Drug & supplement interaction

Evodia + Erythromycin Gluceptate

Erythromycin Gluceptate brand name: Erythromycin Gluceptate.

Moderate Interaction
The bottom line Moderate

Erythromycin Gluceptate falls into 4 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
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Evodia and Erythromycin Gluceptate

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Evodia interacts with whole categories of medication. Erythromycin Gluceptate falls into 4 of those categories, so it can interact with Evodia in 4 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 4

Why this applies to Erythromycin Gluceptate

Erythromycin Gluceptate 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 gist with this pairing: erythromycin slows down a liver enzyme called CYP3A4, and that same enzyme helps break down the active compounds in evodia (evodiamine and rutaecarpine). So when you take them together, evodia may not clear as quickly, and its levels in your body could climb a bit higher than usual.

I want to be upfront, though. This concern comes only from animal and test-tube studies, not from people, so it's theoretical. If evodia builds up, you might notice more of its effects, like stomach upset or changes in how warm you feel. Nothing here is an emergency, but since evodia is poorly studied in humans, it's worth running it by your pharmacist or doctor before combining the two.

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 4

Erythromycin Gluceptate 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 combining Evodia with erythromycin. In this case, it's the supplement that takes the back seat, not your medicine. Erythromycin can slow down a liver enzyme called CYP1A2, which happens to be the same enzyme that breaks down one of Evodia's active compounds (rutaecarpine). So in theory, the erythromycin could let more of the Evodia build up in your body, possibly making its effects and any side effects stronger.

I want to be honest about the strength of this: it comes only from lab and animal research, so it's a theoretical concern, not something proven in people. Erythromycin's own effectiveness shouldn't change. Still, since Evodia isn't well studied in humans, run it by your pharmacist or doctor before pairing the two.

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
Moderate

QT INTERVAL-PROLONGING DRUGS

3 of 4

Erythromycin Gluceptate also falls under QT INTERVAL-PROLONGING DRUGS.

Theoretically, evodia might have an additive effect with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
Evodia has demonstrated dose-dependent activity as a proarrhythmic agent in animal and in vitro studies. Evodia infusion in animals extends the action duration potential and induces prolongation of the QT interval and Torsade de pointes.
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 concern with pairing these two. Erythromycin (given here as the gluceptate IV form) is well known to affect the heart's electrical timing, something doctors call QT prolongation. Evodia, based on lab and animal studies, may do the same thing. Put them together and the worry is an additive effect that nudges your heart rhythm out of sync, which in rare cases can lead to a dangerous fast rhythm.

I'll be honest, this is mostly theoretical and comes from test tube and animal research, not from people. So I'm not trying to scare you. Still, since erythromycin already carries real QT risk on its own, I'd rather you skip the evodia or at least run it by your pharmacist or doctor first before combining them.

References
  1. Baburin I, Varkvisser R, Schramm A, et al. Dehydroevodiamine and hortiamine, alkaloids from the traditional Chinese herbal drug Evodia rutaecarpa, are IKr blockers with proarrhythmic effects in vitro and in vivo. Pharmacol Res. 2018 May;131:150-163. DOI
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 4

Erythromycin Gluceptate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

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

Here's the gist: your body clears erythromycin partly through a liver enzyme called CYP3A4. In test-tube studies, evodia appears to slow that enzyme down. If that same effect happened in people, erythromycin could build up a bit higher than usual, which might nudge up its common side effects like nausea, stomach cramping, or diarrhea. At higher levels, erythromycin can also affect heart rhythm (a change called QT prolongation), so that's the one I'd watch most closely.

I want to be honest though, this is theoretical. It's only been seen in lab research, not in actual patients, so we don't know if it matters in real life. Still, it's worth a quick chat with your pharmacist or doctor before combining them.

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 Erythromycin Gluceptate 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.

Everything else you take

See Every Supplement That Interacts With Erythromycin Gluceptate

This page covers Evodia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Erythromycin Gluceptate page lists 187 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 10 major · 146 moderate · 31 minor.

From our pharmacist’s overview on the Erythromycin Gluceptate page

“Grapefruit is the entry to know first on the Erythromycin Gluceptate page. Clinical research shows it blocks CYP3A4, the drug-clearing enzyme this antibiotic also inhibits, so levels of many medicines can climb higher than intended.”

Reviewed by 2 · Jul 18, 2026

Open the Erythromycin Gluceptate 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 Erythromycin Gluceptate 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 Erythromycin Gluceptate 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

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

29 days ago today
Medication Erythromycin Gluceptate
Top half

#842 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
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 Erythromycin Gluceptate Together: Common Questions

Can you take Evodia with Erythromycin Gluceptate?
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 4 interactions listed for Evodia and Erythromycin Gluceptate?
Erythromycin Gluceptate 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 Erythromycin Gluceptate 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.