Borage - Mitapivat Interaction
Herbal: Borage
Also Known As: Bee Plant, Beebread, Borage Oil, Borage Seed Oil, Borago, Borraja, Burage, Burrage, Common Borage, Common Bugloss, Cool Tankard, Ox's Tongue, Starflower, Starflower Oil, Talewort
Drug: Mitapivat
Brand names:
Pyrukynd
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Mitapivat is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Inducers
Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
- Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20.
Borage Overview
Borage (Borago officinalis) is an herb native to the Mediterranean region. It is known for its hairy, light blue flowers and hairy, hairy leaves.
In herbal medicine, borage is used to treat a wide range of health conditions, including respiratory problems, inflammation, and anxiety. It is also used to stimulate the appetite and to help improve mood. Borage oil, which is extracted from the seeds of the plant and contains gamma-linolenic acid (GLA), an omega-6 fatty acid, is used topically to treat skin conditions such as eczema and dermatitis.
Borage must be used cautiously if taken orally as the plant parts may contain liver-toxic compounds (pyrrolizidine alkaloids). It is important to only ingest preparations that are free of pyrrolizidine alkaloids.
Mitapivat Overview
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Mitapivat is used to treat hemolytic anemia (a blood disorder that occurs when red blood cells are destroyed faster than they can be made in the body) in people with pyruvate kinase deficiency. Mitapivat is in a class of medications called pyruvate kinase activators. It works by increasing pyruvate kinase available to increase red blood cell (RBC) lifespan.
Borage - More Interactions
Borage interacts with 219 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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