Drug & supplement interaction

Baikal Skullcap + Etoposide

Etoposide brand names: VePesid, VP16, Etopophos.

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

Etoposide falls into 2 drug categories that Baikal Skullcap can interact with; the most serious is rated minor. Theoretically, Baikal skullcap might increase levels of drugs transported by P-glycoprotein.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Baikal Skullcap and Etoposide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Baikal Skullcap interacts with whole categories of medication. Etoposide falls into 2 of those categories, so it can interact with Baikal Skullcap in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Etoposide

Etoposide falls under P-GLYCOPROTEIN SUBSTRATES — the group Baikal Skullcap interacts with.

Theoretically, Baikal skullcap might increase levels of drugs transported by P-glycoprotein.
In vitro and animal research suggests that baicalein, oroxylin A, and wogonin, constituents of Baikal skullcap, can inhibit P-glycoprotein. This effect has not been reported in humans.
Severity Minor 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 gist for etoposide (VP-16). Your body uses a kind of cellular pump called P-glycoprotein to move etoposide around and help clear it out. Lab and animal studies hint that compounds in Baikal skullcap (baicalein, wogonin, and others) can slow that pump down. In theory, that could let a bit more etoposide build up than expected, which might mean stronger side effects like low blood counts, more nausea, mouth sores, or increased infection risk.

That said, this is only seen in test tubes and animals, not in people, and it's rated as a minor, possible interaction. Since etoposide is serious chemotherapy, I'd still loop in your oncology team or pharmacist before adding any herbal supplement. Don't change your treatment on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lee, Y., Yeo, H., Liu, S. H., Jiang, Z., Savizky, R. M., Austin, D. J., and Cheng, Y. C. Increased anti-P-glycoprotein activity of baicalein by alkylation on the A ring. J Med Chem 10-21-2004;47(22):5555-5566. PubMed
  2. Lee, E., Enomoto, R., Suzuki, C., Ohno, M., Ohashi, T., Miyauchi, A., Tanimoto, E., Maeda, K., Hirano, H., Yokoi, T., and Sugahara, C. Wogonin, a plant flavone, potentiates etoposide-induced apoptosis in cancer cells. Ann N Y Acad Sci 2007;1095:521-526. PubMed
  3. Go, W. J., Ryu, J. H., Qiang, F., and Han, H. K. Evaluation of the flavonoid oroxylin A as an inhibitor of P-glycoprotein-mediated cellular efflux. J Nat Prod 2009;72(9):1616-1619. PubMed
  4. Enomoto, R., Koshiba, C., Suzuki, C., and Lee, E. Wogonin potentiates the antitumor action of etoposide and ameliorates its adverse effects. Cancer Chemother.Pharmacol 2011;67(5):1063-1072. PubMed
Minor

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

2 of 2

Etoposide also falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP).

Theoretically, Baikal skullcap might alter the levels and clinical effects of OATP substrates.
Some pharmacokinetic research shows that baicalin, a constituent of Baikal skullcap, can decrease plasma levels of rosuvastatin. The mechanism is thought to involve stimulation of the activity of the organic anion-transporting polypeptide 1B1 (OATP1B1), which transports rosuvastatin into the liver. This decreases plasma levels of the drug, but increases levels at the site of action in the liver. The degree to which rosuvastatin levels are affected depends on the OATP1B1 haplotype of the individual. Baikal skullcap might also affect other OATP1B1 substrates.
Severity Minor Likelihood Possible Evidence B

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 gist for your situation. Etoposide is one of the medicines that relies on liver transporters called OATP to move it around your body. In some lab and early human studies, baicalin (a compound in Baikal skullcap) seems to speed up one of these transporters (OATP1B1). In theory, that could pull more etoposide into the liver and lower the amount circulating in your blood, which might mean a slightly weaker effect from your chemo.

