Periwinkle

Periwinkle/Drug Interactions:

  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Based on animal research, alkaloids from lesser periwinkle may have antiplatelet and antithrombotic effects and may significantly prolong bleeding (11; 8). Theoretically, concurrent use of periwinkle and anticoagulants or antiplatelets may increase the risk of bleeding.
  • Antidepressant agents, monoamine oxidase inhibitors (MAOIs)Antidepressant agents, monoamine oxidase inhibitors (MAOIs): Catharanthus alkaloids may be selective reversible inhibitors of monoamine oxidase-B (MAO-B) (31). Theoretically, concurrent use of periwinkle and MAO inhibitors may increase the risk of a hypertensive crisis.
  • AntihypertensivesAntihypertensives: According to secondary sources, periwinkle may cause severe drops in blood pressure. Theoretically, concurrent use of periwinkle and antihypertensives may increase the risk of hypotension.
  • Antineoplastic agentsAntineoplastic agents: Vincristine from Catharanthus roseus and the alkaloid derivative vinorelbine may have antineoplastic activity (26; 13). Cisapride may interfere with the metabolism of vinca alkaloids in periwinkle through CYP450, leading to toxic levels and subsequent bone marrow toxicity (24). The disposition of vinorelbine is not altered by concurrent administration of cisplatin.
  • Cytochrome P450-metabolized agentsCytochrome P450-metabolized agents: Vinca alkaloids found in Catharanthus roseus are extensively metabolized by the liver cytochrome P450 enzymes. Theoretically, Catharanthus roseus may alter the levels of agents metabolized by CYP450.
  • Hepatotoxic agentsHepatotoxic agents: Based on secondary sources, periwinkle may cause hepatotoxicity. Theoretically, concurrent use of periwinkle and hepatotoxic agents may increase the risk of liver damage.
  • ImmunosuppressantsImmunosuppressants: According to secondary sources, vinca alkaloids in periwinkle may cause myelosuppression. Theoretically, concomitant use of periwinkle with immunosuppressants may increase the risk of immunosuppression.
  • VasodilatorsVasodilators: Alkaloid derivatives from lesser periwinkle may have vasodilating effects (4). Theoretically, concurrent use of periwinkle and vasodilators may cause additive effects.

    • Periwinkle/Herb Interactions:

  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Based on animal research, alkaloids from lesser periwinkle may have antiplatelet and antithrombotic effects and may significantly prolong bleeding (11; 8). Theoretically, concurrent use of periwinkle and anticoagulants or antiplatelets may increase the risk of bleeding.
  • Antidepressant agents, monoamine oxidase inhibitors (MAOIs)Antidepressant agents, monoamine oxidase inhibitors (MAOIs): Catharanthus alkaloids may be selective reversible inhibitors of monoamine oxidase-B (MAO-B) (31). Theoretically, concurrent use of periwinkle and MAO inhibitors may increase the risk of a hypertensive crisis.
  • AntineoplasticsAntineoplastics: Vincristine from Catharanthus roseus and the alkaloid derivative vinorelbine may have antineoplastic activity (26; 13). Cisapride may interfere with the metabolism of vinca alkaloids in periwinkle through CYP450, leading to toxic levels and subsequent bone marrow toxicity (24). The disposition of vinorelbine is not altered by concurrent administration of cisplatin.
  • Cytochrome P450-metabolized herbs and supplementsCytochrome P450-metabolized herbs and supplements: Vinca alkaloids found in Catharanthus roseus are extensively metabolized by the liver cytochrome P450 enzymes. Theoretically, Catharanthus roseus may alter the levels of agents metabolized by CYP450.
  • Hepatotoxic herbsHepatotoxic herbs: Based on secondary sources, periwinkle may cause hepatotoxicity. Theoretically, concurrent use of periwinkle and hepatotoxic agents may increase the risk of liver damage.
  • HypotensivesHypotensives: According to secondary sources, periwinkle may cause severe drops in blood pressure. Theoretically, concurrent use of periwinkle and antihypertensives may increase the risk of hypotension.
  • ImmunosuppressantsImmunosuppressants: According to secondary sources, vinca alkaloids in periwinkle may cause myelosuppression. Theoretically, concomitant use of periwinkle with immunosuppressants may increase the risk of immunosuppression.
  • Vasodilator herbs and supplementsVasodilator herbs and supplements: Alkaloid derivatives from lesser periwinkle may have vasodilating effects (4). Theoretically, concurrent use of periwinkle and vasodilators may cause additive effects.

    • Periwinkle/Food Interactions:

  • Tyramine-containing foodsTyramine-containing foods: Catharanthus alkaloids may be selective reversible inhibitors of monoamine oxidase-B (MAO-B) (31). Theoretically, concurrent use of periwinkle and tyramine containing foods may increase the risk of a hypertensive crisis.

    • Periwinkle/Lab Interactions:

  • Coagulation panelCoagulation panel: Based on animal research, alkaloids from lesser periwinkle may have antiplatelet and antithrombotic effects and may significantly prolong bleeding (11; 8).