Drug & supplement interaction

Boneset + Oritavancin Diphosphate

Oritavancin Diphosphate brand names: Orbactiv, Kimyrsa.

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

Boneset has a moderate interaction with Oritavancin Diphosphate. Boneset belongs to the genus Eupatorium, and many species of this genus contain hepatotoxic pyrrolizidine alkaloids (PAs).

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

Boneset and Oritavancin Diphosphate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Oritavancin Diphosphate

Oritavancin Diphosphate falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Boneset interacts with.

Boneset belongs to the genus Eupatorium, and many species of this genus contain hepatotoxic pyrrolizidine alkaloids (PAs). Hepatotoxic PAs are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), 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 understand about this pairing. Oritavancin (the active drug in Orbactiv and Kimyrsa) is known to gently speed up the CYP3A4 enzyme in your liver. Boneset can contain pyrrolizidine alkaloids, plant compounds that may be hard on the liver. Those compounds get processed by that very same enzyme. So the worry is that a faster-running enzyme could turn more of boneset's alkaloids into liver-damaging byproducts.

I want to be honest with you: this is a theoretical concern based on how these things work on paper, not on real patient studies. Oritavancin is also usually a one-time or short IV course, so the overlap is brief. Still, since boneset itself can stress the liver, I'd skip it during treatment and run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  2. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. 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

Boneset Also Interacts With Other Medications

Boneset has 86 moderate known drug interactions in our database — the Oritavancin Diphosphate one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Oritavancin Diphosphate)
Taking anything else?

Check Another of Your Medications Against Boneset

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

Everything else you take

See Every Supplement That Interacts With Oritavancin Diphosphate

This page covers Boneset only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Oritavancin Diphosphate page lists 48 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Alkanna (moderate), Alpine Ragwort (moderate), Bacillus Coagulans (moderate), Bacillus Subtilis (moderate) and Bifidobacterium Animalis Subsp. Lactis (moderate).

By severity: 47 moderate · 1 minor.

From our pharmacist’s overview on the Oritavancin Diphosphate page

“Oritavancin (Orbactiv, Kimyrsa) is a long-acting antibiotic given as a single IV infusion for serious skin infections, and because one dose stays in the body for days, supplement timing matters more than usual. Even so, none of the 48 ingredients on file rise past moderate, so for most people this list is about knowing what to watch ra…”

Reviewed by 2 · Jul 18, 2026

Open the Oritavancin Diphosphate interaction page

One more smart check

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

We hold 118 real supplement products containing Boneset, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Boneset. Your product may carry other ingredients that interact with Oritavancin Diphosphate too, on top of Boneset — 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 Boneset and Oritavancin Diphosphate 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 Boneset
Top half

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

29 days ago today
Medication Oritavancin Diphosphate
Steady interest

#2,299 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 Boneset

What is Boneset?

  • Colds and flu
  • Fever
  • Body aches
  • Congestion
  • Immune support

Boneset is a traditional North American herb long used in teas for fevers, colds, and flu, but modern human studies are very limited. It contains compounds (pyrrolizidine alkaloids) that may harm the liver, so it should be used cautiously and avoided during pregnancy and breastfeeding.

Read the full Boneset monograph & all interactions
Medication

About Oritavancin Injection

What Is Oritavancin Injection Used For?

Brand names: Orbactiv, Kimyrsa

Oritavancin injection — available as Orbactiv and Kimyrsa — is used to treat acute bacterial skin and skin structure infections (ABSSSI) in adults. These are serious skin infections caused by susceptible gram-positive bacteria, including Staphylococcus aureus (including MRSA), several Streptococcus species, and vancomycin-susceptible Enterococcus faecalis.

This antibiotic should only be used when a bacterial infection is confirmed or strongly suspected. Using it unnecessarily can contribute to antibiotic resistance.

See full Oritavancin Injection drug information
Keep checking

Other Drugs & Boneset

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Boneset page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Boneset list.

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

Can you take Boneset with Oritavancin Diphosphate?
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.
How serious is the Boneset and Oritavancin Diphosphate 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

Still Have a Question About Oritavancin Diphosphate and Boneset?

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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.