Drug & supplement interaction

Terminalia + Lurasidone

Lurasidone brand name: Latuda.

Moderate Interaction
The bottom line Moderate

Terminalia has a moderate interaction with Lurasidone. Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.

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

Terminalia and Lurasidone

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Lurasidone

Lurasidone falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Terminalia interacts with.

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.
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 Latuda (lurasidone): your liver relies heavily on an enzyme called CYP3A4 to clear this medication. Lab studies suggest Terminalia arjuna can slow that enzyme down. If the enzyme works more slowly, lurasidone may not be cleared as quickly, so levels in your body could creep up. That could mean more of the usual side effects, like drowsiness, dizziness, restlessness, muscle stiffness, or feeling lightheaded when you stand up.

I want to be honest though: this is theoretical, based only on test-tube research, not real patients. So it's a reason to be thoughtful, not alarmed. Lurasidone is already sensitive to CYP3A4 changes, so before combining the two, please check with 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

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 Lurasidone 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.

From our Q&A

Questions About Terminalia or Lurasidone

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 Lurasidone, 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 Lurasidone

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lurasidone page lists 149 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Indian Snakeroot (major), Rauvolfia Vomitoria (major) and St. John's Wort (major).

By severity: 5 major · 104 moderate · 40 minor.

From our pharmacist’s overview on the Lurasidone page

“Supplements deserve real scrutiny alongside lurasidone (Latuda), a medication for schizophrenia and bipolar depression that relies almost entirely on one liver enzyme, CYP3A4, to clear it. Grapefruit blocks that enzyme and can push lurasidone levels high enough to worsen side effects, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Lurasidone 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 Lurasidone 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 Lurasidone 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 Lurasidone
Steady interest

#2,109 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 Lurasidone

What Is Lurasidone Used For?

Brand name: Latuda

Lurasidone hydrochloride tablets are approved to treat schizophrenia in adults and adolescents aged 13 to 17, and to treat depressive episodes associated with bipolar I disorder (bipolar depression) in adults and children aged 10 to 17. Latuda is one of the brand names under which lurasidone is available as a tablet.

For bipolar depression, lurasidone can be used on its own (monotherapy) in adults and pediatric patients aged 10 to 17, or used alongside lithium or valproate (adjunctive therapy) in adults.

See full Lurasidone 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 Lurasidone Together: Common Questions

Can you take Terminalia with Lurasidone?
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 Lurasidone 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 Lurasidone 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.