Drug & supplement interaction

Evodia + Azelastine Hydrochloride, Fluticasone Propionate

Azelastine Hydrochloride, Fluticasone Propionate brand name: Dymista.

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

Evodia has a moderate interaction with Azelastine Hydrochloride, Fluticasone Propionate. Theoretically, evodia might increase the levels and clinical effects of CYP3A4 substrates.

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

Evodia and Azelastine Hydrochloride, Fluticasone Propionate

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Azelastine Hydrochloride, Fluticasone Propionate

Azelastine Hydrochloride, Fluticasone Propionate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Evodia interacts with.

Theoretically, evodia might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that evodia extract inhibits hepatic CYP3A4. This effect 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

Dymista is a nasal spray that combines azelastine, an antihistamine, with fluticasone, a steroid. The fluticasone part is partly broken down by a liver enzyme called CYP3A4. In lab dishes, evodia has been shown to slow that enzyme down. In theory, that could let a little more fluticasone linger in your body, which might mean slightly stronger steroid effects over time.

Here's the honest part: this has only been seen in test tubes, never confirmed in people, and a nasal spray puts very little medicine into your bloodstream to begin with. So I wouldn't lose sleep over it. Still, since human data is missing, it's worth a quick chat with your pharmacist or doctor before adding an evodia supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Iwata H, Tezuka Y, Kadota S, et al. Mechanism-based inactivation of human liver microsomal CYP3A4 by rutaecarpine and limonin from Evodia fruit extract. Drug Metab Pharmacokinet 2005;20:34-45. 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

Evodia Also Interacts With Other Medications

Evodia has 949 moderate known drug interactions in our database — the Azelastine Hydrochloride, Fluticasone Propionate one above is one of them. If you take anything else, check it against the full list below.

Moderate 949 No known interaction 1,881 (incl. Azelastine Hydrochloride, Fluticasone Propionate)
Taking anything else?

Check Another of Your Medications Against Evodia

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

Everything else you take

See Every Supplement That Interacts With Azelastine Hydrochloride, Fluticasone Propionate

This page covers Evodia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azelastine Hydrochloride, Fluticasone Propionate page lists 154 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lily-of-the-valley (major), St. John's Wort (major) and Acacia Rigidula (moderate).

By severity: 4 major · 110 moderate · 40 minor.

From our pharmacist’s overview on the Azelastine Hydrochloride, Fluticasone Propionate page

“Grapefruit is my first concern for anyone using Dymista (azelastine with fluticasone), the combination allergy nasal spray. The fluticasone in it is cleared by a liver enzyme called CYP3A4, and grapefruit blocks that enzyme well enough that steroid levels can climb.”

Reviewed by 2 · Jul 18, 2026

Open the Azelastine Hydrochloride, Fluticasone Propionate interaction page

One more smart check

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

We hold 182 real supplement products containing Evodia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Evodia. Your product may carry other ingredients that interact with Azelastine Hydrochloride, Fluticasone Propionate too, on top of Evodia — 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 Evodia and Azelastine Hydrochloride, Fluticasone Propionate 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 Evodia
Top half

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

29 days ago today
Medication Azelastine Hydrochloride, Fluticasone Propionate
Steady interest

#1,507 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 Evodia

What is Evodia?

  • Digestive upset and nausea
  • Headaches
  • Menstrual cramps
  • Abdominal pain
  • Diarrhea

Evodia is a fruit used in traditional Chinese medicine, most often for digestive complaints, headaches, and menstrual pain. Human evidence for these uses is very limited, and it is mostly studied in laboratory and animal research. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Evodia monograph & all interactions
Keep checking

Other Drugs & Evodia

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

0Major
949Moderate
0Minor
1,880No known interaction
949 Moderate 1,880 No interaction
Moderate

949 interactions

Showing 60 of 949 moderate interactions — see all 949 on the Evodia page.

No interaction 1,880 drugs checked — show the list

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

Showing the 60 most looked-up of 1,880 medications checked with no known interaction — see the full Evodia list.

See the full Evodia interactions page
See every supplement checked against Azelastine Hydrochloride, Fluticasone Propionate, 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
Evodia monograph › Uses, safety, and every drug interaction in one place Azelastine Hydrochloride, Fluticasone Propionate supplement interactions › Every supplement checked against Azelastine Hydrochloride, Fluticasone Propionate, 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 Evodia and Azelastine Hydrochloride, Fluticasone Propionate Together: Common Questions

Can you take Evodia with Azelastine Hydrochloride, Fluticasone Propionate?
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 Evodia and Azelastine Hydrochloride, Fluticasone Propionate 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 Azelastine Hydrochloride, Fluticasone Propionate and Evodia?

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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.