Drug & supplement interaction

Tribulus + Eplerenone

Eplerenone brand name: Inspra.

Moderate Interaction
The bottom line Moderate

Tribulus has a moderate interaction with Eplerenone. Theoretically, taking tribulus with antihypertensive drugs might increase the risk of hypotension.

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

Tribulus and Eplerenone

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Eplerenone

Eplerenone falls under ANTIHYPERTENSIVE DRUGS — the group Tribulus interacts with.

Theoretically, taking tribulus with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that tribulus can lower blood pressure by inhibiting angiotensin-converting enzyme (ACE). Tribulus has also demonstrated hypotensive effects in pre-hypertensive adults.
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 simple version: Eplerenone (Inspra) already works to bring your blood pressure down. Tribulus, at least in animal studies and some early human research, seems to nudge blood pressure lower too, partly by acting a bit like an ACE inhibitor. Stack the two together and the worry is that your pressure could dip more than intended.

If that happened, you might notice dizziness, lightheadedness, feeling faint when you stand up, or unusual tiredness. I want to be honest, though: this is mostly theoretical and based on lab and animal work, so it's a possibility, not a sure thing. Eplerenone is not a prodrug, so this isn't about it building up, just an added blood-pressure-lowering effect. Before adding Tribulus, please run it by your pharmacist or doctor so they can keep an eye on your numbers.

References
  1. Sharifi AM, Darabi R, Akbarloo N. Study of antihypertensive mechanism of Tribulus terrestris in 2K1C hypertensive rats: role of tissue ACE activity. Life Sci 2003;73:2963-71. PubMed
  2. Siddiqui MA, Itrat M, Mobeen A, Khan MI. Efficacy of khar-i-khasak (Tribulus terrestris Linn.) in prehypertension: a randomized, double-blind, placebo-controlled trial. J Complement Integr Med. 2021.

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

Tribulus Also Interacts With Other Medications

Tribulus has 258 moderate known drug interactions in our database — the Eplerenone 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 Tribulus

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

From our Q&A

Questions About Tribulus or Eplerenone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Tribulus or Eplerenone, 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 Eplerenone

This page covers Tribulus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Eplerenone page lists 136 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), Tyramine (major) and Adrafinil (moderate).

By severity: 4 major · 111 moderate · 21 minor.

Open the Eplerenone interaction page

One more smart check

Taking Tribulus as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,680 real supplement products containing Tribulus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tribulus. Your product may carry other ingredients that interact with Eplerenone too, on top of Tribulus — 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 Tribulus and Eplerenone 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 Tribulus
Top 10%

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

29 days ago today
Medication Eplerenone
Steady interest

#2,220 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 Tribulus

What is Tribulus?

Tribulus
  • Low libido and sexual function
  • Athletic performance and muscle building
  • Testosterone support
  • Male and female fertility
  • General 'vitality' or wellness

Tribulus is a plant supplement most often marketed to boost libido, testosterone, and athletic performance, but the human evidence behind these claims is weak and inconsistent. It is generally well tolerated by healthy adults in the short term, but it should be avoided during pregnancy and breastfeeding and discussed with your pharmacist or doctor before use.

Read the full Tribulus monograph & all interactions
Medication

About Eplerenone

What Is Eplerenone Used For?

Brand name: Inspra

Eplerenone treats two conditions. First, it is used to lower high blood pressure (hypertension) in adults. Lowering blood pressure reduces the risk of stroke and heart attack. It can be used alone or alongside other blood pressure medicines.

Second, eplerenone is used to improve survival in stable adults who have heart failure with reduced ejection fraction (HFrEF) — meaning the heart pumps less blood than normal — following an acute myocardial infarction (heart attack).

See full Eplerenone drug information
Keep checking

Other Drugs & Tribulus

Browse every other medication we’ve checked against Tribulus — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
258Moderate
0Minor
2,571No known interaction
Moderate

258 interactions

Showing 60 of 258 moderate interactions — see all 258 on the Tribulus page.

No interaction 2,571 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 Tribulus and Eplerenone Together: Common Questions

Can you take Tribulus with Eplerenone?
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 Tribulus and Eplerenone 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 Eplerenone and Tribulus?

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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.