Drug & supplement interaction

Dusty Miller + Apalutamide

Apalutamide brand name: Erleada.

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

Dusty Miller has a moderate interaction with Apalutamide. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in dusty miller.

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

Dusty Miller and Apalutamide

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Apalutamide

Apalutamide falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Dusty Miller interacts with.

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in dusty miller.
Dusty miller contains PAs. PAs are substrates of CYP3A4. Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites.
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 thing to know about this combo. Apalutamide (Erleada) is a strong CYP3A4 inducer, meaning it revs up that liver enzyme. Dusty Miller contains pyrrolizidine alkaloids, and those compounds get turned into toxic, liver-damaging byproducts by that very same enzyme. So in theory, taking apalutamide could speed up how much of Dusty Miller's harmful breakdown products your body makes, which could mean more strain on your liver.

I want to be honest that this is a theoretical concern based on lab data, not real patient cases. Even so, Dusty Miller isn't considered safe to take on its own because of those liver-toxic compounds. My honest advice: skip it, and check with your oncology team or pharmacist before trying any product made from it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  2. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. 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

Dusty Miller Also Interacts With Other Medications

Dusty Miller has 86 moderate known drug interactions in our database — the Apalutamide one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Apalutamide)
Taking anything else?

Check Another of Your Medications Against Dusty Miller

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

Everything else you take

See Every Supplement That Interacts With Apalutamide

This page covers Dusty Miller only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Apalutamide page lists 155 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).

By severity: 3 major · 113 moderate · 39 minor.

From our pharmacist’s overview on the Apalutamide page

“Apalutamide (Erleada) treats prostate cancer, and it only works when its blood level stays where it should, so approach this list with genuine care. Three of the 155 ingredients on file are rated major: grapefruit can push apalutamide levels up, St.”

Reviewed by 2 · Jul 18, 2026

Open the Apalutamide interaction page

How much people look this up

Where Dusty Miller and Apalutamide 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 Dusty Miller
Steady interest

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

29 days ago today
Medication Apalutamide
Steady interest

#1,961 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 Dusty Miller

What is Dusty Miller?

  • Cataracts (traditional eye use)
  • Eye irritation and inflammation
  • Wound healing (folk use)
  • Menstrual complaints (folk use)

Dusty Miller is a silvery ornamental plant that has been used in folk medicine, mainly as an eye remedy for cataracts and irritation. There is no reliable scientific evidence that it works, and the plant contains compounds (pyrrolizidine alkaloids) that can be toxic, so it is not considered safe for self-treatment. Talk to a pharmacist or doctor before using any product made from it.

Read the full Dusty Miller monograph & all interactions
Medication

About Apalutamide

What Is Apalutamide Used For?

Brand name: Erleada

Erleada (apalutamide) is used to treat two types of prostate cancer. The first is metastatic castration-sensitive prostate cancer (mCSPC) — prostate cancer that has spread to other parts of the body and still responds to hormone-lowering therapy. The second is non-metastatic castration-resistant prostate cancer (nmCRPC) — prostate cancer that has stopped responding to standard hormone therapy but has not yet spread to other organs.

Erleada is always used alongside a gonadotropin-releasing hormone (GnRH) analog — a medicine that lowers testosterone — or in patients who have already had surgery to remove the testicles.

See full Apalutamide drug information
Keep checking

Other Drugs & Dusty Miller

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Dusty Miller page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Dusty Miller list.

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

Can you take Dusty Miller with Apalutamide?
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 Dusty Miller and Apalutamide 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 Apalutamide and Dusty Miller?

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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.