Drug & supplement interaction

Eucalyptus + Bedaquiline

Bedaquiline brand name: Sirturo.

Moderate Interaction
The bottom line Moderate

Eucalyptus has a moderate interaction with Bedaquiline. Theoretically, eucalyptus might increase the levels of CYP3A4 substrates.

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

Eucalyptus and Bedaquiline

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Bedaquiline

Bedaquiline falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Eucalyptus interacts with.

Theoretically, eucalyptus might increase the levels of CYP3A4 substrates.
In vitro research suggests that eucalyptus oil might inhibit CYP3A4, although this 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 for bedaquiline (Sirturo). Your body relies on a liver enzyme called CYP3A4 to clear this drug out. Some lab studies hint that eucalyptol, the active part of eucalyptus oil, might slow that enzyme down. If that happened in people, bedaquiline could build up a bit higher than expected. That matters here because higher bedaquiline levels can nudge the heart's rhythm (a QT change on the EKG) and may bother the liver, both things your TB team already watches closely.

Now, the honest part: this is only based on test-tube work, not real patients, so it's theoretical. Bedaquiline is not a prodrug, so it isn't flipped. Everyday vapor rubs or a cough lozenge are unlikely to be an issue, but never swallow the oil. Just mention any eucalyptus use to your pharmacist or TB doctor.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 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

Eucalyptus Also Interacts With Other Medications

Eucalyptus has 877 moderate known drug interactions in our database — the Bedaquiline 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 Eucalyptus

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

Everything else you take

See Every Supplement That Interacts With Bedaquiline

This page covers Eucalyptus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bedaquiline page lists 146 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 98 moderate · 40 minor.

From our pharmacist’s overview on the Bedaquiline page

“Someone months into bedaquiline (Sirturo) for drug-resistant tuberculosis is often exhausted and tempted by anything promising energy or immune support, and that is exactly where this list earns real care. Bedaquiline is cleared by the CYP3A4 enzyme and can stretch the heart's QT interval, and 121 of the 146 interacting ingredients tou…”

Reviewed by 2 · Jul 18, 2026

Open the Bedaquiline interaction page

One more smart check

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

We hold 216 real supplement products containing Eucalyptus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eucalyptus. Your product may carry other ingredients that interact with Bedaquiline too, on top of Eucalyptus — 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 Eucalyptus and Bedaquiline 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 Eucalyptus
Top half

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

29 days ago today
Medication Bedaquiline
Steady interest

#2,404 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 Eucalyptus

What is Eucalyptus?

Eucalyptus
  • Cough and chest congestion
  • Colds and flu symptoms
  • Stuffy nose
  • Sore throat
  • Minor muscle and joint aches
  • Aromatherapy

Eucalyptus is best known for its strong-smelling oil used in vapor rubs, inhalants, and lozenges to ease coughs and congestion. It may provide mild, short-term relief of cold symptoms, but the oil is toxic if swallowed and must never be taken by mouth undiluted. Talk to a pharmacist or doctor before using it, especially in children, during pregnancy, or while breastfeeding.

Read the full Eucalyptus monograph & all interactions
Medication

About Bedaquiline

What Is Bedaquiline Used For?

Brand name: Sirturo

Sirturo (bedaquiline) is used as part of a combination treatment for pulmonary TB — TB that affects the lungs — caused by bacteria resistant to at least both rifampin and isoniazid. It is approved for adults and for children 2 years and older who weigh at least 8 kg (about 17.6 lbs).

Sirturo is not used for latent TB (TB infection with no active symptoms), TB outside the lungs, drug-sensitive TB, or infections caused by non-tuberculosis mycobacteria. It must always be used alongside other TB medicines — never alone.

See full Bedaquiline drug information
Keep checking

Other Drugs & Eucalyptus

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

0Major
877Moderate
0Minor
1,952No known interaction
Moderate

877 interactions

Showing 60 of 877 moderate interactions — see all 877 on the Eucalyptus page.

No interaction 1,952 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 Eucalyptus and Bedaquiline Together: Common Questions

Can you take Eucalyptus with Bedaquiline?
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 Eucalyptus and Bedaquiline 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 Bedaquiline and Eucalyptus?

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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.