Drug & supplement interaction

Cubebs + Amoxicillin, Omeprazole Magnesium, Rifabutin

Amoxicillin, Omeprazole Magnesium, Rifabutin brand name: Talicia.

Moderate Interaction
The bottom line Moderate

Amoxicillin, Omeprazole Magnesium, Rifabutin falls into 2 drug categories that Cubebs can interact with; the most serious is rated moderate. Several compounds isolated from cubebs can 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

Cubebs and Amoxicillin, Omeprazole Magnesium, Rifabutin

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

Why Are There 2 Interactions?

Cubebs interacts with whole categories of medication. Amoxicillin, Omeprazole Magnesium, Rifabutin falls into 2 of those categories, so it can interact with Cubebs 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 Amoxicillin, Omeprazole Magnesium, Rifabutin

Amoxicillin, Omeprazole Magnesium, Rifabutin falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Cubebs interacts with.

Several compounds isolated from cubebs can inhibit cytochrome P450 3A4 (CYP3A4) in vitro. So far, this effect has not been reported in humans. Theoretically, cubebs might increase the effects and side effects of drugs metabolized by CYP3A4. These include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), 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

Talicia is a three-drug combo for H. pylori, and the piece that matters here is rifabutin, which your body partly clears through an enzyme called CYP3A4. In lab dishes, certain compounds in cubebs can slow that same enzyme. If that happened in real life, rifabutin could build up a bit and you might see more of its typical effects, like stomach upset, a harmless reddish-orange color to urine or tears, or, less commonly, low blood counts. The amoxicillin and omeprazole pieces are not cleared this way and aren't really affected.

Here's the honest part: this is only seen in test-tube studies, never reported in actual people, so it's theoretical. A sprinkle of cubeb as a spice is very unlikely to matter. Concentrated cubeb oils or extracts are the bigger question, so check with your pharmacist or doctor before using those.

References
  1. Usia T, Watabe T, Kadota S, Tezuka Y. Potent CYP3A4 inhibitory constituents of Piper cubeba. J Nat Prod 2005;68(1):64-8.
Minor

PROTON PUMP INHIBITORS (PPIs)

2 of 2

Amoxicillin, Omeprazole Magnesium, Rifabutin also falls under PROTON PUMP INHIBITORS (PPIs).

Theoretically, due to reports that cubebs increases stomach acid, cubebs might decrease the effectiveness of PPIs. PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).
Severity Minor 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

Talicia is a three-in-one combo used to treat H. pylori stomach infections. It pairs two antibiotics (amoxicillin and rifabutin) with omeprazole, a proton pump inhibitor that lowers stomach acid. That acid-lowering part matters, because keeping acid down helps the antibiotics work better against the bug.

Here is the concern with cubebs: there are old, anecdotal reports that these peppery berries may bump up stomach acid. In theory, that could work against the omeprazole piece and make the whole treatment less effective. To be clear, this is weak, mostly traditional evidence, not solid proof. A sprinkle of cubeb as a spice is unlikely to matter much, but I would skip concentrated extracts or oils while on Talicia. Check with your pharmacist or doctor first.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Cubebs Also Interacts With Other Medications

Cubebs has 642 moderate, 22 minor known drug interactions in our database — the Amoxicillin, Omeprazole Magnesium, Rifabutin 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 Cubebs

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

Everything else you take

See Every Supplement That Interacts With Amoxicillin, Omeprazole Magnesium, Rifabutin

This page covers Cubebs only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amoxicillin, Omeprazole Magnesium, Rifabutin page lists 250 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Grapefruit (major) and Khat (major).

By severity: 8 major · 193 moderate · 49 minor.

From our pharmacist’s overview on the Amoxicillin, Omeprazole Magnesium, Rifabutin page

“Talicia combines amoxicillin, omeprazole, and rifabutin in one capsule to clear H. pylori, and because success depends on all three staying at full strength, the supplements flagged here warrant genuine care rather than a quick skim.”

Reviewed by 2 · Jul 18, 2026

Open the Amoxicillin, Omeprazole Magnesium, Rifabutin interaction page

One more smart check

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

We hold 19 real supplement products containing Cubebs, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cubebs. Your product may carry other ingredients that interact with Amoxicillin, Omeprazole Magnesium, Rifabutin too, on top of Cubebs — 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 Cubebs and Amoxicillin, Omeprazole Magnesium, Rifabutin 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 Cubebs
Top half

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

29 days ago today
Medication Amoxicillin, Omeprazole Magnesium, Rifabutin
Top half

#1,008 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 Cubebs

What is Cubebs?

Cubebs
  • Coughs and bronchitis
  • Indigestion and gas
  • Urinary tract complaints
  • Sore throat
  • Culinary spice

Cubebs are spicy, peppery berries from a vine in the pepper family that have long been used in traditional medicine for coughs, digestion, and urinary problems. Modern human studies are very limited, so its benefits are not well proven. Use it cautiously as a food spice, and talk to your pharmacist or doctor before using concentrated extracts or oils.

Read the full Cubebs monograph & all interactions
Keep checking

Other Drugs & Cubebs

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

0Major
642Moderate
22Minor
2,165No known interaction
Moderate

642 interactions

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

Minor

22 interactions

No interaction 2,165 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

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Pharmacist Counseling Corner

Taking Cubebs and Amoxicillin, Omeprazole Magnesium, Rifabutin Together: Common Questions

Can you take Cubebs with Amoxicillin, Omeprazole Magnesium, Rifabutin?
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 Cubebs and Amoxicillin, Omeprazole Magnesium, Rifabutin?
Amoxicillin, Omeprazole Magnesium, Rifabutin belongs to more than one drug category, and Cubebs 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 Cubebs and Amoxicillin, Omeprazole Magnesium, Rifabutin 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

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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.