Noni - Cerebyx (Fosphenytoin) Interaction
Herbal: Noni
Also Known As: Morinda citrifolia, Ba Ji Tian, Bois Douleur, Canarywood, Cheese Fruit, Hawaiian Noni, Hog Apple, Indian Mulberry, Indian Noni, Luoling, Mengkudu, Morinda, Mulberry, Nhau, Noni Juice, Nono, Nonu, Rotten Cheese Fruit, Ura, Wild Pine
Drug: Fosphenytoin
Brand names:
Cerebyx
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Fosphenytoin is classified as belonging to the following category: Hepatotoxic Drugs
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
There is concern that noni might cause hepatotoxicity in some patients. Advise patients against combining noni with potentially hepatotoxic drugs.
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
- Millonig G, Stadlmann S, Vogel W. Herbal hepatotoxicity: acute hepatitis caused by a Noni preparation (Morinda citrifolia). Eur J Gastroenterol Hepatol 2005;17:445-7.
- Stadlbauer V, Fickert P, Lackner C, et al. Hepatotoxicity of NONI juice: report of two cases. World J Gastroenterol 2005;11:4758-60.
- Yuce B, Gulberg V, Diebold J, Gerbes AL. Hepatitis induced by noni juice from morinda citrifolia: a rare cause of hepatotoxicity or the tip of the iceberg? Digestion 2006;73:167-70.
Interaction Details
Fosphenytoin is classified as belonging to the following category: Phenytoin (Dilantin)
Theoretically, taking noni fruit juice concomitantly with phenytoin may lower phenytoin levels and increase the risk of seizures.
In one case report, an adult taking phenytoin for partial seizures experienced low serum phenytoin levels while taking noni juice 90-200 mL daily. Serum phenytoin levels increased after decreasing noni juice consumption; similarly, serum phenytoin levels decreased after increasing noni juice consumption. Some researchers believe noni juice may induce cytochrome P450 2C9 enzymes, which would decrease phenytoin levels, but this has not been well studied. Patients may need additional monitoring when starting or stopping noni juice supplementation.
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
- Yu-Chan Kang, Ming-Hong Chen, Shung-Lon Lai. Potentially Unsafe Herb-drug Interactions Between a Commercial Product of Noni Juice and Phenytoin- A Case Report. Acta Neurol Taiwan. 2015 Jun;24(2):43-6.
Noni Overview
Noni (Morinda citrifolia) is a tropical fruit that is native to Southeast Asia and the Pacific Islands. It is also known by a variety of other names, including Indian mulberry, beach mulberry, and cheese fruit. Noni fruit is typically not eaten fresh due to its strong flavor and smell. Regardless, many parts of the plant, including the roots, fruit, stem, bark, leaves, and flowers are used to make juice, supplements, and other products.
Noni has a long history of use in traditional medicine. Some studies have suggested that noni may have potential health benefits, including the ability to reduce inflammation, improve immune function, and lower blood pressure. It is also thought to have antioxidant and anti-tumor effects.
Fosphenytoin Overview
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Fosphenytoin injection is used to treat primary generalized tonic-clonic seizures (formerly known as a grand mal seizure; seizure that involves the entire body) and to treat and prevent seizures that may begin during or after surgery to the brain or nervous system. Fosphenytoin injection may also be used to control certain type of seizures in people who cannot take oral phenytoin. Fosphenytoin is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.
Noni - More Interactions
Noni interacts with 513 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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