Drug & supplement interaction

Bupleurum + Mirikizumab-mrkz

Mirikizumab-mrkz brand name: Omvoh.

Moderate Interaction
The bottom line Moderate

Bupleurum has a moderate interaction with Mirikizumab-mrkz. 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 Mirikizumab-mrkz

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Mirikizumab-mrkz

Mirikizumab-mrkz 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 thing to keep in mind with Omvoh (mirikizumab). It's a targeted antibody medicine that calms an overactive immune system to control ulcerative colitis. Bupleurum works in the opposite direction. Lab and animal studies hint that it may stimulate immune activity, so in theory it could push back against what your Omvoh is trying to do and make the medicine work less well.

If that happened, you might notice your gut symptoms creeping back, things like more frequent stools, cramping, or blood. I want to be honest though: this concern comes only from test-tube and animal research, not from studies in people, so it's more of a theoretical caution than a proven problem. Before adding bupleurum, please run it by your doctor or pharmacist first.

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 Mirikizumab-mrkz one above is one of them. If you take anything else, check it against the full list below.

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 Mirikizumab-mrkz

This page covers Bupleurum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mirikizumab-mrkz page lists 89 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Beer (major), Siberian Cocklebur (major), Wine (major), Active Hexose Correlated Compound (ahcc) (moderate) and Alfalfa (moderate).

By severity: 3 major · 85 moderate · 1 minor.

From our pharmacist’s overview on the Mirikizumab-mrkz page

“Mirikizumab (Omvoh) treats inflammatory bowel disease by dialing down part of the immune system, and its interaction list deserves genuine wariness, most of all around the liver. The three most serious entries, Siberian cocklebur plus beer and wine, all raise the odds of liver damage when combined with a medication that can stress the…”

Reviewed by 2 · Jul 18, 2026

Open the Mirikizumab-mrkz 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 Mirikizumab-mrkz 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 Mirikizumab-mrkz 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%

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

29 days ago today
Medication Mirikizumab-mrkz
Steady interest

#2,310 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 Mirikizumab-Mrkz

What Is Mirikizumab-Mrkz Used For?

Brand name: Omvoh

Omvoh (mirikizumab-mrkz) is used to treat moderately to severely active ulcerative colitis in adults — a condition where the large intestine becomes chronically inflamed and ulcerated. It is also used to treat moderately to severely active Crohn's disease in adults, another form of inflammatory bowel disease that can affect any part of the digestive tract.

Both uses are specific to Omvoh administered by injection — first as intravenous (into the vein) infusions to start treatment, then as subcutaneous (under the skin) injections for ongoing maintenance.

See full Mirikizumab-Mrkz 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
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
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

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Pharmacist Counseling Corner

Taking Bupleurum and Mirikizumab-mrkz Together: Common Questions

Can you take Bupleurum with Mirikizumab-mrkz?
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 Mirikizumab-mrkz 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

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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.