Drug & supplement interaction

Colocynth + Avatrombopag Maleate

Avatrombopag Maleate brand name: Doptelet.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Colocynth and Avatrombopag Maleate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Avatrombopag Maleate states a food rule worth keeping to.

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Interaction report

Colocynth and Avatrombopag Maleate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Avatrombopag Maleate and Colocynth in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Colocynth safety at a glance

Colocynth overall Avoid Colocynth is a strong irritant and poison that can cause severe gut damage and death.

Pregnancy Avoid It may stimulate the uterus and is considered unsafe in pregnancy.

Breastfeeding Unsafe When used orally due to severe gastrointestinal toxicity; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Avatrombopag Maleate and Colocynth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Avatrombopag Maleate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Avatrombopag Maleate is filed under 2 classifications — p-glycoprotein substrates, oral drugs. Colocynth has documented interactions with 5 drug classes — the most serious being antidiabetes drugs (moderate), digoxin (lanoxin) (moderate) and diuretic drugs (moderate) — and none of Avatrombopag Maleate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Colocynth Does Interact With Other Medications

Colocynth has 185 moderate known drug interactions in our database — Avatrombopag Maleate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 185 No known interaction 2,645 (incl. Avatrombopag Maleate)

Taking anything else?

Check Another of Your Medications Against Colocynth

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

What to actually watch for

What Colocynth Itself Has Been Linked To

This is not an interaction — nothing below involves Avatrombopag Maleate. It is the side-effect record for Colocynth on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Colocynth, this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

Seizures / Kidney problems Worth acting on Additional detail

“Orally, colocynth is generally regarded as unsafe. Topically, colocynth seems to be well tolerated when used short-term.

Most Common Adverse Effects:

Orally: Diarrhea.

Serious Adverse Effects (Rare):

Orally: Bloody diarrhea, hemorrhagic cystitis, kidney damage, convulsions, paralysis, death.”

Colocynth · Natural Medicines adverse-effect record, reported in diarrhea.
Itching Additional detail
“Topically, mild pruritus has been reported in one patient that used a sesame oil-based colocynth fruit extract in a small clinical study.”

Colocynth · Natural Medicines adverse-effect record, reported in pruritus.
1 source cited

98602. Heydari M, Homayouni K, Hashempur MH, Shams M. Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: A double-blind randomized placebo-controlled clinical trial. J Diabetes. 2016;8(2):246-52. DOI
Diarrhea Additional detail
“Orally, ingestion of colocynth 0.6-1 grams can cause severe irritation of the gastric mucosa and bloody diarrhea (2,18). Cases of bloody diarrhea and intestinal cramps have been reported in case reports of individuals consuming the fresh fruit, the 'size of an orange' or unknown amounts of the extract. Colocynth ingestion can also cause acute toxic colitis.”

Colocynth · Natural Medicines adverse-effect record, reported in diarrhea.
5 sources cited

2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

98601. Khan SA, Shelleh HH, Bhat AR, Bhat KS. Colocynth toxicity. A possible cause of bloody diarrhea. Saudi Med J. 2003;24(8):904-6. DOI

10653. Goldfain D, Lavergne A, Galian A, et al. Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Gut 1989;30:1412-18.. PubMed

98604. Huseini HF, Darvishzadeh F, Heshmat R, Jafariazar Z, Raza M, Larijani B. The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial. Phytot

Everything above comes from the Natural Medicines adverse-effect record for Colocynth — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Avatrombopag Maleate’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Avatrombopag Maleate column appears here.

Special populations

Colocynth in Pregnancy & Breastfeeding

Lactation Unsafe

When used orally due to severe gastrointestinal toxicity; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Avatrombopag Maleate Products Have a Food Rule — Colocynth Should Not Break It

At least one FDA label for a product containing Avatrombopag Maleate says to take it with food. If you take Colocynth on an empty stomach out of habit, keep them separate — and take Avatrombopag Maleate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Avatrombopag Maleate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Administer DOPTELET tablets and DOPTELET SPRINKLE with food.

From the Dosage and Administration section of the FDA label we read for Avatrombopag Maleate — where that label names a specific product, the instruction is that product's. See the Avatrombopag Maleate drug page ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Avatrombopag Maleate Is Prescribed For, and What Colocynth Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Avatrombopag Maleate is a prescription medicine with approved uses on its FDA label. Colocynth is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Avatrombopag Maleate is prescribed for: Avatrombopag treats thrombocytopenia (a low platelet count that raises bleeding risk) in three groups of patients. Doptelet tablets are used in adults with chronic liver disease who need their platelet count raised before a medical procedure, and in adults with chronic immune thrombocytopenia (ITP) whose platelet count has not responded well enough to earlier treatments. Doptelet tablets are also used in children aged 6 years and older with persistent or chronic ITP who have not responded to prior treatment. Doptelet Sprinkle (oral granules) is specifically indicated for children aged 1 year to less than 6 years with persistent or chronic ITP who have not responded adequately to a previous treatment.

Colocynth has been studied for:

Liver disease studied, not established Colocynth has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

Colocynth for liver disease

Although there has been interest in using oral colocynth for liver disease, there is insufficient reliable information about the clinical effects of colocynth for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Avatrombopag Maleate on your own; if you are taking Colocynth for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Avatrombopag Maleate

This page covers Colocynth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Avatrombopag Maleate page lists 54 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), Bitter Melon (moderate), Black Pepper (moderate) and Bulbine Natalensis (moderate).

By severity: 2 major · 35 moderate · 17 minor.

