Drug & supplement interaction

Cranberry + Lefamulin Acetate

Lefamulin Acetate brand name: Xenleta.

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

Cranberry has a moderate interaction with Lefamulin Acetate. Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.

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

Cranberry and Lefamulin Acetate

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Lefamulin Acetate

Lefamulin Acetate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Cranberry interacts with.

Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.
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 basics: your body uses an enzyme called CYP3A4 to help break down lefamulin (Xenleta). The idea on file is that cranberry might slow that enzyme down a little, which could let lefamulin build up slightly higher than expected. In theory that might mean a bit more chance of side effects like nausea, diarrhea, or changes in your heart's rhythm (QT prolongation), which lefamulin can cause.

That said, I want to keep this in perspective. The evidence here is weak and mostly theoretical, based on a single case with a different drug plus some animal data. Most people drinking normal amounts of cranberry juice won't notice anything. Lefamulin is also usually a short hospital-style course, so it's a brief overlap. Still, mention any cranberry supplements to your pharmacist or doctor just to be safe.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
  2. Doad GJ, Kabange W. Cranberry juice, atorvastatin and back pain. J Med Assoc Ga 2014;103(1):14.

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

Cranberry Also Interacts With Other Medications

Cranberry has 642 moderate, 69 minor known drug interactions in our database — the Lefamulin Acetate one above is one of them. If you take anything else, check it against the full list below.

Moderate 642 Minor 69 No known interaction 2,119 (incl. Lefamulin Acetate)
Taking anything else?

Check Another of Your Medications Against Cranberry

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

From our Q&A

Questions About Cranberry or Lefamulin Acetate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cranberry or Lefamulin Acetate, 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 Lefamulin Acetate

This page covers Cranberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lefamulin Acetate page lists 178 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 130 moderate · 40 minor.

From our pharmacist’s overview on the Lefamulin Acetate page

“Before adding any supplement to lefamulin acetate (Xenleta), a short-course antibiotic for pneumonia, look hard at the eight major-rated entries among its 178 documented interactions. They cluster around two dangers: ingredients that change how much lefamulin reaches your blood, and ingredients that can stretch the heart's rhythm on to…”

Reviewed by 2 · Jul 18, 2026

Open the Lefamulin Acetate interaction page

One more smart check

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

We hold 5,249 real supplement products containing Cranberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cranberry. Your product may carry other ingredients that interact with Lefamulin Acetate too, on top of Cranberry — 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 Cranberry and Lefamulin Acetate 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 Cranberry
Top 5%

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

29 days ago today
Medication Lefamulin Acetate
Top 25%

#688 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 Cranberry

What is Cranberry?

Cranberry
  • Urinary tract infection prevention
  • Bladder health
  • Antioxidant support
  • Source of vitamin C

Cranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an active UTI, which usually needs antibiotics. For most people cranberry products are well tolerated, but check with a pharmacist before relying on them, especially if you have frequent infections.

Read the full Cranberry monograph & all interactions
Medication

About Lefamulin Injection

What Is Lefamulin Injection Used For?

Brand name: Xenleta

Xenleta Injection is approved for treating community-acquired bacterial pneumonia (CABP) — a type of lung infection caught outside of a hospital — in adults. It targets specific bacteria known to cause this infection, including Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible strains), Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.

Xenleta Injection is given intravenously (by IV infusion) and is only intended for bacterial infections — it will not work against viral illnesses like the flu or COVID-19.

See full Lefamulin Injection drug information
Keep checking

Other Drugs & Cranberry

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

0Major
642Moderate
69Minor
2,118No known interaction
642 Moderate 69 Minor 2,118 No interaction
Moderate

642 interactions

Showing 60 of 642 moderate interactions — see all 642 on the Cranberry page.

Minor

69 interactions

Showing 60 of 69 minor interactions — see all 69 on the Cranberry page.

No interaction 2,118 drugs checked — show the list

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

Showing the 60 most looked-up of 2,118 medications checked with no known interaction — see the full Cranberry list.

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

Can you take Cranberry with Lefamulin Acetate?
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 Cranberry and Lefamulin Acetate 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 Lefamulin Acetate and Cranberry?

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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.