Drug & supplement interaction

Eleuthero + Ritlecitinib

Ritlecitinib brand name: Litfulo.

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

Ritlecitinib falls into 2 drug categories that Eleuthero can interact with; the most serious is rated moderate. Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.

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

Eleuthero and Ritlecitinib

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. Ritlecitinib 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

IMMUNOSUPPRESSANTS

1 of 2

Why this applies to Ritlecitinib

Ritlecitinib falls under IMMUNOSUPPRESSANTS — the group Eleuthero interacts with.

Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.
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

Litfulo (ritlecitinib) is a medicine that calms down an overactive immune system to help regrow hair in severe alopecia areata. Eleuthero works in the opposite direction, at least in theory. Lab and animal studies suggest it can rev the immune system up a bit. So the worry is that eleuthero could partly push against what ritlecitinib is trying to do, making it work a little less well.

I want to be honest that this is a theoretical concern based on how these two behave, not on real cases in people taking them together. Still, since the whole point of ritlecitinib is dampening immune activity, I'd loop in your pharmacist or dermatologist before adding eleuthero rather than starting it on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Schmolz, M. W., Sacher, F., and Aicher, B. The synthesis of Rantes, G-CSF, IL-4, IL-5, IL-6, IL-12 and IL-13 in human whole-blood cultures is modulated by an extract from Eleutherococcus senticosus L. roots. Phytother.Res 2001;15(3):268-270.
  2. Huang, D. B., Ran, R. Z., and Yu, Z. F. [Effect of Acanthopanax senticosus injection on the activities of human tumor necrosis factor and natural killer cell in blood in the patients with lung cancer]. Zhongguo Zhong.Yao Za Zhi. 2005;30(8):621-624.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Ritlecitinib 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 short version on Litfulo (ritlecitinib) and eleuthero. Ritlecitinib is an active drug (not a prodrug), and the body partly clears it through a liver enzyme called CYP3A4. The theory is that eleuthero could slow that enzyme down, which in turn could let ritlecitinib build up a bit and make side effects more likely, things like headaches, acne, or a higher chance of infections.

The good news is this concern is mostly on paper. It comes from lab and animal studies, and when researchers actually gave eleuthero to healthy people, it did not meaningfully change CYP3A4 activity. So a real problem here is unlikely. Still, since Litfulo affects your immune system, I'd mention any supplement to your pharmacist or doctor before adding it.

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 678 moderate, 461 minor known drug interactions in our database — the Ritlecitinib one above is among them. If you take anything else, check it against the full list below.

Moderate 678 Minor 461 No known interaction 1,691 (incl. Ritlecitinib)
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 Ritlecitinib

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 Ritlecitinib, 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 Ritlecitinib

This page covers Eleuthero only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ritlecitinib page lists 192 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 Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 151 moderate · 38 minor.

From our pharmacist’s overview on the Ritlecitinib page

“For anyone on ritlecitinib (Litfulo), the immune-calming pill for severe alopecia areata, I would treat this page with real care, starting with its three major-rated entries. Grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Ritlecitinib 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 Ritlecitinib 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 Ritlecitinib 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%

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

29 days ago today
Medication Ritlecitinib
Steady interest

#2,443 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
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
678 Moderate 461 Minor 1,690 No 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

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 1,690 medications checked with no known interaction — see the full Eleuthero list.

See the full Eleuthero interactions page
See every supplement checked against Ritlecitinib, 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 Ritlecitinib supplement interactions › Every supplement checked against Ritlecitinib, 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 Eleuthero and Ritlecitinib Together: Common Questions

Can you take Eleuthero with Ritlecitinib?
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 Ritlecitinib?
Ritlecitinib 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 Ritlecitinib 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 Ritlecitinib 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.