Drug & supplement interaction

Eleuthero + Netupitant, Palonosetron (Oral)

Netupitant, Palonosetron (Oral) brand name: Akynzeo.

Minor Interaction
Medically reviewed by · Updated October 2026
The bottom line Minor

Eleuthero has a minor interaction with Netupitant, Palonosetron (Oral). Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Eleuthero and Netupitant, Palonosetron (Oral)

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Netupitant, Palonosetron (Oral)

Netupitant, Palonosetron (Oral) falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Eleuthero interacts with.

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 gist for Akynzeo (netupitant plus palonosetron). The netupitant part is cleared by a liver enzyme called CYP3A4. In test-tube and animal studies, eleuthero looked like it might slow that enzyme down a little, which in theory could let netupitant build up and lead to more of its usual side effects, like headache, constipation, tiredness, or weakness.

The good news is that when researchers actually tested eleuthero in healthy people, it did not meaningfully block CYP3A4. So this is mostly a paper concern, rated minor and unlikely. Still, since Akynzeo is part of your chemo care, it's worth a quick mention to your oncology team or pharmacist before adding eleuthero.

Contact Dr. Brian directly if you have additional questions on this interaction
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 680 moderate, 460 minor known drug interactions in our database — the Netupitant, Palonosetron (Oral) one above is one of them. If you take anything else, check it against the full list below.

Moderate 680 Minor 460 No known interaction 1,690 (incl. Netupitant, Palonosetron (Oral))
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 Netupitant, Palonosetron (Oral)

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 Netupitant, Palonosetron (Oral), 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 Netupitant, Palonosetron (Oral)

This page covers Eleuthero only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Netupitant, Palonosetron (Oral) page lists 158 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 5-htp (moderate).

By severity: 4 major · 113 moderate · 41 minor.

From our pharmacist’s overview on the Netupitant, Palonosetron (Oral) page

“Getting Akynzeo (netupitant and palonosetron) to work is the difference between finishing a chemotherapy cycle comfortably and losing days to nausea, so this list warrants genuine care. Most of it involves a liver enzyme, CYP3A4, that clears netupitant.”

Reviewed by 2 · Jul 18, 2026

Open the Netupitant, Palonosetron (Oral) 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 Netupitant, Palonosetron (Oral) 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 Netupitant, Palonosetron (Oral) 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%

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

29 days ago today
Medication Netupitant, Palonosetron (Oral)
Top 5%

#62 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 Netupitant and Palonosetron

What Is Netupitant and Palonosetron Used For?

Brand name: Akynzeo

Netupitant and palonosetron helps prevent nausea and vomiting from cancer chemotherapy in adults. It is used together with dexamethasone, a steroid medicine. It covers both the first day (acute phase) and the days after (delayed phase).

Akynzeo capsules are used for initial and repeat courses of chemotherapy, including highly emetogenic (strongly nausea-causing) chemotherapy. Akynzeo for injection and Akynzeo injection are used for highly emetogenic chemotherapy only. They have not been studied with anthracycline plus cyclophosphamide chemotherapy.

See full Netupitant and Palonosetron 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
680Moderate
460Minor
1,689No known interaction
680 Moderate 460 Minor 1,689 No interaction
Moderate

680 interactions

Showing 60 of 680 moderate interactions — see all 680 on the Eleuthero page.

Minor

460 interactions

Showing 60 of 460 minor interactions — see all 460 on the Eleuthero page.

No interaction 1,689 drugs checked — show the list

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

Showing the 60 most looked-up of 1,689 medications checked with no known interaction — see the full Eleuthero list.

See the full Eleuthero interactions page
See every supplement checked against Netupitant, Palonosetron (Oral), 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
Eleuthero monograph › Uses, safety, and every drug interaction in one place Netupitant, Palonosetron (Oral) supplement interactions › Every supplement checked against Netupitant, Palonosetron (Oral), ranked by severity Netupitant and Palonosetron 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 Eleuthero and Netupitant, Palonosetron (Oral) Together: Common Questions

Can you take Eleuthero with Netupitant, Palonosetron (Oral)?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Eleuthero and Netupitant, Palonosetron (Oral) interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.