Drug & supplement interaction

European Barberry + Ibrutinib

Ibrutinib brand name: Imbruvica.

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

Ibrutinib falls into 2 drug categories that European Barberry can interact with; the most serious is rated moderate. Theoretically, European barberry might increase the levels and clinical effects of CYP3A4 substrates.

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

European Barberry and Ibrutinib

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Ibrutinib

Ibrutinib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group European Barberry interacts with.

Theoretically, European barberry might increase the levels and clinical effects of CYP3A4 substrates.
There is very preliminary evidence suggesting that berberine, a constituent of European barberry, might inhibit the CYP3A4 enzyme. Theoretically, European barberry might have a similar effect.
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 your situation. Ibrutinib (Imbruvica) is cleared from your body mainly by a liver enzyme called CYP3A4. Berberine, the main active compound in European barberry, may slow that enzyme down. If it does, ibrutinib could build up to higher levels than intended, and that can mean more of its known side effects: easy bruising or bleeding, diarrhea, fatigue, muscle and joint aches, infections, or heart rhythm changes.

I want to be honest about how strong this is. The evidence here is theoretical, based on how berberine behaves in lab studies, not proven in real patients. Still, because ibrutinib is a serious cancer medicine where higher levels matter, I'd play it safe. Please check with your oncologist or pharmacist before adding barberry or any berberine supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Ibrutinib also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, European barberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal evidence suggest that berberine, a constituent of European barberry, might inhibit platelet aggregation. Theoretically, European barberry might have a similar effect.
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 thing to keep in mind with Imbruvica (ibrutinib): one of its known side effects is a higher chance of bruising and bleeding. It can lower your platelets and make small bumps turn into big bruises, so anything else that nudges bleeding risk in the same direction is worth a second look.

European barberry contains berberine, and in lab and animal studies berberine seems to make platelets a little less sticky. Put that next to ibrutinib's own bleeding effect and, in theory, you could see more bruising, nosebleeds, or bleeding gums. I want to be honest, though: this is a theoretical concern based on test-tube and animal data, not strong human studies. Still, since you're on a cancer therapy, please run any barberry or berberine supplement past your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kostalova, D., Bukovsky, M., Koscova, H., and Kardosova, A. [Anticomplement activity of Mahonia aquifolium bisbenzylisoquinoline alkaloids and berberine extract]. Ceska.Slov.Farm 2001;50(6):286-289.
  2. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  3. Xuan, B., Wang, W., and Li, D. X. Inhibitory effect of tetrahydroberberine on platelet aggregation and thrombosis. Zhongguo Yao Li Xue.Bao. 1994;15(2):133-135.
  4. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.

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

European Barberry Also Interacts With Other Medications

European Barberry has 1,209 moderate known drug interactions in our database — the Ibrutinib one above is among them. If you take anything else, check it against the full list below.

Moderate 1,209 No known interaction 1,621 (incl. Ibrutinib)
Taking anything else?

Check Another of Your Medications Against European Barberry

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

Everything else you take

See Every Supplement That Interacts With Ibrutinib

This page covers European Barberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibrutinib page lists 282 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 236 moderate · 41 minor.

From our pharmacist’s overview on the Ibrutinib page

“Ibrutinib (Imbruvica) treats blood cancers such as chronic lymphocytic leukemia, and because the drug itself makes bruising and bleeding more likely, adding the wrong supplement here can carry real consequences. Most of the entries below have blood-thinning or antiplatelet activity that stacks on top of that built-in bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Ibrutinib interaction page

One more smart check

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

We hold 2 real supplement products containing European Barberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides European Barberry. Your product may carry other ingredients that interact with Ibrutinib too, on top of European Barberry — 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 European Barberry and Ibrutinib 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 European Barberry
Top half

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

29 days ago today
Medication Ibrutinib
Top 25%

#527 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 European Barberry

What is European Barberry?

European Barberry
  • Digestive upset
  • Antimicrobial support
  • Blood sugar support
  • Cholesterol and metabolic support
  • Skin conditions

European barberry is a shrub whose root, bark, and berries contain berberine, a bitter plant alkaloid that has been studied mostly in isolated form. Some early research on berberine is promising for blood sugar and cholesterol, but high-quality evidence for the whole barberry herb is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full European Barberry monograph & all interactions
Medication

About Ibrutinib

What Is Ibrutinib Used For?

Brand name: Imbruvica

Imbruvica (ibrutinib) is used in adults to treat chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), including cases with a specific genetic change called 17p deletion. It is also used in adults to treat Waldenström's macroglobulinemia (WM), a rare type of slow-growing blood cancer.

Imbruvica is also approved for adults and children aged 1 year and older with chronic graft-versus-host disease (cGVHD) — a serious immune complication that can occur after a stem cell or bone marrow transplant — when at least one prior treatment has not worked.

See full Ibrutinib drug information
Keep checking

Other Drugs & European Barberry

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

0Major
1,209Moderate
0Minor
1,620No known interaction
1,209 Moderate 1,620 No interaction
Moderate

1,209 interactions

Showing 60 of 1,209 moderate interactions — see all 1,209 on the European Barberry page.

No interaction 1,620 drugs checked — show the list

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

Showing the 60 most looked-up of 1,620 medications checked with no known interaction — see the full European Barberry list.

See the full European Barberry interactions page
See every supplement checked against Ibrutinib, 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
European Barberry monograph › Uses, safety, and every drug interaction in one place Ibrutinib supplement interactions › Every supplement checked against Ibrutinib, ranked by severity Ibrutinib 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 European Barberry and Ibrutinib Together: Common Questions

Can you take European Barberry with Ibrutinib?
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 European Barberry and Ibrutinib?
Ibrutinib belongs to more than one drug category, and European Barberry 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 European Barberry and Ibrutinib 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 Ibrutinib and European Barberry?

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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.