Bitter Melon - Zejula (Niraparib Tosylate) Interaction
Herbal: Bitter Melon
Also Known As: Momordica charantia, African Cucumber, Ampalaya, Balsam Pear, Balsam-Apple, Balsambirne, Balsamine, Balsamo, Bitter Cucumber, Bitter Gourd, Bittergurke, Carilla Gourd, Cerasee, Chinli-Chih, Cundeamor, Karavella, Karela, Kareli, Kathilla, Kerala, Korolla, Kugua, Kuguazi
Drug: Niraparib Tosylate
Brand names:
Zejula
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 11, 2025
Interaction Details
Niraparib Tosylate is classified as belonging to the following category: P-Glycoprotein Substrates
Theoretically, bitter melon might increase levels of P-glycoprotein substrates.
Bitter melon might inhibit the p-glycoprotein (P-gp) intestinal pump and increase intracellular levels of P-gp substrates. In vitro research in intestinal cells shows that 1-monopalmitin, a constituent of bitter melon, increases levels of daunomycin, a P-gp substrate. Additionally, drinking bitter melon juice has been associated with a case of acute pancreatitis in a patient who had been taking pazopanib, a P-gp substrate, for 8 years. Researchers theorize that inhibition of P-gp led to increased levels of pazopanib, resulting in pazopanib-induced pancreatitis.
Interaction Rating
Likelihood of Occurrence
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
References
- Konishi T, Satsu H, Hatsugai Y, et al. Inhibitory effect of a bitter melon extract on the P-glycoprotein activity in intestinal Caco-2 cells. Br J Pharmacol. 2004;143(3):379-87.
- Unsal O, Sütcüoglu O, Yazici O. Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: a case of acute pancreatitis. J Oncol Pharm Pract 2022;28(2):486-8.
Bitter Melon Overview
Bitter melon, also known as bitter gourd or karela, is a tropical fruit native to Asia, Africa, and the Caribbean. It is a long, green fruit with a bumpy exterior and flesh that is pale green or white in color.
In traditional medicine, bitter melon is purported to have a number of health benefits. It is a rich source of antioxidants and has been historically used as a natural remedy for a variety of ailments, including diabetes, asthma, and immune conditions.
Niraparib Tosylate Overview
-
Niraparib is used to help maintain the response of certain types of ovarian (female reproductive organs where eggs are formed), fallopian tube (tube that transports eggs released by the ovaries to the uterus), and peritoneal (layer of tissue that lines the stomach) cancer in people who have completely responded or partially responded to other chemotherapy medication(s). It is also used to treat certain types of ovarian, fallopian tube, or peritoneal cancer when the cancer has gotten worse after 3 or more chemotherapy treatments. Niraparib is in a class of medications called poly (ADP-ribose) polymerase (PARP) inhibitors. It works by killing cancer cells.
Bitter Melon - More Interactions
Bitter Melon interacts with 274 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
Return to the main supplement interaction checker page
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
Drug descriptions are provided by MedlinePlus.
Ask A Pharmacist About Your Herbal Questions!
Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
Ask A Pharmacist