Drug & supplement interaction

Aristolochia + Pretomanid

Pretomanid brand name: Pretomanid.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Aristolochia and Pretomanid in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Pretomanid states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Aristolochia and Pretomanid

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Pretomanid and Aristolochia in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Aristolochia safety at a glance

Aristolochia overall Avoid Aristolochia contains aristolochic acid, which can cause kidney failure and cancer; it should not be used.
Pregnancy Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Unsafe When used orally; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Pretomanid and Aristolochia? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Pretomanid

Interactions in our licensed database are recorded against drug classes, not just single drug names. Pretomanid is filed under 5 classifications — including immunosuppressants, qt interval-prolonging drugs, antibiotic drugs. Aristolochia has documented interactions with 1 drug class — the most serious being nephrotoxic drugs (moderate) — and none of Pretomanid’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Aristolochia Does Interact With Other Medications

Aristolochia has 355 moderate known drug interactions in our database — Pretomanid isn’t one of them. If you take anything else, check it against the full list below.

Moderate 355 No known interaction 2,475 (incl. Pretomanid)
Taking anything else?

Check Another of Your Medications Against Aristolochia

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

What to actually watch for

No Interaction Found — But Data Suggests Aristolochia and Pretomanid May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Aristolochia

    “Orally, use of aristolochia can cause end-stage renal failure and urothelial carcinoma of the bladder. These adverse effects are well documented. A case of hepatotoxicity associated with aristolochia use has also been reported.”

    Aristolochia · Natural Medicines adverse-effect record, reported in kidney failure.

    5 sources cited
    1. 12782. Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Mutagenesis 2002;17:265-77. PubMed
    2. 32376. News Potpourri. Southern Medical Journal 2000;93(11):1129-1130.
    3. 94872. Shaohua Z, Ananda S, Ruxia Y, Liang R, Xiaorui C, Liang L. Fatal renal failure due to the Chinese herb "GuanMu Tong" (Aristolochia manshuriensis): autopsy findings and review of literature. Forensic Sci Int. 2010;199(1-3):e5-7. PubMed
    4. 100337. Tazi I, Nafil H, Mahmal L. Fatal renal failure due to self administration of Aristolochia Longa after treatment with chemotherapy. Arab J Nephrol Transplant. 2012 Jan;5(1):54; discussion 55.
    5. 32383. Centre for Reviews and Dissemination (CRD). Systematic review: hepatotoxic events associated with herbal medicinal products. 2004;

    Pretomanid

    Listed in the ADVERSE REACTIONS section of the FDA label for Pretomanid. Read the label on DailyMed ›

Reported for Aristolochia but not commonly for Pretomanid: kidney problems.

Effects for Pretomanid come from the ADVERSE REACTIONS section of its FDA label; effects for Aristolochia come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 647 voluntary FDA FAERS reports for Pretomanid that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Aristolochia in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Pretomanid Products Have a Food Rule — Aristolochia Should Not Break It

At least one FDA label for a product containing Pretomanid says to take it with food. If you take Aristolochia on an empty stomach out of habit, keep them separate — and take Pretomanid with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Pretomanid products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Recommended Dosage Pretomanid Tablets must be administered in combination with bedaquiline and linezolid with food [see Clinical Pharmacology (12.3) ] .

From the Dosage and Administration section of the FDA label we read for Pretomanid — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Pretomanid

This page covers Aristolochia 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

How much people look this up

Where Aristolochia 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 Aristolochia
Top half

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

29 days ago today
Medication Pretomanid
Steady interest

#2,114 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Aristolochia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Aristolochia and Pretomanid records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Aristolochia

What is Aristolochia?

Aristolochia
  • Promoting menstruation
  • Aphrodisiac
  • Immune stimulation
  • Snakebite remedies
  • Pain and inflammation

Aristolochia contains aristolochic acid, a potent toxin linked to severe kidney damage and cancer, and it is not safe to take. The FDA and other health authorities have warned against any product containing aristolochic acid. Despite its history in traditional medicine, no proven benefit outweighs these serious dangers.

Aristolochia spp. · Aristolochiaceae · Root, stem, and aerial parts (in traditional remedies) · Dried herb, powders, capsules, teas, and traditional tinctures

An interaction check asks whether these two react with each other — it does not ask whether Aristolochia is a good idea for someone in your situation. Here is what our Aristolochia record says about it on its own.

Aristolochia: dosing

There is no safe or recommended dose of Aristolochia. Because it contains a toxic, cancer-causing compound, it should not be taken at all.If you come across a supplement, tea, or traditional remedy that lists Aristolochia (or related names like birthwort, Mu Tong, or Fang Ji) as an ingredient, do not use it.

From our Aristolochia monograph — the full record covers uses, side effects and every documented interaction.

Read the full Aristolochia 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 regimen — together with bedaquiline and linezolid — to treat adults with pulmonary (lung) tuberculosis that is resistant to multiple antibiotics, including isoniazid, rifamycins, a fluoroquinolone, and a second-line injectable TB drug. It is also used for adults whose TB is resistant to isoniazid and rifampin and who cannot tolerate or are not responding to standard TB therapy.

