Medication interaction hub

What Supplements Interact with Salmeterol?

Salmeterol brand name: Serevent. Every interaction below applies to the brands too.

141 Interactions 7 Major 105 Moderate 29 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Salmeterol? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Salmeterol against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

Salmeterol (Serevent) is the long-acting inhaler taken twice daily for asthma or COPD, and its supplement list is one I would approach with real caution. Seven of the 141 ingredients on file rate major: grapefruit can raise salmeterol levels by blocking the enzyme that clears it, St. John's wort revs that same enzyme and can weaken the drug, and several botanicals can stretch the heart's QT rhythm on top of salmeterol's own tendency to do so, raising the odds of a dangerous arrhythmia.

The larger moderate tier, 105 entries alongside 29 minor ones, mostly repeats two patterns: herbs processed by that same enzyme, and caffeine, which in large amounts can add stimulant strain to a heart already feeling salmeterol's push. Concentrated caffeine products are the worry, not your morning cup. With seven majors touching heart rhythm and drug levels, I would treat this page as one to check every time.

— , Clinical Pharmacist · July 18, 2026

Major 7 Moderate 105 Minor 29 No known interaction 1,311

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Salmeterol: Top Interactions at a Glance

The most significant Salmeterol supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 141 interacting ingredients — plus 1,311 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Salmeterol + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Likely Grapefruit + Salmeteroli

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Probable Arsenic + Salmeteroli

Arsenic trioxide can prolong the QT interval.

Read the full interaction Major Likelihood Probable Cesium + Salmeteroli

Theoretically, taking cesium concomitantly with other drugs that prolong the QT interval may increase the risk of ventricular arrhythmias and death.

Read the full interaction Major Likelihood Probable Ephedra + Salmeteroli

Theoretically, ephedra might have an additive effect with drugs that prolong the QT interval.

Read the full interaction Major Likelihood Probable Sida Cordifolia + Salmeteroli

Theoretically, Sida cordifolia might increase the risk of additive QT interval prolongation when taken with QT interval-prolonging drugs.

Read the full interaction Major Likelihood Probable St. John's Wort + Salmeteroli

St.

Read the full interaction
The complete list

Every Supplement Checked Against Salmeterol

All 1,452 ingredients in our database, ranked by severity — 141 with a Salmeterol interaction on file and 1,311 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Salmeterol?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Yerba Mate with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, the caffeine in yerba mate might increase the cardiac inotropic effects of beta-agonists, especially if taken in large amount...

Full Yerba Mate + Salmeterol answer

Can you take Neem with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, neem leaf extract might increase the levels and clinical effects of CYP3A4 substrates.

Full Neem + Salmeterol answer

Can you take Astaxanthin with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.

Full Astaxanthin + Salmeterol answer

Can you take Ayahuasca with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, ayahuasca might increase plasma concentrations of CYP3A4 substrates.

Full Ayahuasca + Salmeterol answer

Can you take Bacopa with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.

Full Bacopa + Salmeterol answer

Can you take Beet with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, beet might increase the levels of CYP3A4 substrates.

Full Beet + Salmeterol answer

Can you take Berberine with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, berberine might increase serum levels of drugs metabolized by CYP3A4.

Full Berberine + Salmeterol answer

Can you take Beta-methylphenethylamine (bmpea) with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, BMPEA might increase the levels and clinical effects of CYP3A4 substrates.

Full Beta-methylphenethylamine (bmpea) + Salmeterol answer

Can you take Bishop's Weed with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Full Bishop's Weed + Salmeterol answer

Can you take Bitter Orange with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the...

Full Bitter Orange + Salmeterol answer

Can you take Black Pepper with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.

Full Black Pepper + Salmeterol answer

Can you take Bog Labrador Tea with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research shows that aqueous and ethanolic extracts of Bog Labrador tea leaves can increase the concentration of cytochrome P450 3A4...

Full Bog Labrador Tea + Salmeterol answer

Can you take Boswellia Serrata with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.

Full Boswellia Serrata + Salmeterol answer

Can you take Bulbine Natalensis with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP3A4 substrates.

Full Bulbine Natalensis + Salmeterol answer

Can you take Calamus with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effec...

Full Calamus + Salmeterol answer

Can you take Cannabis with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.

Full Cannabis + Salmeterol answer

Can you take Cat's Claw with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, cat's claw might increase or decrease the levels and effects of drugs metabolized by CYP3A4.

Full Cat's Claw + Salmeterol answer

Can you take Ceylon Leadwort with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Full Ceylon Leadwort + Salmeterol answer

Can you take Chanca Piedra with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, use of chanca piedra might increase the levels and clinical effects of CYP3A4 substrates.

Full Chanca Piedra + Salmeterol answer

Can you take Chokeberry with Salmeterol?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.

Full Chokeberry + Salmeterol answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Salmeterol is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Salmeterol, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Salmeterol sits in 3 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Salmeterol through this category.

Beta-Adrenergic Agonists 15 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

15 of the supplement ingredients on this page reach Salmeterol through this category.

Qt Interval-Prolonging Drugs 13 ingredients

Medications that can affect the heart's electrical rhythm (the QT interval). Supplements with similar effects can add to that risk.

13 of the supplement ingredients on this page reach Salmeterol through this category.

About Salmeterol

Salmeterol is a long-acting inhaled bronchodilator used to treat asthma, prevent exercise-induced bronchospasm, and manage chronic obstructive pulmonary disease (COPD).

Generic name: Salmeterol  ·  Brand name: Serevent.

See the full Salmeterol Oral Inhalation drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Salmeterol

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Salmeterol.

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Pharmacist Counseling Corner

Salmeterol & Supplements: Common Questions

What supplements interact with Salmeterol?
More than you might expect — 141 in total, though they are far from equal: 7 are rated major, 105 moderate, and 29 minor. The ranked list on this page puts the ones that genuinely matter first, and every entry opens a full report on that exact pair. The highest-ranked right now: Grapefruit, Arsenic, Cesium.
Which Salmeterol supplement interactions are the most serious?
Focus on the major group: Grapefruit, Arsenic, Cesium, Ephedra and Sida Cordifolia, among others. A major rating means the combination can be clinically significant, not that harm is guaranteed — but it's exactly the kind of thing to run past your pharmacist before your next dose, not after. Jump to the ranked list.
Can I take vitamins or supplements while on Salmeterol?
Usually yes — most people on Salmeterol can take most supplements. The catch is the exceptions, and they aren't always the exotic ones (St. John's Wort trips up more prescriptions than almost anything sold next to it). Look up each ingredient you actually take in the list above, and treat "no known interaction" as a green-ish light, not a guarantee. Try the label scanner or the interaction checker.
Do brands like Serevent have the same supplement interactions as Salmeterol?
Yes — Serevent all contain Salmeterol, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
What about Salmeterol and my other medications?
This page covers Salmeterol against supplements and herbal ingredients. Checking Salmeterol against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Salmeterol Oral Inhalation drug information.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 22, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.