I want to be straight with you though: this is mostly theoretical, drawn from a rosuvastatin study, and it's rated a minor interaction. We don't have solid data in people taking etoposide. Because your chemo is too important to risk weakening, please don't add this herb without first running it by your oncology team or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fan L, Zhang W, Guo D, et al. The effect of herbal medicine baicalin on pharmacokinetics of rosuvastatin, substrate of organic anion-transporting polypeptide 1B1. Clin Pharmacol Ther 2007;83:471-6. PubMed
  2. Chen C, Mireles RJ, Campbell SD, et al. Differential interaction of 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors with ABCB1, ABCC2, and OATP1B1. Drug Metab Dispos 2005;33:537-46. PubMed
  3. Pasanen MK, Fredrikson H, Neuvonen PJ, Niemi M. Different effects of SLCO1B1 polymorphism on the pharmacokinetics of atorvastatin and rosuvastatin. Clin Pharmacol Ther 2007;82:726-33. PubMed
  4. Konig J, Seithel A, Gradhand U, Fromm MF. Pharmacogenomics of human OATP transporters. Naunyn-Schmiedeberg Arch Pharmacol 2006;372:432-43. 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

Baikal Skullcap Also Interacts With Other Medications

Baikal Skullcap has 594 moderate, 351 minor known drug interactions in our database — the Etoposide one above is among them. If you take anything else, check it against the full list below.

Moderate 594 Minor 351 No known interaction 1,885 (incl. Etoposide)
Taking anything else?

Check Another of Your Medications Against Baikal Skullcap

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

Everything else you take

See Every Supplement That Interacts With Etoposide

This page covers Baikal Skullcap only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etoposide page lists 152 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Grapefruit (major), St. John's Wort (major) and Sweet Orange (major).

By severity: 5 major · 107 moderate · 40 minor.

From our pharmacist’s overview on the Etoposide page

“Chemotherapy is unforgiving of level swings, and swings are exactly what most of this list can cause for etoposide (VePesid, Etopophos). Of the 152 supplements and herbs on file, 121 can change how your liver clears etoposide through the CYP3A4 enzyme, meaning too little drug and an undertreated cancer, or too much and harsher toxicity.”

Reviewed by 2 · Jul 18, 2026

Open the Etoposide interaction page

One more smart check

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

We hold 737 real supplement products containing Baikal Skullcap, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Baikal Skullcap. Your product may carry other ingredients that interact with Etoposide too, on top of Baikal Skullcap — 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 Baikal Skullcap and Etoposide 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 Baikal Skullcap
Top 25%

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

29 days ago today
Medication Etoposide
Top half

#1,204 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 Baikal Skullcap

What is Baikal Skullcap?

Baikal Skullcap
  • Inflammation
  • Allergies
  • Anxiety and sleep
  • Immune support
  • Respiratory infections

Baikal skullcap is a traditional Chinese herb (Huang Qin) used for inflammation, allergies, and infections, with active compounds like baicalin and baicalein studied mostly in the lab. Human evidence remains limited, so it should not replace proven treatments. Talk to your pharmacist or doctor before using it, and avoid it in pregnancy and breastfeeding.

Read the full Baikal Skullcap monograph & all interactions
Medication

About Etoposide

What Is Etoposide Used For?

Brand names: VePesid, VP16, Etopophos

Etoposide injection (available as Avopef, Etopophos, Toposar, and Etoposide) is used to treat refractory testicular tumors — cancers that have already been treated with surgery, radiation, and other chemotherapy — always in combination with other cancer drugs. It is also used for small cell lung cancer (SCLC) as a first-line treatment, given together with other chemotherapy and, in the case of Avopef, with immunotherapy as well.

Etoposide capsules (VePesid and Etoposide capsules) are approved for small cell lung cancer as first-line treatment in combination with other chemotherapy agents. Capsule forms are not approved for testicular cancer, as the label notes that adequate data on their use in that setting are not available.

See full Etoposide drug information
Keep checking

Other Drugs & Baikal Skullcap

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

0Major
594Moderate
351Minor
1,884No known interaction
594 Moderate 351 Minor 1,884 No interaction
Moderate

594 interactions

Showing 60 of 594 moderate interactions — see all 594 on the Baikal Skullcap page.

Minor

351 interactions

Showing 60 of 351 minor interactions — see all 351 on the Baikal Skullcap page.

No interaction 1,884 drugs checked — show the list

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

Showing the 60 most looked-up of 1,884 medications checked with no known interaction — see the full Baikal Skullcap list.

See the full Baikal Skullcap interactions page
See every supplement checked against Etoposide, 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
Baikal Skullcap monograph › Uses, safety, and every drug interaction in one place Etoposide supplement interactions › Every supplement checked against Etoposide, ranked by severity Etoposide 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 Baikal Skullcap and Etoposide Together: Common Questions

Can you take Baikal Skullcap with Etoposide?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Baikal Skullcap and Etoposide?
Etoposide belongs to more than one drug category, and Baikal Skullcap interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Baikal Skullcap and Etoposide interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Etoposide and Baikal Skullcap?

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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.