Drug & supplement interaction

Bishop's Weed + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

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

Nintedanib Esylate falls into 2 drug categories that Bishop's Weed can interact with; the most serious is rated moderate. Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

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

Bishop's Weed and Nintedanib Esylate

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

Why Are There 2 Interactions?

Bishop's Weed interacts with whole categories of medication. Nintedanib Esylate falls into 2 of those categories, so it can interact with Bishop's Weed in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Nintedanib Esylate

Nintedanib Esylate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Bishop's Weed interacts with.

Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro. Theoretically, bishop's weed might inhibit elimination and increase blood levels of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include alprazolam (Xanax), amitriptyline (Elavil), amiodarone (Cordarone), buspirone (Buspar), cerivastatin (Baycol), citalopram (Celexa), felodipine (Plendil), fexofenadine (Allegra), itraconazole (Sporanox), ketoconazole (Nizoral), lansoprazole (Prevacid), losartan (Cozaar), lovastatin (Mevacor), ondansetron (Zofran), prednisone (Deltasone, Orasone), sertraline (Zoloft), sibutramine (Meridia), sildenafil (Viagra), simvastatin (Zocor), verapamil (Calan, Covera-HS, Isoptin), and many others.
Severity Moderate 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 situation with Ofev (nintedanib) and Bishop's Weed. A compound in this plant called bergapten can slow down a liver enzyme (CYP3A4) that helps clear nintedanib from your body. In theory, blocking that pathway could let nintedanib levels creep up, which may mean more of its common side effects, things like diarrhea, nausea, vomiting, belly pain, loss of appetite, and changes in liver enzyme tests.

I want to be honest about the strength here: this is mostly based on lab data and theory, not strong human studies, so the real-world risk is uncertain. Still, nintedanib is already a tough drug on the stomach, so I wouldn't add Bishop's Weed without checking with your doctor or pharmacist first. Please don't change your Ofev on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther 2001;69:14-23. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Nintedanib Esylate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Bergapten, a constituent of bishop's weed, has antiplatelet activity. Theoretically, bishop's weed might have additive effects with anticoagulant or antiplatelet drugs and possibly increase the risk of bleeding.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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 thing to know about combining Bishop's Weed with Ofev (nintedanib). Nintedanib already carries a known risk of bleeding on its own, since it blocks signals that blood vessels use to grow and repair. Bishop's Weed contains a compound called bergapten that may have a mild blood-thinning effect of its own. So the worry is that, stacked together, they could nudge your bleeding risk a bit higher.

In real life, that might show up as easier bruising, nosebleeds, bleeding gums, or cuts that take longer to stop. I'll be honest with you, this concern is theoretical and based on how these compounds behave in the lab, not on proven cases. Still, since nintedanib is already a bleeding-risk drug, please loop in your doctor or pharmacist before mixing the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Dr. Duke's Phytochemical and Ethnobotanical Databases. Available at: http://www.ars-grin.gov/duke/.

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

Bishop's Weed Also Interacts With Other Medications

Bishop's Weed has 953 moderate known drug interactions in our database — the Nintedanib Esylate one above is among them. If you take anything else, check it against the full list below.

Moderate 953 No known interaction 1,877 (incl. Nintedanib Esylate)
Taking anything else?

Check Another of Your Medications Against Bishop's Weed

Covers the 2,830 medications we’ve checked against Bishop's Weed. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Bishop's Weed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

One more smart check

Taking Bishop's Weed as Part of a Dietary Supplement Product? Check It for Interactions

We hold 83 real supplement products containing Bishop's Weed, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bishop's Weed. Your product may carry other ingredients that interact with Nintedanib Esylate too, on top of Bishop's Weed — 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 Bishop's Weed and Nintedanib Esylate 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 Bishop's Weed
Top half

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

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,887 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 Bishop's Weed

What is Bishop's Weed?

Bishop's Weed
  • Vitiligo (loss of skin color)
  • Psoriasis
  • Digestive complaints
  • Asthma and breathing problems
  • Kidney stones
  • Diuretic (increasing urine)

Bishop's Weed (Ammi majus) is a flowering plant whose seeds contain natural light-sensitizing compounds called psoralens, which have been studied mainly for skin conditions like vitiligo and psoriasis when combined with light therapy. The plant is potentially toxic and can cause severe skin and eye reactions when exposed to sunlight, so it is not something to take on your own. If you are interested in psoralen-based treatments, work with a dermatologist rather than self-treating.

Read the full Bishop's Weed monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
Keep checking

Other Drugs & Bishop's Weed

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

0Major
953Moderate
0Minor
1,876No known interaction
953 Moderate 1,876 No interaction
Moderate

953 interactions

Showing 60 of 953 moderate interactions — see all 953 on the Bishop's Weed page.

No interaction 1,876 drugs checked — show the list

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

Showing the 60 most looked-up of 1,876 medications checked with no known interaction — see the full Bishop's Weed list.

See the full Bishop's Weed interactions page
See every supplement checked against Nintedanib Esylate, 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
Bishop's Weed monograph › Uses, safety, and every drug interaction in one place Nintedanib Esylate supplement interactions › Every supplement checked against Nintedanib Esylate, ranked by severity Nintedanib 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 Bishop's Weed and Nintedanib Esylate Together: Common Questions

Can you take Bishop's Weed with Nintedanib Esylate?
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.
Why are there 2 interactions listed for Bishop's Weed and Nintedanib Esylate?
Nintedanib Esylate belongs to more than one drug category, and Bishop's Weed 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 Bishop's Weed and Nintedanib Esylate 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.