yohimbine (generic name)
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Interactions with Drugs
Multiple drug interactions may occur with the use of yohimbine hydrochloride. In theory, these effects may also apply to yohimbe bark extract, which contains variable (usually low) amounts of yohimbine.
Based on human study, yohimbine has been reported to block the effects of alpha-adrenergic drugs. Yohimbine may increase the effects of drugs that are anti-adrenergic, such as clonidine or guanabenz. Use of yohimbine with central nervous system stimulants may have additive effects. In theory, due to inhibition of monoamine oxidase (MAOI activity), use of yohimbine with drugs like isocarboxazid (Marplan®), phenelzine (Nardil®), tranylcypromine (Parnate®), or linezolid (Zyvox®) may produce additive side effects, such as an increased risk of extremely high blood pressure.
Based on human study, use of ethanol (alcohol) with yohimbine may produce an additive effect of increasing intoxication. Based on human study, yohimbine may increase pain relief from morphine and may increase or decrease withdrawal symptoms caused by the medication naloxone. According to historical use and animal study, yohimbine may increase the effects of diabetic medications, including insulin, although there is no reliable scientific evidence in this area. Caution is advised when using medications that may lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.
Based on human study, use of yohimbine with physostigmine in patients with Alzheimer's disease may be associated with anxiety, agitation, restlessness, and chest pain. Use of yohimbine with antihistamines is cautioned, although there is no reliable scientific evidence in this area. The combination of yohimbine with anti-muscarinic agents may result in increased risk of toxicity. In theory, yohimbine may add to the effects of drugs that lower blood pressure.
In theory, yohimbine may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs (and yohimbine) in the blood may be altered and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional or pharmacist about possible interactions.
Yohimbine may also interact with benzodiazepines (tranquilizers), antibiotics such as linezolid, phenothiazines, and tricyclic antidepressants (TCAs). Patients using any medications should check the package insert and speak with a qualified healthcare professional or pharmacist about possible interactions.
Interactions with Herbs & Dietary Supplements
Multiple interactions may occur between the drug yohimbine hydrochloride and herbs/supplements. In theory, these effects may also apply to yohimbe bark extract, which contains variable (usually low) amounts of yohimbine.
In theory, other over-the-counter products containing stimulants, including caffeine, phenylephrine, and phenylpropanolamine (removed from the U.S. market), may lead to additive effects when used in combination with yohimbine. Yohimbine theoretically may interfere with blood pressure control and should be used cautiously with other herbs or supplements that affect blood pressure.
Due to inhibition of monoamine oxidase, use of yohimbine with herbs/supplements with possible similar properties may produce additive effects, such as an increased risk of dangerously high blood pressure (hypertensive crisis). In theory, caffeine-containing agents such as coffee, tea, cola, guarana, and mate may also increase the risk of hypertensive crisis when taken with yohimbine.
Yohimbine theoretically may add to the effects of herbs or supplements that may lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
In theory, yohimbine may interfere with the way the body processes herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of herbs or supplements (and yohimbine) in the blood may be altered, and may cause increased or decreased effects or potentially serious adverse reactions. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
Other possible interactions with yohimbine include herbs and supplements used for Alzheimer's disease, bacterial infections, or depression. In theory, yohimbine may interact with goldenseal or berberine-containing herbs.