Drug & supplement interaction

Cubebs + Esomeprazole Magnesium

Esomeprazole Magnesium brand name: Nexium 24hr.

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

Esomeprazole Magnesium 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 Esomeprazole Magnesium

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. Esomeprazole Magnesium 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 Esomeprazole Magnesium

Esomeprazole Magnesium 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

Here's the gist with Nexium (esomeprazole). Your body clears this acid-reducer partly through a liver enzyme called CYP3A4. Some compounds in cubeb berries have been shown to slow that enzyme down, but only in lab dish studies. Nothing like this has actually been seen in real people, and esomeprazole leans more heavily on a different enzyme (CYP2C19) anyway.

In theory, if cubebs slowed CYP3A4, a little more esomeprazole could linger, which might mean slightly stronger effects or minor side effects like headache, nausea, or stomach upset. Honestly, the everyday spice amount you'd use in food is very unlikely to matter. If you're thinking about concentrated cubeb oil or extracts, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
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

Esomeprazole Magnesium 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

Here's the simple version. Esomeprazole (Nexium 24hr) works by shutting down the little acid pumps in your stomach lining, which lowers how much acid you make. The theory on file is that cubebs may nudge your stomach to produce more acid. If that happens, it could work against what the medicine is trying to do, so you might notice your usual heartburn or reflux symptoms creeping back.

I want to be honest about how shaky this is. It's rated minor and rests only on anecdotal reports, not solid studies. A bit of cubeb as a kitchen spice is very unlikely to matter. Concentrated extracts or oils are the bigger question mark. If you plan to use those regularly, run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Esomeprazole Magnesium one above is among them. If you take anything else, check it against the full list below.

Moderate 642 Minor 22 No known interaction 2,166 (incl. Esomeprazole Magnesium)
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 Esomeprazole Magnesium

This page covers Cubebs only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esomeprazole Magnesium page lists 154 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

Open the Esomeprazole Magnesium 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 Esomeprazole Magnesium 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 Esomeprazole Magnesium 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

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

29 days ago today
Medication Esomeprazole Magnesium
Steady interest

#2,055 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
642 Moderate 22 Minor 2,165 No 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

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

Showing the 60 most looked-up of 2,165 medications checked with no known interaction — see the full Cubebs list.

See the full Cubebs interactions page
See every supplement checked against Esomeprazole Magnesium, 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
Cubebs monograph › Uses, safety, and every drug interaction in one place Esomeprazole Magnesium supplement interactions › Every supplement checked against Esomeprazole Magnesium, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Cubebs and Esomeprazole Magnesium Together: Common Questions

Can you take Cubebs with Esomeprazole Magnesium?
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 Esomeprazole Magnesium?
Esomeprazole Magnesium 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 Esomeprazole Magnesium 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.