Drug & supplement interaction

Cat's Claw + Ritlecitinib

Ritlecitinib brand name: Litfulo.

Moderate Interaction
The bottom line Moderate

Ritlecitinib falls into 2 drug categories that Cat's Claw can interact with; the most serious is rated moderate. Theoretically, cat's claw might increase or decrease the levels and effects of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cat's Claw and Ritlecitinib

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

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Why this applies to Ritlecitinib

Ritlecitinib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Cat's Claw interacts with.

Theoretically, cat's claw might increase or decrease the levels and effects of drugs metabolized by CYP3A4.
Cat's claw may affect the clearance of drugs metabolized by CYP3A4. In vitro research shows that cat's claw can inhibit CYP3A4 enzymes. In one case report, a patient taking cat's claw (at an unspecified dose) experienced increased serum levels of atazanavir, ritonavir, and saquinavir, all of which are CYP3A4 substrates. Levels returned to normal 15 days after discontinuation of the cat's claw supplement, suggesting inhibition of CYP3A4 by cat's claw. In contrast, animal research suggests that rhynchophylline, an alkaloid contained in cat's claw, induces CYP3A expression and accelerates the metabolism of nirmatrelvir, the active component in the nirmatrelvir/ritonavir combination product.
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 short version: Litfulo (ritlecitinib) is partly cleared by a liver enzyme called CYP3A4, and cat's claw has been shown in lab studies to tinker with that same enzyme. It isn't a prodrug, so if cat's claw slows CYP3A4 down, ritlecitinib could build up a bit and you might notice more of its usual effects, things like headache, acne, or a higher chance of infections. Interestingly, one animal study suggested the opposite, that cat's claw could speed the enzyme up and weaken the drug.

The honest truth is this is theoretical, based mostly on lab and animal work plus one case report with other medicines, not on studies with ritlecitinib itself. I wouldn't panic, but since this drug affects your immune system, it's worth a quick chat with your pharmacist or doctor before combining them.

References
  1. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  2. Müller AC, Kanfer I. Potential pharmacokinetic interactions between antiretrovirals and medicinal plants used as complementary and African traditional medicines. Biopharm Drug Dispos. 2011;32(8):458-70. PubMed
  3. Lei S, Guo A, Lu J, et al. Activation of PXR causes drug interactions with Paxlovid in transgenic mice. Acta Pharm Sin B 2023;13(11):4502-4510. PubMed
Moderate

IMMUNOSUPPRESSANTS

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Ritlecitinib also falls under IMMUNOSUPPRESSANTS.

Theoretically, cat's claw might interfere with immunosuppressive therapy.
In human and laboratory research, cat's claw has been shown to have immunostimulating activity. It stimulates phagocytosis and increases respiratory cellular activity and the mobility of leukocytes. Theoretically, this could interfere with the activity of immunosuppressant medications.
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: Litfulo (ritlecitinib) works by calming down part of your immune system. It's prescribed for severe alopecia areata to stop your immune cells from attacking your hair follicles. Cat's claw seems to do the opposite. In lab and animal studies, it has shown immune-stimulating activity, meaning it revs up certain immune cells. Theoretically, that could push against what ritlecitinib is trying to accomplish and make it work less well.

I'll be honest, this is a theoretical concern based on early lab research, not strong human proof, so I don't want to alarm you. But since these two pull in opposite directions, it's worth a quick chat with your pharmacist or dermatologist before adding cat's claw. Please don't stop or change your Litfulo on your own.

References
  1. Sandoval M, Charbonnet RM, Okuhama NN, et al. Cat's claw inhibits TNFalpha production and scavenges free radicals: role in cytoprotection. Free Radic Biol Med 2000;29:71-78.
  2. Sheng, Y., Bryngelsson, C., and Pero, R. W. Enhanced DNA repair, immune function and reduced toxicity of C-MED-100, a novel aqueous extract from Uncaria tomentosa. J Ethnopharmacol. 2000;69(2):115-126. PubMed
  3. Lamm, S., Sheng, Y., and Pero, R. W. Persistent response to pneumococcal vaccine in individuals supplemented with a novel water soluble extract of Uncaria tomentosa, C-Med-100. Phytomedicine 2001;8(4):267-274.
  4. Sheng, Y., Li, L., Holmgren, K., and Pero, R. W. DNA repair enhancement of aqueous extracts of Uncaria tomentosa in a human volunteer study. Phytomedicine 2001;8(4):275-282.

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

Cat's Claw Also Interacts With Other Medications

Cat's Claw has 961 moderate known drug interactions in our database — the Ritlecitinib 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 Cat's Claw

Covers the 2,830 medications we’ve checked against Cat's Claw. Pick one to open its full report.

From our Q&A

Questions About Cat's Claw or Ritlecitinib

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cat's Claw or Ritlecitinib, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ritlecitinib

This page covers Cat's Claw only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ritlecitinib page lists 192 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 151 moderate · 38 minor.

From our pharmacist’s overview on the Ritlecitinib page

“For anyone on ritlecitinib (Litfulo), the immune-calming pill for severe alopecia areata, I would treat this page with real care, starting with its three major-rated entries. Grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Ritlecitinib interaction page

One more smart check

Taking Cat's Claw as Part of a Dietary Supplement Product? Check It for Interactions

We hold 910 real supplement products containing Cat's Claw, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cat's Claw. Your product may carry other ingredients that interact with Ritlecitinib too, on top of Cat's Claw — 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 Cat's Claw and Ritlecitinib 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 Cat's Claw
Top 25%

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

29 days ago today
Medication Ritlecitinib
Steady interest

#2,563 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 Cat's Claw

What is Cat's Claw?

Cat's Claw
  • Osteoarthritis and rheumatoid arthritis
  • Inflammation
  • Immune support
  • Digestive complaints
  • General wellness/tonic

Cat's claw is a South American vine traditionally used for inflammation, joint pain, and immune support. Some small studies hint it may help with arthritis symptoms, but the overall evidence is limited and not strong enough to confirm clear benefits. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Cat's Claw monograph & all interactions
Keep checking

Other Drugs & Cat's Claw

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

0Major
961Moderate
0Minor
1,868No known interaction
Moderate

961 interactions

Showing 60 of 961 moderate interactions — see all 961 on the Cat's Claw page.

No interaction 1,868 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 Cat's Claw and Ritlecitinib Together: Common Questions

Can you take Cat's Claw with Ritlecitinib?
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 Cat's Claw and Ritlecitinib?
Ritlecitinib belongs to more than one drug category, and Cat's Claw 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 Cat's Claw and Ritlecitinib 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 Ritlecitinib and Cat's Claw?

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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.