Drug & supplement interaction

Eleuthero + Itraconazole

Itraconazole brand names: Sporanox, Sporanox Injection, Tolsura.

Moderate Interaction
The bottom line Moderate

Itraconazole falls into 2 drug categories that Eleuthero can interact with; the most serious is rated moderate. Theoretically, eleuthero might increase levels of P-glycoprotein substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Eleuthero and Itraconazole

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

Why Are There 2 Interactions?

Eleuthero interacts with whole categories of medication. Itraconazole falls into 2 of those categories, so it can interact with Eleuthero in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Itraconazole

Itraconazole falls under P-GLYCOPROTEIN SUBSTRATES — the group Eleuthero interacts with.

Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.
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 itraconazole (Sporanox, Tolsura) and eleuthero. Your body uses a little 'pump' called P-glycoprotein to move certain drugs back out of cells, and itraconazole rides along with that pump. Lab studies hint that eleuthero may slow that pump down. If that happened in real life, a bit more itraconazole could stick around, which in theory could mean stronger effects or more side effects like nausea, stomach upset, headache, or, less often, liver strain.

The honest part: this is based only on test-tube research and has never been reported in actual people, so it's more of a theoretical caution than a proven problem. Still, since itraconazole matters for clearing a real infection, it's worth a quick word with your pharmacist or doctor before combining them.

References
  1. Takahashi T, Kaku T, Sato T, et al. Effects of Acanthopanax senticosus HARMS extract on drug transport in human intestinal cell line Caco-2. J Nat Med. 2010;64(1):55-62. PubMed
  2. Freye E, GLeske J. Siberian ginseng results in beneficial effects on glucose metabolism in diabetes type 2 patients: a double blind placebo-controlled study in comparison to panax ginseng. Int J Clin Nutr. 2013;1(1):11-17.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Itraconazole also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the idea behind this pairing: your body uses an enzyme called CYP3A4 to break down and clear itraconazole. Eleuthero has shown, in lab dishes and animal studies, that it might slow that enzyme down. If that happened, itraconazole could build up a bit more than usual, which in theory could mean more of its typical side effects, like stomach upset, nausea, headache, or (less commonly) liver irritation.

But here's the reassuring part: when researchers actually gave eleuthero to healthy people for two weeks, it did not meaningfully affect CYP3A4. So this is mostly a theoretical concern, rated minor and unlikely. Still, since itraconazole already interacts with many things, it's worth a quick mention to your pharmacist or doctor before you combine them.

References
  1. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  2. Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. 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

Eleuthero Also Interacts With Other Medications

Eleuthero has 678 moderate, 461 minor known drug interactions in our database — the Itraconazole 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 Eleuthero

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

From our Q&A

Questions About Eleuthero or Itraconazole

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

This page covers Eleuthero only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Itraconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 136 moderate · 40 minor.

From our pharmacist’s overview on the Itraconazole page

“Serious fungal infections are what itraconazole (Sporanox, Tolsura) is for, and the drug travels through CYP3A4, the liver enzyme that also handles a large share of supplements. That overlap is why this list reaches 182 ingredients, and it earns genuine care; start with the six rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Itraconazole interaction page

One more smart check

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

We hold 3,795 real supplement products containing Eleuthero, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eleuthero. Your product may carry other ingredients that interact with Itraconazole too, on top of Eleuthero — 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 Eleuthero and Itraconazole 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 Eleuthero
Top 5%

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

29 days ago today
Medication Itraconazole
Top half

#845 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 Eleuthero

What is Eleuthero?

Eleuthero
  • Fatigue and low energy
  • Physical and athletic performance
  • Stress resistance (adaptogen)
  • Immune support
  • Mental focus and alertness

Eleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so it should not replace proven treatments. It is generally well tolerated short-term, but pregnant and breastfeeding people and those with certain conditions should avoid it or check with a healthcare provider first.

Read the full Eleuthero monograph & all interactions
Medication

About Itraconazole

What Is Itraconazole Used For?

Brand names: Sporanox, Sporanox Injection, Tolsura

Itraconazole capsules (including Sporanox capsules and generic itraconazole capsules) treat serious fungal infections — blastomycosis, histoplasmosis, and aspergillosis — in both people with normal immune systems and those who are immunocompromised. Capsule forms are also approved for nail fungus (onychomycosis) caused by dermatophytes in non-immunocompromised patients. Tolsura (a gelatin-coated capsule formulation) treats blastomycosis, histoplasmosis, and aspergillosis in adults, but is not approved for nail fungus and is not interchangeable with other itraconazole products.

Itraconazole oral solution is specifically approved for oropharyngeal candidiasis (thrush — a fungal infection of the mouth) and esophageal candidiasis (a fungal infection of the food pipe). Only the oral solution has been shown to work for these mouth and throat infections; capsules cannot be substituted for this use.

See full Itraconazole drug information
Keep checking

Other Drugs & Eleuthero

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

0Major
678Moderate
461Minor
1,690No known interaction
Moderate

678 interactions

Showing 60 of 678 moderate interactions — see all 678 on the Eleuthero page.

Minor

461 interactions

Showing 60 of 461 minor interactions — see all 461 on the Eleuthero page.

No interaction 1,690 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 Eleuthero and Itraconazole Together: Common Questions

Can you take Eleuthero with Itraconazole?
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 Eleuthero and Itraconazole?
Itraconazole belongs to more than one drug category, and Eleuthero 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 Eleuthero and Itraconazole 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 Itraconazole and Eleuthero?

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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.