Drug & supplement interaction

Terminalia + Morphine Sulfate

Morphine Sulfate brand names: MS Contin, Kadian, Avinza, Morphabond, Arymo ER.

Moderate Interaction
Medically reviewed by · Updated October 2026
The bottom line Moderate

Terminalia has a moderate interaction with Morphine Sulfate. Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.

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

Terminalia and Morphine Sulfate

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Morphine Sulfate

Morphine Sulfate falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Terminalia interacts with.

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2D6 enzymes and reduces CYP2D6 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: lab studies hint that Terminalia arjuna may slow down an enzyme called CYP2D6. The thinking is that if a drug cleared by that enzyme can't break down as fast, it can build up in your body and hit a little harder than expected. For morphine, that could in theory mean more sedation, dizziness, constipation, or in a worst case, slowed breathing.

But I want to keep this in perspective. Morphine is mostly handled by a different pathway (glucuronidation), not heavily by CYP2D6, and this concern comes only from test-tube research, not real patients. So a meaningful interaction is unlikely. Still, since morphine is a strong opioid, please run any Terminalia supplement by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
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 934 moderate known drug interactions in our database — the Morphine Sulfate one above is one of them. If you take anything else, check it against the full list below.

Moderate 934 No known interaction 1,896 (incl. Morphine Sulfate)
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 Morphine Sulfate

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 Morphine Sulfate, 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 Morphine Sulfate

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Morphine Sulfate page lists 172 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 8 major · 138 moderate · 26 minor.

From our pharmacist’s overview on the Morphine Sulfate page

“With morphine sulfate (MS Contin, Kadian, Avinza), an opioid powerful enough to slow breathing on its own, this list warrants genuine respect. Of the 172 supplements and foods on file, 8 carry a major rating, and most of those pile extra sedation onto a drug that already sedates.”

Reviewed by 2 · Jul 18, 2026

Open the Morphine Sulfate 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 Morphine Sulfate 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 Morphine Sulfate 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%

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

29 days ago today
Medication Morphine Sulfate
Top half

#1,014 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 Morphine

What Is Morphine Used For?

Brand names: MS Contin, Kadian, Avinza, Morphabond, Arymo ER

Morphine is used for pain that is severe enough to need an opioid and that other treatments cannot control well. It is meant for people who have not done well on, or cannot tolerate, other options.

Some uses depend on the product. Morphine sulfate tablets treat acute pain in adults and in children weighing at least 50 kg, and chronic pain in adults. Morphine oral solution (2 mg/mL and 4 mg/mL) treats acute and chronic pain in adults and acute pain in children 2 years and older. The 20 mg/mL oral solution is only for opioid-tolerant adults. Extended-release capsules and tablets, including MS Contin, are for severe, persistent pain that needs daily, long-term opioid treatment. Duramorph and preservative-free morphine injection can be given by vein, or into the epidural or intrathecal space (around the spinal cord). Infumorph and Mitigo are only for continuous epidural or intrathecal infusion for intractable chronic pain.

See full Morphine 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
934Moderate
0Minor
1,895No known interaction
934 Moderate 1,895 No interaction
Moderate

934 interactions

Showing 60 of 934 moderate interactions — see all 934 on the Terminalia page.

No interaction 1,895 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.

Showing the 60 most looked-up of 1,895 medications checked with no known interaction — see the full Terminalia list.

See the full Terminalia interactions page
See every supplement checked against Morphine Sulfate, ranked by severity
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

Keep exploring
Terminalia monograph › Uses, safety, and every drug interaction in one place Morphine Sulfate supplement interactions › Every supplement checked against Morphine Sulfate, ranked by severity Morphine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Terminalia and Morphine Sulfate Together: Common Questions

Can you take Terminalia with Morphine Sulfate?
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 Morphine Sulfate 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 Morphine Sulfate 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.