Drug & supplement interaction

Dusty Miller + Carbamazepine

Carbamazepine brand names: Tegretol, Tegretol XR, Equetro, Carbatrol, Carnexiv.

Moderate Interaction
The bottom line Moderate

Dusty Miller has a moderate interaction with Carbamazepine. 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 Carbamazepine

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Carbamazepine

Carbamazepine 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 concern with this pairing, and the bigger issue is really the Dusty Miller itself. This plant contains pyrrolizidine alkaloids (PAs), which can be harmful to the liver. Your body uses an enzyme called CYP3A4 to process these PAs, and unfortunately that process can turn them into toxic byproducts.

Carbamazepine is a strong CYP3A4 inducer, meaning it revs up that enzyme. In theory, that could speed up the formation of these toxic PA metabolites and raise the risk of liver damage. I want to be honest that this concern is theoretical and based only on lab studies, not real-world cases. Still, Dusty Miller isn't considered safe to take on its own. Please don't use any Dusty Miller product without first checking with your doctor or pharmacist.

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 Carbamazepine one above is one of them. If you take anything else, check it against the full list below.

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.

From our Q&A

Questions About Dusty Miller or Carbamazepine

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

This page covers Dusty Miller only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Carbamazepine page lists 284 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 12 major · 235 moderate · 37 minor.

From our pharmacist’s overview on the Carbamazepine page

“Carbamazepine (Tegretol, Carbatrol, Equetro) only controls seizures and mood episodes when its blood level stays inside a tight window, and 284 supplement and herbal ingredients on file can disturb that balance, 12 of them rated major. Grapefruit can push carbamazepine levels up, St.”

Reviewed by 2 · Jul 18, 2026

Open the Carbamazepine interaction page

How much people look this up

Where Dusty Miller and Carbamazepine 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
Top half

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

29 days ago today
Medication Carbamazepine
Top 25%

#434 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 Carbamazepine

What Is Carbamazepine Used For?

Brand names: Tegretol, Tegretol XR, Equetro, Carbatrol, Carnexiv

Carbamazepine is used to treat certain types of seizures — including partial seizures, generalized tonic-clonic (grand mal) seizures, and mixed seizure patterns. It works best for those specific seizure types; it does not appear to control absence (petit mal) seizures.

It is also prescribed to relieve the intense facial pain of trigeminal neuralgia — a nerve condition that causes sudden, severe pain along the face. It is not a general painkiller and shouldn't be used for ordinary aches and pains.

See full Carbamazepine 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
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
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 Dusty Miller and Carbamazepine Together: Common Questions

Can you take Dusty Miller with Carbamazepine?
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 Carbamazepine 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.