Drug & supplement interaction

Bupleurum + Ibrutinib

Ibrutinib brand name: Imbruvica.

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

Bupleurum has a moderate interaction with Ibrutinib. Theoretically, bupleurum might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.

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

Bupleurum and Ibrutinib

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Ibrutinib

Ibrutinib falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Bupleurum interacts with.

Theoretically, bupleurum might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research suggests that saikosaponins, constituents of bupleurum, can inhibit platelet aggregation.
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 concern with pairing Bupleurum and ibrutinib (Imbruvica). Ibrutinib already carries a real bleeding risk on its own, because it affects how your platelets stick together. People on it can notice easy bruising, nosebleeds, bleeding gums, or, less often, more serious bleeding. Lab studies hint that saikosaponins in bupleurum may also slow platelet clumping, so stacking the two could, in theory, add up to a higher bleeding tendency.

I want to be honest about the strength of this: it's a theoretical concern based on test-tube research, not solid human studies. Still, given that ibrutinib is a serious cancer medicine with its own bleeding effects, I'd play it safe. Please run any bupleurum or Chinese herbal formula past your oncologist or pharmacist before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hattori T, Ito M, Suzuki Y. [Studies on antinephritic effects of plant components in rats (1). Effects of saikosaponins original-type anti-GBM nephritis in rats and its mechanisms]. Nippon Yakurigaku Zasshi 1991;97:13-21. PubMed
  2. Chang WC, Hsu FL. Inhibition of platelet activation and endothelial cell injury by flavan-3-ol and saikosaponin compounds. Prostaglandins Leukot Essent Fatty Acids 1991;44:51-6. 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 Ibrutinib 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. Ibrutinib)
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 Ibrutinib

This page covers Bupleurum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibrutinib page lists 282 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 · 236 moderate · 41 minor.

From our pharmacist’s overview on the Ibrutinib page

“Ibrutinib (Imbruvica) treats blood cancers such as chronic lymphocytic leukemia, and because the drug itself makes bruising and bleeding more likely, adding the wrong supplement here can carry real consequences. Most of the entries below have blood-thinning or antiplatelet activity that stacks on top of that built-in bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Ibrutinib 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 Ibrutinib 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 Ibrutinib 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 25%

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

29 days ago today
Medication Ibrutinib
Top half

#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 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 Ibrutinib

What Is Ibrutinib Used For?

Brand name: Imbruvica

Imbruvica (ibrutinib) is used in adults to treat chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), including cases with a specific genetic change called 17p deletion. It is also used in adults to treat Waldenström's macroglobulinemia (WM), a rare type of slow-growing blood cancer.

Imbruvica is also approved for adults and children aged 1 year and older with chronic graft-versus-host disease (cGVHD) — a serious immune complication that can occur after a stem cell or bone marrow transplant — when at least one prior treatment has not worked.

See full Ibrutinib 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 Ibrutinib, 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 Ibrutinib supplement interactions › Every supplement checked against Ibrutinib, ranked by severity Ibrutinib 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 Ibrutinib Together: Common Questions

Can you take Bupleurum with Ibrutinib?
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 Ibrutinib 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 Ibrutinib 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.