Drug & supplement interaction

Ceylon Leadwort + Emapalumab-Lzsg

Emapalumab-Lzsg brand name: Gamifant.

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

Ceylon Leadwort has a moderate interaction with Emapalumab-Lzsg. Plumbagin, a constituent of Ceylon leadwort, has demonstrated immunosuppressant activity in animal research.

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

Ceylon Leadwort and Emapalumab-Lzsg

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Emapalumab-Lzsg

Emapalumab-Lzsg falls under IMMUNOSUPPRESSANTS — the group Ceylon Leadwort interacts with.

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 situation with Gamifant (emapalumab-lzsg): it's a powerful infused antibody that calms an overactive immune system in people with HLH, a serious and life-threatening condition. The concern with Ceylon Leadwort is that one of its compounds, plumbagin, has shown immune-affecting activity in lab and animal studies. In theory, layering it on top of an immunosuppressant could nudge how the immune system responds, though we honestly don't have human data to say what really happens.

I want to be straight with you: this is a theoretical worry, not something proven in people. But given how delicate HLH treatment is, I would not mix anything herbal in without your specialist's blessing. Please loop in your doctor or pharmacist before adding Ceylon Leadwort.

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

Moderate 1,096 No known interaction 1,734 (incl. Emapalumab-Lzsg)
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 Emapalumab-Lzsg

This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Emapalumab-Lzsg page lists 53 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate), Andrographis (moderate) and Ashwagandha (moderate).

By severity: 52 moderate · 1 minor.

From our pharmacist’s overview on the Emapalumab-Lzsg page

“Emapalumab-lzsg (Gamifant) quiets an immune system that has turned dangerously overactive in a rare condition called hemophagocytic lymphohistiocytosis. All 53 supplement interactions on file share a single theme, a possible boost to immune activity that could work against the drug.”

Reviewed by 2 · Jul 18, 2026

Open the Emapalumab-Lzsg 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 Emapalumab-Lzsg 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 Emapalumab-Lzsg 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

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

29 days ago today
Medication Emapalumab-Lzsg
Top 25%

#409 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 Emapalumab-lzsg Injection

What Is Emapalumab-lzsg Injection Used For?

Brand name: Gamifant

Gamifant is used to treat primary hemophagocytic lymphohistiocytosis (HLH) — a rare, life-threatening condition where the immune system becomes dangerously overactivated — in adults and children whose disease has not responded to, has come back during, or has progressed on standard HLH therapy, or who cannot tolerate it.

Gamifant is also used for HLH/macrophage activation syndrome (MAS) in adults and children with known or suspected Still's disease, including systemic Juvenile Idiopathic Arthritis (sJIA), when glucocorticoids (steroid medicines) have not worked well enough, cannot be tolerated, or when MAS keeps coming back.

See full Emapalumab-lzsg Injection 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 Emapalumab-Lzsg, 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 Emapalumab-Lzsg supplement interactions › Every supplement checked against Emapalumab-Lzsg, ranked by severity Emapalumab-lzsg Injection 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 Emapalumab-Lzsg Together: Common Questions

Can you take Ceylon Leadwort with Emapalumab-Lzsg?
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 Ceylon Leadwort and Emapalumab-Lzsg 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 Emapalumab-Lzsg 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.