Drug & supplement interaction

Beta-hydroxybutyrate (bhb) + Rilpivirine

Rilpivirine brand names: Edurant, Edurant Ped.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Beta-hydroxybutyrate (bhb) and Rilpivirine 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 Rilpivirine states a food rule worth keeping to.

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Interaction report

Beta-hydroxybutyrate (bhb) and Rilpivirine

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 Rilpivirine and Beta-hydroxybutyrate (bhb) 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Beta-hydroxybutyrate (bhb) at all — not against Rilpivirine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Beta-hydroxybutyrate (bhb) safety at a glance

Beta-hydroxybutyra... overall Use caution Generally tolerated short-term but may cause stomach upset and adds significant minerals or sodium; long-term safety is not well studied.
Pregnancy Avoid Not enough safety data; avoid during pregnancy unless your doctor advises otherwise.
Breastfeeding Avoid Not enough safety data; best to avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rilpivirine and Beta-hydroxybutyrate (bhb)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Beta-hydroxybutyrate (bhb) Itself Has Been Linked To

This is not an interaction — nothing below involves Rilpivirine. It is the side-effect record for Beta-hydroxybutyrate (bhb) on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Beta-hydroxybutyrate (bhb), this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • Dehydration Worth acting on Additional detail

    “Orally, BHB has been reported to cause mild dehydration. This is possibly due to the use of the sodium salt of BHB resulting in increased sodium intake.”

    Beta-hydroxybutyrate (bhb) · Natural Medicines adverse-effect record, reported in dehydration.

    2 sources cited
    1. 96084. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
    2. 96085. Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8.
  • Bloating or gas / Constipation / Stomach pain Additional detail

    “Orally, BHB may cause indigestion, diarrhea, nausea, gastrointestinal upset, and vomiting in some patients. In a small crossover study, nausea, diarrhea, and vomiting were reported in 37%, 16%, and 11% of patients, respectively, taking two 0.38 gram/kg doses of BHB salts separated by 45 minutes on a single day.”

    Beta-hydroxybutyrate (bhb) · Natural Medicines adverse-effect record, reported in constipation.

    4 sources cited
    1. 96084. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
    2. 96096. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
    3. 102024. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
    4. 96088. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed
  • Stomach upset / Diarrhea / Vomiting / Nausea Additional detail

    Recorded for Beta-hydroxybutyrate (bhb) in the same Natural Medicines adverse-effect record shown under Dehydration above.

Everything above comes from the Natural Medicines adverse-effect record for Beta-hydroxybutyrate (bhb) — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Rilpivirine’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Rilpivirine column appears here.

How to take them

Some Rilpivirine Products Have a Food Rule — Beta-hydroxybutyrate (bhb) Should Not Break It

At least one FDA label for a product containing Rilpivirine says to take it with food. If you take Beta-hydroxybutyrate (bhb) on an empty stomach out of habit, keep them separate — and take Rilpivirine 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 Rilpivirine 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.

2 DOSAGE AND ADMINISTRATION One 25 mg rilpivirine tablet taken once daily with a meal for patients weighing at least 35 kg.

From the Dosage and Administration section of the FDA label we read for Rilpivirine — where that label names a specific product, the instruction is that product's. See the Rilpivirine drug page ›

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 Rilpivirine

This page covers Beta-hydroxybutyrate (bhb) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rilpivirine page lists 175 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: 11 major · 127 moderate · 37 minor.

From our pharmacist’s overview on the Rilpivirine page

“St. John's wort is the supplement I would rule out first for anyone taking rilpivirine (Edurant) for HIV.”

Reviewed by 2 · Jul 18, 2026

Open the Rilpivirine interaction page

How much people look this up

Where Beta-hydroxybutyrate (bhb) and Rilpivirine 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 Beta-hydroxybutyrate (bhb)
Steady interest

#1,373 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Rilpivirine
Steady interest

#2,421 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 Beta-hydroxybutyrate (bhb) reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Beta-hydroxybutyrate (bhb) and Rilpivirine 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 Beta-hydroxybutyrate (bhb)

What is Beta-hydroxybutyrate (bhb)?

