The short answer
Yes, there is evidence of an interaction. In a small study of healthy men, a single dose of gugulipid, an extract of guggul resin, lowered the amount of propranolol and of diltiazem that reached the blood. Both the peak level and the total exposure fell. Less drug in the blood could mean the medicine works less well.
The study was tiny, with 10 men for propranolol and 7 for diltiazem, and its summary does not say by how much the levels fell. We found no study of regular guggulu use in patients on these medicines. If you take either one, tell your prescribing doctor before you start guggulu, and ask whether your blood pressure and pulse should be checked.
Propranolol is sold in India as Ciplar.
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Lower peak level and total exposure (Cmax, AUC) of both drugs[1][2][3] | Not established. Lab studies suggest guggul switches on CYP3A4, an enzyme that clears diltiazem. | Less propranolol or diltiazem in the blood; possibly a weaker effect | Small clinical study |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Single-dose study in healthy men, 1994 Small clinical study
Healthy men took propranolol 40 mg (10 men) or diltiazem 60 mg (7 men), once alone and once with 1 g of gugulipid, in random order. Blood was sampled hourly for eight hours. With gugulipid, both the peak level and the total exposure of each drug fell significantly. The abstract gives no percentages, no effect on blood pressure or pulse, and no details of how the extract was standardised.[1]
What your doctor may watch for
- Blood pressure and pulse, and any return of the symptoms the medicine was prescribed for.[1]
- The diltiazem label advises against taking it with medicines that switch on CYP3A4. Memorial Sloan Kettering notes that lab studies suggest guggul does this.[3]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, guggulu (name of product, and whether it is plain guggul or a mixture) along with propranolol or diltiazem. A small study found gugulipid lowered blood levels of both drugs. Should my blood pressure and pulse be checked more often?”
Withheld until review
Questions people ask
Does this apply to guggulu tablets like Yogaraja or Kanchanara guggulu?
Not known. The study used gugulipid, a resin extract, and mixtures with many herbs may behave differently. Show your doctor the full ingredient list of what you take.[1]
Related
Guggulu and cholesterol medicines (statins)
Guggul raised rosuvastatin levels in rats, and lab work suggests it speeds up an enzyme that clears some statins. We found no study in people.
InteractionPippali, black pepper and propranolol
In one small study, a week of piperine, the compound in pippali and black pepper, raised propranolol levels in healthy volunteers.
FormulationYogaraja Guggulu
A guggulu tablet for joints and amavata. A large Indian study saw knee pain fall, but it had no comparison group and used three medicines together.
InteractionGuggulu and blood thinners (warfarin, aspirin, clopidogrel)
Lab studies suggest guggul speeds up a liver enzyme that helps clear warfarin. Which way the INR would move is not known, and no study tested the pair.
Sources
- Dalvi SS, Nayak VK, Pohujani SM, Desai NK, Kshirsagar NA, Gupta KC. Effect of gugulipid on bioavailability of diltiazem and propranolol. J Assoc Physicians India. 1994;42:454-455. PMID 7852226.
- Memorial Sloan Kettering Cancer Center. About Herbs: Guggul.
- Cardizem CD (diltiazem hydrochloride) extended-release capsules, US prescribing information (DailyMed).
Updated 4 November 2026
Taking guggulu with other medicines? A vaidya can check your full list.
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