Drug & supplement interaction

Breadfruit + Cabotegravir, Rilpivirine

Cabotegravir, Rilpivirine brand name: Cabenuva.

Moderate Interaction
The bottom line Moderate

Cabotegravir, Rilpivirine falls into 2 drug categories that Breadfruit can interact with; the most serious is rated moderate. Breadfruit might increase the levels of drugs metabolized by uridine diphosphoglucuronosyl transferase (UGT).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Breadfruit and Cabotegravir, Rilpivirine

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

Why Are There 2 Interactions?

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

Moderate

GLUCURONIDATED DRUGS

1 of 2

Why this applies to Cabotegravir, Rilpivirine

Cabotegravir, Rilpivirine falls under GLUCURONIDATED DRUGS — the group Breadfruit interacts with.

Breadfruit might increase the levels of drugs metabolized by uridine diphosphoglucuronosyl transferase (UGT). So far, this interaction has not been reported in humans. However, in vitro evidence shows that the breadfruit constituent artocarpin inhibits UGT. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Some drugs that are metabolized through glucuronide conjugation include acetaminophen (Tylenol, others) and oxazepam (Serax), haloperidol (Haldol), lamotrigine (Lamictal), morphine (MS Contin, Roxanol), zidovudine (AZT, Retrovir), 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 connection worth knowing. The cabotegravir piece of Cabenuva is partly cleared by a liver enzyme system called UGT (glucuronidation). A natural compound in breadfruit called artocarpin has been shown, in a test tube only, to slow that same enzyme down. In theory, if breadfruit blocked UGT, cabotegravir could hang around longer in your body, which might mean a bit more of its usual effects like injection-site soreness, headache, or feeling tired.

I want to keep this in perspective. This has never been seen in real people, and eating breadfruit as a normal food is very different from taking concentrated leaf teas or extracts. Since keeping HIV treatment steady really matters, just give your pharmacist or doctor a heads-up before using any breadfruit supplement product.

References
  1. Qu W, Liu X. Identification of cytochrome P450 isoforms involved in the metabolism of artocarpin and assessment of its drug-drug interaction. Biomed Chromatogr. 2018;32(4). PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cabotegravir, Rilpivirine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, breadfruit might inhibit cytochrome P450 3A4 (CYP3A4) and increase levels of drugs metabolized by these enzymes; until more is known, use with caution. In vitro, the breadfruit constituent artocarpin can inhibit CYP3A4 enzymes. Also, animal research shows that breadfruit leaf extract can weakly inhibit CYP3A4 enzymes. However, it is unclear if this inhibitory activity causes a clinically meaningful effect on the metabolism of CYP3A4 substrates.
Some drugs metabolized by CYP3A4 include amitriptyline (Elavil), amiodarone (Cordarone), citalopram (Celexa), felodipine (Plendil), lansoprazole (Prevacid), ondansetron (Zofran), prednisone (Deltasone), sertraline (Zoloft), and many others.
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 good news on this one. The concern is purely theoretical. In lab and animal studies, a compound in breadfruit called artocarpin showed weak ability to slow down the CYP3A4 enzyme. Rilpivirine, one half of your Cabenuva shots, is partly handled by that same enzyme. If breadfruit blocked it in real life, rilpivirine levels could creep up a bit, which in theory might mean more side effects like headache, nausea, trouble sleeping, or mood changes.

That said, there's no human evidence this actually happens, and eating breadfruit as a food is very different from taking concentrated leaf teas or extracts. I wouldn't lose sleep over enjoying the fruit. If you're thinking about breadfruit leaf supplements for blood pressure or sugar, just run it by your HIV provider or pharmacist first.

References
  1. Nwokocha CR, Owu DU, McLaren M, et al. Possible mechanisms of action of the aqueous extract of Artocarpus altilis (breadfruit) leaves in producing hypotension in normotensive Sprague-Dawley rats. Pharm Biol. 2012;50(9):1096-102.
  2. Qu W, Liu X. Identification of cytochrome P450 isoforms involved in the metabolism of artocarpin and assessment of its drug-drug interaction. Biomed Chromatogr. 2018;32(4). 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

Breadfruit Also Interacts With Other Medications

Breadfruit has 437 moderate, 504 minor known drug interactions in our database — the Cabotegravir, Rilpivirine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Breadfruit

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

Everything else you take

See Every Supplement That Interacts With Cabotegravir, Rilpivirine

This page covers Breadfruit only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cabotegravir, Rilpivirine page lists 134 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 7 major · 98 moderate · 29 minor.

From our pharmacist’s overview on the Cabotegravir, Rilpivirine page

“Cabenuva, the long-acting injection of cabotegravir and rilpivirine given every month or two, keeps HIV suppressed only while its blood levels hold steady, so the 134 supplement interactions on file here deserve real vigilance. St.”

Reviewed by 2 · Jul 18, 2026

Open the Cabotegravir, Rilpivirine interaction page

How much people look this up

Where Breadfruit and Cabotegravir, 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 Breadfruit
Top half

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

29 days ago today
Medication Cabotegravir, Rilpivirine
Top 10%

#282 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 Breadfruit

What is Breadfruit?

  • Source of nutrition and energy
  • High blood pressure
  • Diabetes and blood sugar support
  • Inflammation and joint discomfort
  • Skin conditions

Breadfruit is a starchy tropical fruit eaten as a staple food, and its leaves are used in traditional medicine for conditions like high blood pressure and diabetes. As a food it is nutritious and generally safe, but the medicinal use of leaf teas or extracts has very little human research to back it up. Talk with your pharmacist or doctor before using breadfruit products for a health condition.

Read the full Breadfruit monograph & all interactions
Medication

About Cabotegravir and Rilpivirine Injections

What Is Cabotegravir and Rilpivirine Injections Used For?

Brand name: Cabenuva

CABENUVA (cabotegravir + rilpivirine) is used to treat HIV-1 infection in adults and adolescents 12 years and older who weigh at least 35 kg (about 77 lbs). It is not a starter treatment — it's designed for people who are already virologically suppressed, meaning their HIV is currently undetectable on a stable daily pill regimen and who have no history of treatment failure.

The goal is to keep the virus fully suppressed while freeing the person from taking a pill every day. Because it stays active in the body for weeks after each injection, strict adherence to the injection schedule is essential.

See full Cabotegravir and Rilpivirine Injections drug information
Keep checking

Other Drugs & Breadfruit

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

0Major
437Moderate
504Minor
1,888No known interaction
Moderate

437 interactions

Showing 60 of 437 moderate interactions — see all 437 on the Breadfruit page.

Minor

504 interactions

Showing 60 of 504 minor interactions — see all 504 on the Breadfruit page.

No interaction 1,888 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Breadfruit and Cabotegravir, Rilpivirine Together: Common Questions

Can you take Breadfruit with Cabotegravir, Rilpivirine?
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 Breadfruit and Cabotegravir, Rilpivirine?
Cabotegravir, Rilpivirine belongs to more than one drug category, and Breadfruit 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 Breadfruit and Cabotegravir, Rilpivirine 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 Cabotegravir, Rilpivirine and Breadfruit?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.