Beta-hydroxybutyrate (bhb)
  • Weight loss and fat burning
  • Boosting energy on a ketogenic diet
  • Athletic and exercise performance
  • Mental focus and clarity
  • Reducing 'keto flu' symptoms

Beta-hydroxybutyrate (BHB) is a ketone body your liver naturally makes when carbs are low, and it is sold as a supplement marketed for weight loss, energy, and athletic performance. Despite bold marketing claims, human evidence that BHB supplements help with weight loss or performance is limited and mixed. If you want to try it, talk with your pharmacist or doctor first, especially if you have kidney, heart, or blood pressure concerns.

Not applicable (a ketone body made by the body or produced as a synthetic salt) · Capsules, powders, drink mixes (often as BHB salts bound to sodium, calcium, magnesium, or potassium; also BHB esters)

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

Beta-hydroxybutyrate (bhb): dosing

There is no official, standardized dose of BHB. Products vary widely in how much BHB they contain and which minerals they are paired with.The best approach is to follow the directions on the product label and not exceed them. Many people start with a smaller amount to see how their stomach reacts before using more.Because mineral content matters, check how much sodium, calcium, magnesium, or potassium each serving provides.

From our Beta-hydroxybutyrate (bhb) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Beta-hydroxybutyrate (bhb) monograph & all interactions
Medication

About Rilpivirine

What Is Rilpivirine Used For?

Brand names: Edurant, Edurant Ped

Rilpivirine tablets (sold as Edurant, Edurant Ped, and generic rilpivirine) are used along with other antiretroviral medicines to treat HIV-1 infection in patients who have not previously been treated with HIV medicines (treatment-naïve). Eligibility depends on age, body weight, and the level of virus in the blood at the start of treatment.

Edurant tablets are also approved, in combination with cabotegravir (Vocabria), for short-term oral use in adults and adolescents who are already virologically suppressed — specifically as a lead-in before starting the long-acting injectable regimen Cabenuva, or as a bridge if a Cabenuva injection dose will be missed.

Most-Reported Side Effects for Rilpivirine

From FAERS, the FDA’s public side-effect reporting system (24,864 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Bone density decreased 4,430 reports
Renal injury 3,215 reports
Skeletal injury 2,981 reports
Chronic kidney disease 2,716 reports
Tooth loss 2,413 reports
See full Rilpivirine drug information
Keep checking

Other Drugs & Beta-hydroxybutyrate (bhb)

Browse every other medication we’ve checked against Beta-hydroxybutyrate (bhb) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Beta-hydroxybutyrate (bhb) References

The 6 references that drive our Beta-hydroxybutyrate (bhb) 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. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
  2. Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8.
  3. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed
  4. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
  5. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
  6. Malhi MS, Duerson F, Salabei JK, Okonoboh P. Starvation Ketoacidosis Induced by Ketogenic Diet and Consumption of Ketone Supplement. Cureus. 2021;13(6):e15778. Published 2021 Jun 20. 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 Beta-hydroxybutyrate (bhb) and Rilpivirine Together: Common Questions

Is it safe to take Beta-hydroxybutyrate (bhb) with Rilpivirine?
We do not list a known interaction between Beta-hydroxybutyrate (bhb) and Rilpivirine. 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.
Should I take Beta-hydroxybutyrate (bhb) and Rilpivirine at the same time of day?
At least one FDA label for a product containing Rilpivirine says to take it with food. If you take Beta-hydroxybutyrate (bhb) on an empty stomach out of habit, keep them separate and take Rilpivirine with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Rilpivirine products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Does Rilpivirine interact with any supplements?
Yes. Rilpivirine has documented interactions with 175 supplements in our database — Beta-hydroxybutyrate (bhb) is not one of them. The Rilpivirine interaction page linked on this page lists every one, ranked by severity.

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.