Drug & supplement interaction

Andrographis + Pretomanid

Pretomanid brand name: Pretomanid.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Andrographis has a moderate interaction with Pretomanid. Theoretically, andrographis might interfere with the effects of immunosuppressive drugs.

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

Andrographis and Pretomanid

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Pretomanid

Pretomanid falls under IMMUNOSUPPRESSANTS — the group Andrographis interacts with.

Theoretically, andrographis might interfere with the effects of immunosuppressive drugs.
Laboratory research suggests that andrographolide has immunostimulant activity.
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's the honest picture with Pretomanid and andrographis. The interaction on file comes from the idea that andrographis can nudge the immune system to be more active, which in theory could push back against immune-suppressing medicines. Pretomanid, though, isn't really an immunosuppressant in the usual sense. It's a TB-fighting drug that works alongside bedaquiline and linezolid to kill the bacteria, so this particular concern doesn't map neatly onto how Pretomanid actually works.

This flag is theoretical and based only on lab and animal research, so I wouldn't lose sleep over it. Still, treating multi-drug resistant TB is serious business, and you don't want any wild card added in. Please check with your pharmacist or doctor before adding andrographis rather than starting it on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Puri A, Saxena R, Saxena RP, et al. Immunostimulant agents from Andrographis paniculata. J Nat Prod 1993;56:995-9. 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

Andrographis Also Interacts With Other Medications

Andrographis has 407 moderate, 5 minor known drug interactions in our database — the Pretomanid one above is one of them. If you take anything else, check it against the full list below.

Moderate 407 Minor 5 No known interaction 2,418 (incl. Pretomanid)
Taking anything else?

Check Another of Your Medications Against Andrographis

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

Everything else you take

See Every Supplement That Interacts With Pretomanid

This page covers Andrographis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pretomanid page lists 143 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 10 major · 122 moderate · 11 minor.

From our pharmacist’s overview on the Pretomanid page

“Pretomanid is reserved for highly drug-resistant tuberculosis, and it can stress the liver and lengthen the heart's QT interval, so the supplements on this page deserve genuine care. Ten of the 143 ingredients on file carry a major rating, and nearly all of those either compound the liver risk (alcohol in beer or wine is the plainest e…”

Reviewed by 2 · Jul 18, 2026

Open the Pretomanid interaction page

One more smart check

Taking Andrographis as Part of a Dietary Supplement Product? Check It for Interactions

We hold 656 real supplement products containing Andrographis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Andrographis. Your product may carry other ingredients that interact with Pretomanid too, on top of Andrographis — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Andrographis and Pretomanid 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 Andrographis
Top 25%

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

29 days ago today
Medication Pretomanid
Steady interest

#2,518 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 Andrographis

What is Andrographis?

Andrographis
  • Common cold and flu symptoms
  • Upper respiratory infections
  • Sore throat
  • Fever
  • Immune support
  • Digestive complaints

Andrographis is a bitter Asian herb traditionally used for colds, flu, and infections, and some studies suggest it may ease cold symptoms and shorten how long they last. The evidence is limited and the quality of studies varies, so it should not replace standard care. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy.

Read the full Andrographis monograph & all interactions
Medication

About Pretomanid

What Is Pretomanid Used For?

Brand name: Pretomanid

Pretomanid Tablet is used only as part of a three-drug combination regimen with bedaquiline and linezolid. It is approved for adults with pulmonary (lung) tuberculosis (TB) that has become resistant to multiple standard TB drugs — specifically those resistant to isoniazid, rifamycins, a fluoroquinolone, and a second-line injectable antibiotic.

It is also approved for adults with TB resistant to both isoniazid and rifampin who cannot tolerate standard therapy or whose TB has not responded to it. This approval is based on limited clinical data, and pretomanid is intended for a specific, narrow patient population only.

See full Pretomanid drug information
Keep checking

Other Drugs & Andrographis

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

0Major
407Moderate
5Minor
2,417No known interaction
407 Moderate 5 Minor 2,417 No interaction
Moderate

407 interactions

Showing 60 of 407 moderate interactions — see all 407 on the Andrographis page.

Minor

5 interactions

No interaction 2,417 drugs checked — show the list

We also checked Andrographis against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,417 medications checked with no known interaction — see the full Andrographis list.

See the full Andrographis interactions page
See every supplement checked against Pretomanid, ranked by severity
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

Keep exploring
Andrographis monograph › Uses, safety, and every drug interaction in one place Pretomanid supplement interactions › Every supplement checked against Pretomanid, ranked by severity Pretomanid drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Andrographis and Pretomanid Together: Common Questions

Can you take Andrographis with Pretomanid?
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 Andrographis and Pretomanid 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

Still Have a Question About Pretomanid and Andrographis?

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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.