Drug & supplement interaction

Terminalia + Iloprost

Iloprost brand names: Ventavis, Aurlumyn.

Moderate Interaction
The bottom line Moderate

Terminalia has a moderate interaction with Iloprost. Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.

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

Terminalia and Iloprost

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Iloprost

Iloprost falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Terminalia interacts with.

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 thing to know about combining Terminalia (often Terminalia arjuna) with iloprost (Ventavis). Iloprost relaxes blood vessels to ease pulmonary hypertension, but it also has a known side effect of slowing down platelets, which are the cells that help your blood clot. In lab studies, Terminalia appears to do something similar, gently discouraging platelets from sticking together.

So the worry is additive: stacking the two could nudge you toward easier bruising, nosebleeds, or bleeding that's slower to stop. I want to be honest though, this is theoretical and based only on test-tube research, not real patient cases, so it may not amount to much. Still, since iloprost already affects bleeding, please check with your pharmacist or doctor before adding Terminalia.

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 Iloprost one above is one of 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.

Everything else you take

See Every Supplement That Interacts With Iloprost

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Iloprost page lists 287 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), Danshen (major) and Piracetam (major).

By severity: 6 major · 254 moderate · 27 minor.

Open the Iloprost 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 Iloprost 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 Iloprost 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%

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

29 days ago today
Medication Iloprost
Top half

#1,045 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 Iloprost

What Is Iloprost Used For?

Brand names: Ventavis, Aurlumyn

Aurlumyn (iloprost injection, given intravenously) is approved to treat severe frostbite in adults, specifically to reduce the risk of losing fingers or toes (digit amputations). Its effectiveness was established in young, healthy adults who experienced frostbite at high altitudes.

See full Iloprost 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 Iloprost Together: Common Questions

Can you take Terminalia with Iloprost?
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 Terminalia and Iloprost 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.