP3A4 enzymes and reduces CYP3A4 substrate metabolism.
Interaction Rating
Likelihood of Occurrence
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
References
- 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.
Interaction Details
Clopidogrel is classified as belonging to the following category: Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.
Interaction Rating
Likelihood of Occurrence
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
References
- 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.
Terminalia Overview
Terminalia is a genus of trees that are native to tropical and subtropical regions of the world. There are around 100 species of Terminalia, which are known for their hard, durable wood and their ability to grow in a variety of climates.
In traditional medicine, three species are of particular note, Terminalia arjuna, Terminalia bellirica, and Terminalia chebula. Various parts of these trees, including the bark, leaves, and fruit, are used as a natural remedy for digestive problems, such as constipation and diarrhea, and to boost the immune system. They are also believed to have anti-inflammatory properties, and they may be helpful in reducing inflammation and swelling in the body.
Clopidogrel Overview
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Clopidogrel is used alone or with aspirin to prevent serious or life-threatening problems with the heart and blood vessels in people who have had a stroke, heart attack, or severe chest pain. This includes people who have percutaneous coronary intervention (PCI; angioplasty; a type of heart surgery) that may involve inserting coronary stents (metal tubes surgically placed in clogged blood vessels to improve blood flow) or who have coronary artery bypass grafting (CABG; a type of heart surgery). Clopidogrel is also used to prevent serious or life-threatening problems with the heart and blood vessels in people who have peripheral arterial disease (poor circulation in the blood vessels that supply blood to the legs). Clopidogrel is in a class of medications called antiplatelet medications. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.
Terminalia - More Interactions
Terminalia interacts with 908 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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