The short answer
Yes, there is evidence that arjuna adds to telmisartan. In a 28-day trial in India, 44 people with stage 1 high blood pressure all took telmisartan, plus either arjuna capsules or a placebo. Blood pressure fell more in the arjuna group, and no side effects were put down to arjuna.
The trial was small and short, and its published summary does not say by how much pressure fell. We found no trial of arjuna's effect on blood pressure alongside amlodipine, metoprolol or other blood pressure drugs. If you take a blood pressure medicine, tell your prescribing doctor before you start arjuna, and ask whether you should check your pressure at home.
Common Indian packs include Telma (telmisartan), Amlong (amlodipine) and Met XL (metoprolol). Telma H also contains hydrochlorothiazide, a water pill.
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Greater fall in blood pressure with arjuna added to telmisartan[1] | Not established | Blood pressure may fall further than with telmisartan alone | RCT |
| Arjuna bark extracts blocked three drug-clearing liver enzymes[3] | Inhibition of CYP3A4, CYP2D6 and CYP2C9 in human liver microsomes | Could raise levels of drugs these enzymes clear; not shown in people | In vitro |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Trial on telmisartan, India, 2026 RCT
Forty-four adults aged 30 to 70 with stage 1 high blood pressure all took telmisartan 40 mg a day, unchanged throughout. Half also took arjuna capsules (1.5 g twice a day after food) and half a matching placebo, for 28 days. Systolic and diastolic pressure fell in both groups, and significantly more with arjuna. No side effects were attributed to arjuna. The abstract gives no actual readings, and four weeks is too short to show longer-term effects.[1]
Long-term study in coronary artery disease, New Delhi, 2019 Observational
Thirty-five people with long-standing coronary artery disease took arjuna bark extract (500 mg three times a day) with their usual heart medicines, which included aspirin, beta blockers, statins, nitrates and ARBs. Another 35 took the usual medicines alone. Over nine months to almost five years, two people on arjuna reported gastritis and one constipation. The study looked at side effects, not blood pressure, and was too small to pick up rare problems.[2]
Laboratory study, Mumbai, 2015 In vitro
Alcohol and water extracts of arjuna bark strongly blocked CYP3A4, CYP2D6 and CYP2C9, three liver enzymes that break down many medicines, in human liver tissue in the lab. Three single compounds from arjuna did not. Lab findings like this show a possible route for an interaction. They do not show that one happens in people.[3]
What your doctor may watch for
- Blood pressure and pulse, at home or at the clinic, after starting arjuna.[1]
- Dizziness or fainting, especially on standing up, which can be a sign that blood pressure has gone too low.
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, arjuna (name of product, form and how much) along with my blood pressure medicine. A small trial found arjuna lowered blood pressure further in people on telmisartan. Should I check my blood pressure at home, and what reading should make me call you?”
Withheld until review
Questions people ask
Is arjuna good for BP?
One 28-day trial found arjuna capsules lowered blood pressure more than a placebo in people already on telmisartan. It was small and short, and it does not show that arjuna can replace a blood pressure medicine.[1]
Related
Arjunarishta
A fermented arjuna bark liquid used for the heart. It contains alcohol from fermentation, and the only study of it we found was in rats.
InteractionArjuna and blood thinners
In the lab, arjuna bark extract slowed platelet clumping and blocked enzymes that clear warfarin. We found no study of bleeding or INR with blood thinners.
InteractionArjuna and nitrates for angina
People in arjuna studies also used rescue or background nitrates, but no study we found was designed to check for an interaction between them.
InteractionAmla and blood pressure medicines
Two trials disagree. One found amla lowered blood pressure further in people on BP medicines; a larger one found no extra effect.
Sources
- Nazir A, Bhat MDA, Mir UY. Efficacy of Terminalia arjuna in essential hypertension: a randomized controlled study. Explore (NY). 2026;22:103535. PMID 42753288.
- Dwivedi S, Chopra D, Bhandari B. Role of Terminalia arjuna Wight and Arn. in the treatment of chronic coronary artery disease from pharmacovigilance point of view. AYU. 2019;40(2):104-108. PMID 32398910.
- Varghese A, Savai J, Pandita N, Gaud R. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin and arjungenin on CYP3A4, CYP2D6 and CYP2C9 enzyme activity in human liver microsomes. Toxicol Rep. 2015;2:806-816. PMID 28962416.
Updated 4 November 2026
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