Pretomanid Tablets are not for drug-sensitive TB, latent (inactive) TB infection, TB outside the lungs, or TB that responds to standard treatment. They should only be used in combination with bedaquiline and linezolid — safety and effectiveness with other drug combinations have not been established.

See full Pretomanid drug information
Keep checking

Other Drugs & Aristolochia

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

0Major
355Moderate
0Minor
2,474No known interaction
355 Moderate 2,474 No interaction
Moderate

355 interactions

Showing 60 of 355 moderate interactions — see all 355 on the Aristolochia page.

No interaction 2,474 drugs checked — show the list

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

Showing the 60 most looked-up of 2,474 medications checked with no known interaction — see the full Aristolochia list.

See the full Aristolochia interactions page
See every supplement checked against Pretomanid, ranked by severity
Evidence & sources

Aristolochia References

The 27 references that drive our Aristolochia monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. van Ypersele de Strihou C, Vanherweghem JL. The tragic paradigm of Chinese herbs nephropathy. Nephrol Dial Transplant 1995;10:157-60. DOI
  2. Nortier JL, Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N Engl J Med 2000;342:1686-92.
  3. Lewis CJ, Alpert S. Letter to health care professionals -- FDA concerned about botanical products, including dietary supplements, containing aristolochic acid. Office of Nutritional Products, Labeling, Dietary Supplements. Center for Food Safety and Appli
  4. Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Mutagenesis 2002;17:265-77. PubMed
  5. Cronin AJ, Maidment G, Cook T, et al Aristolochic acid as a causative factor in a case of Chinese herbal nephropathy. Nephrol Dial Transplant 2002;17:524-5. PubMed
  6. Chang CH, Wang YM, Yang AH, Chiang SS. Rapidly progressive interstitial renal fibrosis associated with Chinese herbal medications. Am J Nephrol 2001;21:441-8. PubMed
  7. Lord GM, Cook T, Arlt VM, et al. Urothelial malignant disease and Chinese herbal nephropathy. Lancet 2001;358:1515-6. PubMed
  8. Lord GM, Tagore R, Cook T, et al. Nephropathy caused by Chinese herbs in the UK. Lancet 1999;354:481-2. PubMed
  9. Nortier JL, Vanherweghem JL. Renal interstitial fibrosis and urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). Toxicology 2002;181-182:577-80. PubMed
  10. Martinez M. C., Nortier J., Vereerstraeten P., Vanherweghem J. L. Progression rate of Chinese herb nephropathy: impact of Aristolochia fangchi ingested dose. Nephrol.Dial.Transplant. 2002;17(3):408-12. PubMed
  11. Nortier, J. [Renal interstitial fibrosis and urotelial carcinomas after ingestion of a Chinese herb (Aristolochia fangchi)]. Nephrologie 2002;23(1):37-38.
  12. Ioset, J. R., Raoelison, G. E., and Hostettmann, K. Detection of aristolochic acid in Chinese phytomedicines and dietary supplements used as slimming regimens. Food Chem Toxicol 2003;41(1):29-36. PubMed
  13. Yu Y., Zheng F. L., Li H. [Chinese herbs-induced renal failure with Fanconi syndrome: a report of 6 cases]. Zhonghua Nei Ke.Za Zhi. 2003;42:110-12.
  14. Schaneberg, B. T. and Khan, I. A. Analysis of products suspected of containing Aristolochia or Asarum species. J.Ethnopharmacol. 2004;94(2-3):245-249. PubMed
  15. Chan, T. Y., Tam, H. P., Lai, C. K., and Chan, A. Y. A multidisciplinary approach to the toxicologic problems associated with the use of herbal medicines. Ther Drug Monit. 2005;27(1):53-57. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Aristolochia and Pretomanid Together: Common Questions

Is it safe to take Aristolochia with Pretomanid?
We do not list a known interaction between Aristolochia and Pretomanid. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Aristolochia and Pretomanid have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Aristolochia and Pretomanid at the same time of day?
At least one FDA label for a product containing Pretomanid says to take it with food. If you take Aristolochia on an empty stomach out of habit, keep them separate and take Pretomanid with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Pretomanid products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Aristolochia and Pretomanid combination checked?
Interactions in our licensed database are recorded against drug classes. Pretomanid is filed under 5 classifications, and Aristolochia has documented interactions with 1 drug class — none of Pretomanid's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Aristolochia interact with any other medications?
Yes. Aristolochia has 355 documented drug interactions in our database — Pretomanid is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Pretomanid interact with any supplements?
Yes. Pretomanid has documented interactions with 143 supplements in our database — Aristolochia is not one of them. The Pretomanid interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Aristolochia monograph Uses, safety profile, and every drug interaction in one place Pretomanid drug information The full plain-English guide to this medication Pretomanid supplement interactions Every supplement checked against Pretomanid, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 27 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Pretomanid and Aristolochia?

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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.