Drug & supplement interaction

Alpine Ragwort + Eslicarbazepine Acetate

Eslicarbazepine Acetate brand name: Aptiom.

Moderate Interaction
The bottom line Moderate

Alpine Ragwort has a moderate interaction with Eslicarbazepine Acetate. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in alpine ragwort.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Alpine Ragwort and Eslicarbazepine Acetate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Eslicarbazepine Acetate

Eslicarbazepine Acetate falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Alpine Ragwort interacts with.

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in alpine ragwort.
Alpine ragwort contains PAs. PAs are substrates of CYP3A4. Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here is the first and most important thing: I would steer clear of Alpine Ragwort altogether. It contains pyrrolizidine alkaloids, plant compounds that are known to harm the liver, and there is no proven benefit to balance that risk. So no matter what else you take, this one is best avoided.

Now the specific concern with Aptiom (eslicarbazepine): your seizure medicine speeds up a liver enzyme called CYP3A4. That same enzyme turns those ragwort alkaloids into toxic byproducts. So in theory, your medication could ramp up the production of liver-damaging substances from the plant, raising the chance of liver injury. I want to be honest that this is theoretical, based on lab data rather than real patient reports. Aptiom itself stays the same. Please don't change your seizure medicine, and talk with your doctor or pharmacist before using any new supplement.

References
  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  2. 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. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Alpine Ragwort Also Interacts With Other Medications

Alpine Ragwort has 86 moderate known drug interactions in our database — the Eslicarbazepine Acetate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Alpine Ragwort

Covers the 2,830 medications we’ve checked against Alpine Ragwort. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Eslicarbazepine Acetate

This page covers Alpine Ragwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Eslicarbazepine Acetate page lists 37 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Alkanna (moderate), Boneset (moderate), Borage (moderate) and Butterbur (moderate).

By severity: 1 major · 27 moderate · 9 minor.

From our pharmacist’s overview on the Eslicarbazepine Acetate page

“Missing even part of a dose of Aptiom (eslicarbazepine acetate) can mean a breakthrough seizure, which is why I read this list with real care. Of the 37 supplement ingredients on file, only activated charcoal rates major; it binds the medicine in your gut and can sharply cut what reaches your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Eslicarbazepine Acetate interaction page

How much people look this up

Where Alpine Ragwort and Eslicarbazepine Acetate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Alpine Ragwort
Steady interest

#778 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Eslicarbazepine Acetate
Steady interest

#1,801 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Alpine Ragwort

What is Alpine Ragwort?

Alpine Ragwort
  • Traditional wound care
  • Minor bleeding or bruises
  • Digestive complaints
  • Menstrual discomfort
  • Folk remedy for inflammation

Alpine Ragwort is a wild plant in the daisy family that contains pyrrolizidine alkaloids (PAs), which can severely damage the liver. There is no good scientific evidence that it works for any health condition, and the safety risks are serious. We do not recommend using it.

Read the full Alpine Ragwort monograph & all interactions
Medication

About Eslicarbazepine

What Is Eslicarbazepine Used For?

Brand name: Aptiom

Eslicarbazepine acetate tablets — sold under the brand names Aptiom and Eslicarbazepine Acetate — are used to treat partial-onset seizures (seizures that start in one part of the brain) in patients 4 years of age and older. It can be used alone (monotherapy) or alongside other seizure medications (adjunctive therapy).

Both Aptiom and the generic eslicarbazepine acetate tablets are approved for this same use, in the same age range. The dose is adjusted based on age, body weight, and kidney function.

See full Eslicarbazepine drug information
Keep checking

Other Drugs & Alpine Ragwort

Browse every other medication we’ve checked against Alpine Ragwort — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
86Moderate
0Minor
2,743No known interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Alpine Ragwort page.

No interaction 2,743 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Alpine Ragwort and Eslicarbazepine Acetate Together: Common Questions

Can you take Alpine Ragwort with Eslicarbazepine Acetate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Alpine Ragwort and Eslicarbazepine Acetate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.