Drug & supplement interaction

Bupleurum + Cladribine

Cladribine brand names: Leustatin, Mavenclad.

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

Bupleurum has a moderate interaction with Cladribine. Theoretically, bupleurum might decrease the effects of immunosuppressants.

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

Bupleurum and Cladribine

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Cladribine

Cladribine falls under IMMUNOSUPPRESSANTS — the group Bupleurum interacts with.

Theoretically, bupleurum might decrease the effects of immunosuppressants.
In vitro and animal research suggests that bupleurum might stimulate immune function.
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 simple version: Cladribine (Mavenclad) works by quieting down part of your immune system to calm the nerve attacks of MS. Bupleurum may pull in the opposite direction. In lab dishes and animal studies, it has been shown to give the immune system a little nudge upward.

So the worry is that bupleurum could work against what cladribine is trying to do, possibly making the medicine less effective at controlling your MS. I want to be honest, though: this is only a theoretical concern based on test-tube and animal research, not human studies, so we don't know if it truly happens in people. Since cladribine is a serious drug with careful dosing, I'd skip bupleurum and check with your neurologist or pharmacist before adding any herbal product.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Matsumoto T, Yamada H. Regulation of immune complexes binding of macrophages by pectic polysaccharide from Bupleurum falcatum L.: pharmacological evidence for the requirement of intracellular calcium/calmodulin on Fc receptor up-regulation by bupleuran 2
  2. Kato M, Pu MY, Isobe K, et al. Characterization of the immunoregulatory action of saikosaponin-d. Cell Immunol 1994;159:15-25. PubMed
  3. Ushio Y, Oda Y, Abe H. Effect of saikosaponin on the immune responses in mice. Int J Immunopharmacol 1991;13:501-8. 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

Bupleurum Also Interacts With Other Medications

Bupleurum has 326 moderate known drug interactions in our database — the Cladribine one above is one of them. If you take anything else, check it against the full list below.

Moderate 326 No known interaction 2,504 (incl. Cladribine)
Taking anything else?

Check Another of Your Medications Against Bupleurum

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

Everything else you take

See Every Supplement That Interacts With Cladribine

This page covers Bupleurum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cladribine page lists 70 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate) and Andrographis (moderate).

By severity: 1 major · 59 moderate · 10 minor.

From our pharmacist’s overview on the Cladribine page

“Cladribine (Leustatin, Mavenclad) treats hairy cell leukemia and relapsing multiple sclerosis by deliberately knocking down part of the immune system, so this list calls for real vigilance. Of the 70 supplements and herbs on file, 53 are immune stimulators, herbs like astragalus, ashwagandha, and ginseng that could push immunity back u…”

Reviewed by 2 · Jul 18, 2026

Open the Cladribine interaction page

One more smart check

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

We hold 89 real supplement products containing Bupleurum, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bupleurum. Your product may carry other ingredients that interact with Cladribine too, on top of Bupleurum — 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 Bupleurum and Cladribine 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 Bupleurum
Top half

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

29 days ago today
Medication Cladribine
Steady interest

#2,080 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 Bupleurum

What is Bupleurum?

Bupleurum
  • Liver and digestive support
  • Cold, flu, and fever
  • Inflammation
  • Stress and mood
  • Immune support

Bupleurum (Chai Hu) is a root used in traditional Chinese medicine, usually as part of multi-herb formulas, for liver, digestive, and fever-related complaints. High-quality human evidence for its benefits is limited, and it has been linked to lung and liver problems in some reports, so use it cautiously and only under professional guidance.

Read the full Bupleurum monograph & all interactions
Medication

About Cladribine

What Is Cladribine Used For?

Brand names: Leustatin, Mavenclad

Cladribine tablets (brand name Mavenclad) are used to treat relapsing forms of multiple sclerosis (MS) in adults — specifically relapsing-remitting MS and active secondary progressive MS. Because of its significant safety profile, it is generally reserved for patients who haven't responded well to, or can't tolerate, other MS medicines. It is not recommended for clinically isolated syndrome (CIS), a first episode that may or may not lead to MS.

Cladribine injection (given intravenously) is a separate product used to treat active hairy cell leukemia — a rare blood cancer — in patients who have clinically significant anemia, low white blood cell counts, low platelets, or disease-related symptoms.

See full Cladribine drug information
Keep checking

Other Drugs & Bupleurum

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

0Major
326Moderate
0Minor
2,503No known interaction
326 Moderate 2,503 No interaction
Moderate

326 interactions

Showing 60 of 326 moderate interactions — see all 326 on the Bupleurum page.

No interaction 2,503 drugs checked — show the list

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

Showing the 60 most looked-up of 2,503 medications checked with no known interaction — see the full Bupleurum list.

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

Can you take Bupleurum with Cladribine?
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 Bupleurum and Cladribine 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 Cladribine and Bupleurum?

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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.