Drug & supplement interaction

Catechu + Azathioprine

Azathioprine brand names: Imuran, Azamune.

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

Catechu has a moderate interaction with Azathioprine. Theoretically, catechu might interfere with immunosuppressant therapy.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Catechu and Azathioprine

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Azathioprine

Azathioprine falls under IMMUNOSUPPRESSANTS — the group Catechu interacts with.

Theoretically, catechu might interfere with immunosuppressant therapy.
Animal and in vitro studies suggest that catechu has immunomodulating effects.
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 with azathioprine (Imuran): its whole job is to quiet down your immune system, whether that's protecting a transplanted kidney or calming the joint attacks of rheumatoid arthritis. Catechu is interesting because lab and animal studies hint that it can nudge the immune system too, and that's where the worry comes from. If catechu were to push your immune activity in the opposite direction, it could, in theory, work against what azathioprine is trying to do.

I want to be honest with you, though: this is a theoretical concern, not something proven in people. We just don't have human studies here. Still, because azathioprine is such an important medicine, I'd skip concentrated catechu supplements and run it by your pharmacist or transplant/rheumatology team first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sunil MA, Sunitha VS, Ashitha A, et al. Catechin rich butanol fraction extracted from Acacia catechu L. (a thirst quencher) exhibits immunostimulatory potential. J Food Drug Anal. 2019;27(1):195-207. 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

Catechu Also Interacts With Other Medications

Catechu has 474 moderate known drug interactions in our database — the Azathioprine one above is one of them. If you take anything else, check it against the full list below.

Moderate 474 No known interaction 2,356 (incl. Azathioprine)
Taking anything else?

Check Another of Your Medications Against Catechu

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

Everything else you take

See Every Supplement That Interacts With Azathioprine

This page covers Catechu only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azathioprine page lists 106 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 4 major · 92 moderate · 10 minor.

From our pharmacist’s overview on the Azathioprine page

“Azathioprine (Imuran) quiets an overactive immune system, which is why people take it after a transplant or for autoimmune disease, and it is also why I read this interaction list with real caution. Fully half of the 106 supplements on file, 53 of them, appear because they stimulate immunity and could blunt the very effect you depend on.”

Reviewed by 2 · Jul 18, 2026

Open the Azathioprine interaction page

One more smart check

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

We hold 122 real supplement products containing Catechu, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Catechu. Your product may carry other ingredients that interact with Azathioprine too, on top of Catechu — 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 Catechu and Azathioprine 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 Catechu
Top half

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

29 days ago today
Medication Azathioprine
Top 25%

#605 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 Catechu

What is Catechu?

Catechu
  • Mouth and throat soreness
  • Diarrhea and digestive upset
  • Skin wounds and bleeding gums
  • Astringent gargles and rinses
  • Traditional remedy for inflammation

Catechu is an astringent extract made from the heartwood of the Acacia (Senegalia) catechu tree, used traditionally for mouth sores, sore throat, diarrhea, and minor skin problems. Strong human evidence is lacking for most uses, so it should be viewed as a traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Catechu monograph & all interactions
Medication

About Azathioprine

What Is Azathioprine Used For?

Brand names: Imuran, Azamune

Azathioprine is used alongside other medications to help prevent the body from rejecting a kidney transplant (renal homotransplantation). It is also used to treat active rheumatoid arthritis — reducing signs and symptoms in adults who have not responded well enough to other treatments.

Other pain relievers such as aspirin, NSAIDs, or low-dose steroids may be continued alongside azathioprine for rheumatoid arthritis. Combining azathioprine with disease-modifying antirheumatic drugs (DMARDs) has not been well studied and is not recommended.

See full Azathioprine drug information
Keep checking

Other Drugs & Catechu

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

0Major
474Moderate
0Minor
2,355No known interaction
474 Moderate 2,355 No interaction
Moderate

474 interactions

Showing 60 of 474 moderate interactions — see all 474 on the Catechu page.

No interaction 2,355 drugs checked — show the list

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

Showing the 60 most looked-up of 2,355 medications checked with no known interaction — see the full Catechu list.

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

Can you take Catechu with Azathioprine?
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 Catechu and Azathioprine 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 Azathioprine and Catechu?

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.