Drug & supplement interaction

Terminalia + Ibuprofen lysine

Ibuprofen lysine brand name: NeoProfen.

Moderate Interaction
The bottom line Moderate

Ibuprofen lysine falls into 2 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 report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Terminalia and Ibuprofen lysine

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

Why Are There 2 Interactions?

Terminalia interacts with whole categories of medication. Ibuprofen lysine falls into 2 of those categories, so it can interact with Terminalia 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 2C9 (CYP2C9) SUBSTRATES

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Why this applies to Ibuprofen lysine

Ibuprofen lysine falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Terminalia interacts with.

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.
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: your body clears ibuprofen mainly through a liver enzyme called CYP2C9. Terminalia arjuna may slow that enzyme down a bit. If it does, ibuprofen could hang around a little longer and its effects (both helpful and unwanted) might be slightly stronger. With an NSAID like this, that can mean a higher chance of stomach upset, heartburn, fluid retention, or, with regular use, kidney strain or raised blood pressure.

I want to be honest about the evidence, though. This is only seen in lab (test tube) studies, not in real people, so it's a theoretical concern rather than a proven problem. If you take ibuprofen often or have kidney, stomach, or heart issues, just run the combination by your pharmacist or doctor first.

References
  1. 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
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Ibuprofen lysine also falls under 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.
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 with ibuprofen lysine and Terminalia. Ibuprofen itself already nudges up bleeding risk a little, because it's an NSAID that affects how your platelets stick together and can irritate the stomach lining. Terminalia (especially Terminalia arjuna) has shown, in lab and test-tube studies, that it may also keep platelets from clumping. So in theory, pairing the two could mean it takes longer to stop bleeding.

I want to be honest about the strength of this: it comes from in vitro work, not from people, so it's more of a caution than a proven problem. Still, watch for things like easy bruising, nosebleeds, bleeding gums, or dark or black stools. Please check with your pharmacist or doctor before combining them, especially if you take any other blood thinner.

References
  1. 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.

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

Terminalia Also Interacts With Other Medications

Terminalia has 932 moderate known drug interactions in our database — the Ibuprofen lysine 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 Terminalia

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

From our Q&A

Questions About Terminalia or Ibuprofen lysine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Terminalia or Ibuprofen lysine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ibuprofen lysine

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibuprofen lysine page lists 268 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Beer (major), Danshen (major), Piracetam (major) and Siberian Cocklebur (major).

By severity: 6 major · 235 moderate · 27 minor.

From our pharmacist’s overview on the Ibuprofen lysine page

“Ibuprofen lysine (NeoProfen) is an injectable form of the NSAID ibuprofen, and this list warrants real attention, starting with its six major entries. The dominant pattern is bleeding: 202 of the 268 ingredients on file can thin the blood or slow clotting, which stacks on an NSAID's own tendency to irritate the stomach and blunt platel…”

Reviewed by 2 · Jul 18, 2026

Open the Ibuprofen lysine interaction page

One more smart check

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 Ibuprofen lysine 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:

How much people look this up

Where Terminalia and Ibuprofen lysine 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 Terminalia
Top 25%

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

29 days ago today
Medication Ibuprofen lysine
Top 25%

#643 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 Terminalia

What is Terminalia?

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.

Read the full Terminalia monograph & all interactions
Medication

About Ibuprofen

What Is Ibuprofen Used For?

Brand name: NeoProfen

Oral ibuprofen products (tablets, coated tablets, and liquid-filled capsules) are used to temporarily relieve minor aches and pains from headache, backache, toothache, muscular aches, menstrual cramps, minor arthritis pain, and the common cold, and to temporarily reduce fever. The oral prescription tablet (Ibu) is also indicated for the signs and symptoms of rheumatoid arthritis and osteoarthritis, mild to moderate pain, and primary dysmenorrhea (painful periods).

Caldolor, an intravenous (IV) form, is approved for adults and children 3 months and older to manage mild to moderate pain, to manage moderate to severe pain alongside opioid pain medicines, and to reduce fever. A separate intravenous solution, Ibuprofen Lysine, is used specifically in premature infants to close a patent ductus arteriosus (PDA) — an abnormal blood vessel connection near the heart — when standard medical management has not worked.

See full Ibuprofen drug information
Keep checking

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.

0Major
932Moderate
0Minor
1,897No known interaction
Moderate

932 interactions

Showing 60 of 932 moderate interactions — see all 932 on the Terminalia page.

No interaction 1,897 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

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Pharmacist Counseling Corner

Taking Terminalia and Ibuprofen lysine Together: Common Questions

Can you take Terminalia with Ibuprofen lysine?
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 Terminalia and Ibuprofen lysine?
Ibuprofen lysine belongs to more than one drug category, and Terminalia 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 Terminalia and Ibuprofen lysine 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

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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.