Do Any Herbs Interact With Lexiscan (Regadenoson)?

In our latest question and answer, our pharmacist discusses herbals that may interact with Lexiscan (Regadenoson).

Question

What herbal supplements may interact negatively with regadenoson?

Asked by michelle On Feb 06, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Feb 06, 2023
Last updated Mar 04, 2024

Key points

  • Lexiscan (Regadenoson) is used for imaging purposes during a cardiac stress test.
  • There are some important drug interactions to be aware of, and you should avoid taking products containing caffeine, such as green tea and coffee, for at least 12 hours before a scheduled regadenoson test
  • If you are unsure about what medications are safe to take before your test, be sure to speak with your doctor so you can be sure you don't take something that may interfere with it.

Answer

Thanks for reaching out! This is an interesting question based on the fact we're talking about a drug that lasts in the body for an extremely short amount of time.

Lexiscan (regadenoson) is used for imaging purposes during a stress test of the heart. It is administered intravenously and will be completely metabolized and eliminated from your system a few hours after your dose.

Nevertheless, there is an interaction that is important to know about, and that is with any caffeine-containing products. This would certainly include some herbals that naturally contain caffeine.

Avoid Caffeine-Containing Products With Regadenoson

In terms of dietary supplements, you want to avoid taking anything with caffeine or similar stimulants, and this would include things like green tea and coffee, with regadenoson. Per the prescribing information for the drug:

Patients should be instructed to avoid consumption of any products containing methylxanthines, including caffeinated coffee, tea or other caffeinated beverages, caffeine-containing drug products, aminophylline and theophylline for at least 12 hours before a scheduled radionuclide MPI (Myocardial Perfusion Imaging).
Lexiscan Prescribing Information

The reason why it is recommended to avoid caffeine and caffeine-like drugs is that they may impair the vasodilatory effects of regadenoson (i.e., the blood vessels may not dilate enough). This could ultimately affect the diagnostic conclusions of the stress test.

What About Other Herbals?

Other than caffeine, there are no studies that I am aware of that have evaluated herbal supplements with regadenoson. However, it stands to reason that any herbal that naturally contains caffeine, or has a vasoconstricting effect (like caffeine can have), should not be taken if you are scheduled to have a dose of regadenoson. So, this would include herbs that Butcher's Broom, which can cause vasoconstriction and the following herbs that naturally contain some caffeine:

  • Guarana
  • Cacao
  • Tea leaves
  • Kola Nut
  • Yerba Mate
  • Yaupon

Now, due to the lack of studies on taking specific herbals with regadenoson, it may be prudent to stop taking them at least a day before you are scheduled to get regadenoson, even if they don't contain caffeine. This recommendation is just to keep you on the safe side as you don't want to take anything that can interfere with your test.

Lastly, the manufacturer's website of regadenoson specifically recommends against all caffeine, chocolate, and diet supplements for at least 12 hours before a test:

What not to take with Lexiscan


Regadenoson lasts such a short time in your system, you likely can safely resume taking your herbals the next day or simply after your test.

Final Words

I highly recommend speaking with your doctor regarding what medications and herbs are safe for your particular medical situation.

As mentioned, you certainly want to avoid caffeine and similar stimulants, and any supplement that contains them.

In addition to things like green tea, many diet, and weight loss supplements contain green tea extract and other ingredients that are a source of caffeine (like guarana). Those should be avoided with regadenoson.

Thanks for reaching out and please do so again anytime!

References

  • Lexiscan Prescribing Information, Astellas
  • Effect of caffeine on SPECT myocardial perfusion imaging during regadenoson pharmacologic stress: a prospective, randomized, multicenter study, PubMed
  • Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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