Drug & supplement interaction

Ceylon Leadwort + Cyclophosphamide

Cyclophosphamide brand names: Cytoxan, Neosar.

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

Cyclophosphamide falls into 2 drug categories that Ceylon Leadwort can interact with; the most serious is rated moderate. Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

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

Ceylon Leadwort and Cyclophosphamide

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

Why Are There 2 Interactions?

Ceylon Leadwort interacts with whole categories of medication. Cyclophosphamide falls into 2 of those categories, so it can interact with Ceylon Leadwort 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

1 of 2

Why this applies to Cyclophosphamide

Cyclophosphamide falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Ceylon Leadwort interacts with.

Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro. So far, this interaction has not been reported in humans. Theoretically, Ceylon leadwort might increase the levels of drugs metabolized by CYP3A4. Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), clarithromycin (Biaxin), indinavir (Crixivan), sildenafil (Viagra), triazolam (Halcion), and numerous others.
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 tricky part with cyclophosphamide: it's actually a prodrug, meaning your body has to switch it on using liver enzymes (mainly CYP2B6, but CYP3A4 plays a role too) before it can fight cancer. Ceylon Leadwort contains plumbagin, which has slowed down CYP3A4 in lab dishes. In theory, blocking that enzyme could shift how much active drug your body makes, and with a powerful chemo medicine, even small changes in activation or breakdown could mean either reduced cancer-fighting effect or more toxicity like low blood counts, nausea, or bladder irritation.

I'll be honest with you: this is only test-tube evidence and has never been seen in real patients. Still, with chemo there's no room to guess. Please don't add this supplement without first clearing it with your oncology team.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
Moderate

IMMUNOSUPPRESSANTS

2 of 2

Cyclophosphamide also falls under IMMUNOSUPPRESSANTS.

Plumbagin, a constituent of Ceylon leadwort, has demonstrated immunosuppressant activity in animal research. Theoretically, Ceylon leadwort might interfere with immunosuppressive therapy. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
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 honest picture with Ceylon Leadwort and cyclophosphamide. The plant's main compound, plumbagin, has shown some immune-calming activity, but only in lab dishes and animal studies. Whether that does anything in a real person is unknown, so think of this as a theoretical concern, not a proven one.

The general worry is that an herb with immune effects could nudge your immune-related treatment in an unpredictable direction. Cyclophosphamide is powerful chemotherapy used for serious conditions, and your care team doses and monitors it very carefully. Adding an unstudied botanical with potential tissue-irritating effects isn't worth the gamble. Please don't add Ceylon Leadwort while you're on this drug without first clearing it with your oncologist or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mandavkar, YD, Jalalpure, SS. A comprehensive review on Plumbago zeylanica Linn. African J. Pharmacy and Pharmacology. 2011;5(25):2738-2747. DOI
  2. Checker R, Sharma D, Sandur SK, Khanam S, Poduval TB. Anti-inflammatory effects of plumbagin are mediated by inhibition of NF-kappaB activation in lymphocytes. Int Immunopharmacol. 2009 Jul;9(7-8):949-58. PubMed
  3. Jia Y, Jing J, Bai Y, Li Z, Liu L, Luo J, Liu M, Chen H. Amelioration of experimental autoimmune encephalomyelitis by plumbagin through down-regulation of JAK-STAT and NF-?B signaling pathways. PLoS One. 2011;6(10):e27006. PubMed
  4. Poosarla A, D N R, Athota RR, Sunkara VG. Modulation of T cell proliferation and cytokine response by Plumbagin, extracted from Plumbago zeylanica in collagen induced arthritis. BMC Complement Altern Med. 2011 Nov 16;11:114. 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

Ceylon Leadwort Also Interacts With Other Medications

Ceylon Leadwort has 1,096 moderate known drug interactions in our database — the Cyclophosphamide one above is among them. If you take anything else, check it against the full list below.

Moderate 1,096 No known interaction 1,734 (incl. Cyclophosphamide)
Taking anything else?

Check Another of Your Medications Against Ceylon Leadwort

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

Everything else you take

See Every Supplement That Interacts With Cyclophosphamide

This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cyclophosphamide page lists 220 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 176 moderate · 38 minor.

Open the Cyclophosphamide interaction page

One more smart check

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

We hold 96 real supplement products containing Ceylon Leadwort, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ceylon Leadwort. Your product may carry other ingredients that interact with Cyclophosphamide too, on top of Ceylon Leadwort — 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 Ceylon Leadwort and Cyclophosphamide 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 Ceylon Leadwort
Top half

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

29 days ago today
Medication Cyclophosphamide
Steady interest

#1,830 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 Ceylon Leadwort

What is Ceylon Leadwort?

  • Digestive complaints and poor appetite
  • Skin conditions and wounds (applied to the skin)
  • Joint pain and swelling
  • Traditional 'metabolism-boosting' tonics
  • Antimicrobial folk remedy

Ceylon Leadwort (Plumbago zeylanica) is a plant long used in Ayurvedic and other traditional medicine systems, mainly for digestion, skin problems, and pain. Solid human studies are lacking, and the plant contains plumbagin, a compound that can irritate skin and tissues and may be unsafe in larger amounts. Talk to a pharmacist or doctor before using it, and avoid it in pregnancy.

Read the full Ceylon Leadwort monograph & all interactions
Medication

About Cyclophosphamide

What Is Cyclophosphamide Used For?

Brand names: Cytoxan, Neosar

Cyclophosphamide is used to treat many types of cancer in adults and children, including malignant lymphomas (such as Hodgkin's disease and Burkitt's lymphoma), multiple myeloma, several forms of leukemia, breast cancer, ovarian cancer, neuroblastoma, retinoblastoma, and advanced mycosis fungoides (a type of skin lymphoma). It is often given alongside other chemotherapy drugs rather than on its own.

Oral and injectable powder formulations (but not the Cyclophosphamide Injection solution concentrate) are also approved for minimal change nephrotic syndrome — a kidney condition — in children who have not responded well to, or cannot tolerate, steroid therapy. The injectable solution concentrate is approved for adult patients only due to its alcohol content, and is not approved for use in children.

See full Cyclophosphamide drug information
Keep checking

Other Drugs & Ceylon Leadwort

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

0Major
1,096Moderate
0Minor
1,733No known interaction
1,096 Moderate 1,733 No interaction
Moderate

1,096 interactions

Showing 60 of 1,096 moderate interactions — see all 1,096 on the Ceylon Leadwort page.

No interaction 1,733 drugs checked — show the list

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

Showing the 60 most looked-up of 1,733 medications checked with no known interaction — see the full Ceylon Leadwort list.

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

Can you take Ceylon Leadwort with Cyclophosphamide?
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 Ceylon Leadwort and Cyclophosphamide?
Cyclophosphamide belongs to more than one drug category, and Ceylon Leadwort 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 Ceylon Leadwort and Cyclophosphamide 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 Cyclophosphamide and Ceylon Leadwort?

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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.