Drug & supplement interaction

Evodia + Cimetidine

Cimetidine brand names: Tagamet HB, Tagamet, Cimetidine Injection.

Moderate Interaction
The bottom line Moderate

Cimetidine falls into 2 drug categories that Evodia can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of evodia.

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

Evodia and Cimetidine

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

Why Are There 2 Interactions?

Evodia interacts with whole categories of medication. Cimetidine falls into 2 of those categories, so it can interact with Evodia 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) INHIBITORS

1 of 2

Why this applies to Cimetidine

Cimetidine falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Evodia interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of evodia.
Animal research shows that concomitant administration of ketoconazole, a known CYP3A4 inhibitor, with the alkaloid constituents of evodia significantly increases the area under the curve (AUC), maximum concentration (Cmax), and half-life of these constituents.
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 know if you take cimetidine (Tagamet) along with evodia. Cimetidine is one of those drugs that slows down a liver enzyme called CYP3A4, which is one of the body's main cleanup crews. Evodia's active compounds appear to be broken down partly by that same enzyme.

So in theory, cimetidine could let evodia build up a bit higher and stick around longer in your body, which might make evodia's effects (and any side effects) stronger. I want to be honest though: this is based only on lab and animal studies, not real people, so it's more of a maybe than a proven problem. It's not cimetidine itself that gets stronger here. Still, before pairing them, run it by your pharmacist or doctor first.

References
  1. Zhang W, Guo J, Wang D, et al. Effect of CYP3A inducer/inhibitor on pharmacokinetics of five alkaloids in Evodiae Fructus. Chem Biol Interact 2020;327:109146. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

2 of 2

Cimetidine also falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS.

Theoretically, drugs that inhibit CYP1A2 might increase the levels and clinical effects of evodia.
The evodia constituent rutaecarpine is metabolized by CYP1A2.
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 cimetidine and Evodia. Cimetidine is well known for slowing down a liver enzyme called CYP1A2. One of Evodia's active compounds, rutaecarpine, is broken down by that same enzyme. So if you take them together, cimetidine may slow Evodia's breakdown, letting more of it build up in your body. In plain terms, the worry runs toward stronger Evodia effects, not weaker ones.

I want to be honest about how shaky this is. This concern comes only from lab and animal research, so we don't really know if it matters in real life. Cimetidine itself isn't being changed here. Before pairing these, please check with your pharmacist or doctor, especially since Evodia has limited human safety data.

References
  1. Lee SK, Kim NH, Lee J, et al. Induction of cytochrome P450s by rutaecarpine and metabolism of rutaecarpine by cytochrome P450s. Planta Med 2004;70:753-7. 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 Cimetidine one above is among them. If you take anything else, check it against the full list below.

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.

From our Q&A

Questions About Evodia or Cimetidine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Evodia or Cimetidine, 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 Cimetidine

This page covers Evodia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cimetidine page lists 95 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Pu-erh Tea (major), St. John's Wort (major), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 3 major · 63 moderate · 29 minor.

Open the Cimetidine 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 Cimetidine 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 Cimetidine 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

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

29 days ago today
Medication Cimetidine
Top half

#1,006 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
Medication

About Cimetidine

What Is Cimetidine Used For?

Brand names: Tagamet HB, Tagamet, Cimetidine Injection

Cimetidine tablets sold over the counter — including brands like Acid Controller, Acid Reducer, Basic Care Acid Reducer, Equate Cimetidine, and cimetidine 200 — are used to relieve heartburn associated with acid indigestion and sour stomach, and to prevent heartburn brought on by eating or drinking certain foods and beverages.

Prescription-strength cimetidine tablets and Cimetidine Hydrochloride Oral Solution are used for more serious conditions: short-term treatment of active duodenal ulcers (ulcers in the upper small intestine) and benign gastric ulcers (stomach ulcers), maintenance therapy to keep duodenal ulcers from coming back, healing of erosive GERD (acid reflux that has damaged the lining of the esophagus), and treatment of conditions that cause the stomach to make too much acid — such as Zollinger-Ellison Syndrome, systemic mastocytosis, and multiple endocrine adenomas.

See full Cimetidine drug information
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
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
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 Evodia and Cimetidine Together: Common Questions

Can you take Evodia with Cimetidine?
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 Evodia and Cimetidine?
Cimetidine belongs to more than one drug category, and Evodia 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 Evodia and Cimetidine 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

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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.