Drug & supplement interaction

Eleuthero + Roflumilast

Roflumilast brand names: Daliresp, Zoryve.

Minor Interaction
The bottom line Minor

Eleuthero has a minor interaction with Roflumilast. 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 Roflumilast

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Roflumilast

Roflumilast 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 with eleuthero and roflumilast (Daliresp, Zoryve). Roflumilast is broken down in part by a liver enzyme called CYP3A4. Lab dish and animal studies hinted that eleuthero might slow that enzyme down, which in theory could let roflumilast build up a bit and bump up its usual side effects, things like nausea, diarrhea, headache, trouble sleeping, or weight loss.

But here's the reassuring part: when researchers actually tested eleuthero in healthy people, it did not meaningfully block CYP3A4. So this is a theoretical, low-likelihood concern rather than a proven problem. I still wouldn't start eleuthero without a quick word with your pharmacist or doctor, especially since your COPD treatment matters.

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 679 moderate, 460 minor known drug interactions in our database — the Roflumilast 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 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 Roflumilast

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 Roflumilast, 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 Roflumilast

This page covers Eleuthero only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Roflumilast page lists 141 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 · 96 moderate · 42 minor.

From our pharmacist’s overview on the Roflumilast page

“Roflumilast (Daliresp for severe COPD, Zoryve as a cream for skin conditions) is cleared almost entirely by one liver enzyme, CYP3A4, which is why 121 of the 141 supplements on this page can push its level up or down, and why real caution is warranted here. Start with the three rated major: grapefruit blocks that enzyme and can raise r…”

Reviewed by 2 · Jul 18, 2026

Open the Roflumilast 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 Roflumilast 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 Roflumilast 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 Roflumilast
Top half

#1,076 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 Roflumilast

What Is Roflumilast Used For?

Brand names: Daliresp, Zoryve

Daliresp and roflumilast tablets are used to reduce the risk of COPD (chronic obstructive pulmonary disease) flare-ups in adults with severe COPD linked to chronic bronchitis who have had flare-ups in the past. They are not rescue inhalers and will not relieve a sudden breathing attack.

Zoryve cream is used topically to treat plaque psoriasis (adults and children 2+) and mild to moderate atopic dermatitis (eczema) in adults and children as young as 2. Zoryve topical foam is used to treat seborrheic dermatitis (adults and children 9+) and plaque psoriasis of the scalp and body (adults and children 12+).

See full Roflumilast 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
679Moderate
460Minor
1,690No known interaction
Moderate

679 interactions

Showing 60 of 679 moderate interactions — see all 679 on the Eleuthero page.

Minor

460 interactions

Showing 60 of 460 minor interactions — see all 460 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 Roflumilast Together: Common Questions

Can you take Eleuthero with Roflumilast?
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 Roflumilast 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

Still Have a Question About Roflumilast 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.