From our pharmacist’s overview on the Avatrombopag Maleate page

“Avatrombopag maleate (Doptelet) exists to raise a low platelet count, so anything that drags its blood level down invites the bleeding risk it was prescribed to prevent. I would handle this list of 54 supplements with real care, and the two rated major come first.”

Reviewed by 2 · Jul 18, 2026

Open the Avatrombopag Maleate interaction page

One more smart check

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

We hold 2 real supplement products containing Colocynth, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Colocynth. Even though Colocynth itself has no known interaction with Avatrombopag Maleate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Colocynth and Avatrombopag Maleate 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 Colocynth

Top half

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

29 days ago today

Medication Avatrombopag Maleate

Steady interest

#2,001 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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Colocynth reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Colocynth and Avatrombopag Maleate records this page draws on were last updated July 11, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Colocynth

What is Colocynth?

Constipation
Digestive complaints
Diabetes (traditional use)
Joint and nerve pain
Skin conditions

Colocynth is a bitter desert gourd used in traditional medicine mainly as a powerful laxative, but it is highly toxic and can cause severe, sometimes deadly poisoning even at small doses. There is not enough good human evidence to support its use, and most pharmacists would advise against taking it. If you are curious about it, talk to a doctor or pharmacist before using any product that contains it.

Citrullus colocynthis · Cucurbitaceae · Fruit (pulp), seeds, and root · Dried fruit pulp, powder, capsules, traditional and homeopathic preparations

An interaction check asks whether these two react with each other — it does not ask whether Colocynth is a good idea for someone in your situation. Here is what our Colocynth record says about it on its own.

Colocynth: dosing

There is no established safe dose of colocynth for general use, and most health authorities and pharmacists do not recommend taking it at all because of its toxicity. Never take raw colocynth fruit, pulp, or seeds.

From our Colocynth monograph — the full record covers uses, side effects and every documented interaction.

Read the full Colocynth monograph & all interactions

Medication

About Avatrombopag

What Is Avatrombopag Used For?

Brand name: Doptelet

Avatrombopag treats thrombocytopenia (a low platelet count that raises bleeding risk) in three groups of patients. Doptelet tablets are used in adults with chronic liver disease who need their platelet count raised before a medical procedure, and in adults with chronic immune thrombocytopenia (ITP) whose platelet count has not responded well enough to earlier treatments. Doptelet tablets are also used in children aged 6 years and older with persistent or chronic ITP who have not responded to prior treatment.

Doptelet Sprinkle (oral granules) is specifically indicated for children aged 1 year to less than 6 years with persistent or chronic ITP who have not responded adequately to a previous treatment.

See full Avatrombopag drug information

Keep checking

Other Drugs & Colocynth

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

0Major

185Moderate

0Minor

2,644No known interaction

185 Moderate 2,644 No interaction

Moderate

185 interactions

Showing 60 of 185 moderate interactions — see all 185 on the Colocynth page.

No interaction 2,644 drugs checked — show the list

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

Showing the 60 most looked-up of 2,644 medications checked with no known interaction — see the full Colocynth list.

See the full Colocynth interactions page

See every supplement checked against Avatrombopag Maleate, ranked by severity

Evidence & sources

Colocynth References

The 9 references that drive our Colocynth monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Osol and Farar. The Dispensatory of the United States of America. 25th ed. JB Lippincott Co., 1955.
Goldfain D, Lavergne A, Galian A, et al. Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Gut 1989;30:1412-18.. PubMed
Li Y, Zheng M, Zhai X, et al. Effect of Gymnema Sylvester, Citrullus colocynthis and Artemisa absinthum on blood glucose and lipid profile in diabetic human. Acta Pol Pharm. 2015;72(5):981-5.
Khan SA, Shelleh HH, Bhat AR, Bhat KS. Colocynth toxicity. A possible cause of bloody diarrhea. Saudi Med J. 2003;24(8):904-6. DOI
Heydari M, Homayouni K, Hashempur MH, Shams M. Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: A double-blind randomized placebo-controlled clinical trial. J Diabetes. 2016;8(2):246-52. DOI
Huseini HF, Darvishzadeh F, Heshmat R, Jafariazar Z, Raza M, Larijani B. The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial. Phytot

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Colocynth and Avatrombopag Maleate Together: Common Questions

Is it safe to take Colocynth with Avatrombopag Maleate?

We do not list a known interaction between Colocynth and Avatrombopag Maleate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Should I take Colocynth and Avatrombopag Maleate at the same time of day?

At least one FDA label for a product containing Avatrombopag Maleate says to take it with food. If you take Colocynth on an empty stomach out of habit, keep them separate and take Avatrombopag Maleate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Avatrombopag Maleate products can differ — so check the directions on your own box. This is about absorption, not an interaction.

Are Colocynth and Avatrombopag Maleate used for the same thing?

They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Colocynth in each. That is a conversation for your prescriber, especially if Avatrombopag Maleate is being adjusted to a target.

How was the Colocynth and Avatrombopag Maleate combination checked?

Interactions in our licensed database are recorded against drug classes. Avatrombopag Maleate is filed under 2 classifications, and Colocynth has documented interactions with 5 drug classes — none of Avatrombopag Maleate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.

Does Colocynth interact with any other medications?

Yes. Colocynth has 185 documented drug interactions in our database — Avatrombopag Maleate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Does Avatrombopag Maleate interact with any supplements?

Yes. Avatrombopag Maleate has documented interactions with 54 supplements in our database — Colocynth is not one of them. The Avatrombopag Maleate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Colocynth monograph Uses, safety profile, and every drug interaction in one place Avatrombopag drug information The full plain-English guide to this medication Avatrombopag Maleate supplement interactions Every supplement checked against Avatrombopag Maleate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Avatrombopag Maleate and Colocynth?

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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.