Drug & supplement interaction

Fermented Wheat Germ Extract + Brexpiprazole

Brexpiprazole brand name: Rexulti.

Moderate Interaction
The bottom line Moderate

Fermented Wheat Germ Extract has a moderate interaction with Brexpiprazole. Theoretically, concomitant use of fermented wheat germ extract with serotonergic medications may increase the risk of serotonergic adverse effects.

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

Fermented Wheat Germ Extract and Brexpiprazole

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

Moderate

SEROTONERGIC DRUGS

Why this applies to Brexpiprazole

Brexpiprazole falls under SEROTONERGIC DRUGS — the group Fermented Wheat Germ Extract interacts with.

Theoretically, concomitant use of fermented wheat germ extract with serotonergic medications may increase the risk of serotonergic adverse effects.
Animal research shows that fermented wheat germ can increase levels of serotonin in the brain.
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: brexpiprazole (Rexulti) gently nudges serotonin and dopamine activity in your brain. Fermented wheat germ extract has been shown, but only in animal studies, to raise serotonin levels too. So the worry is that pairing them might stack a bit more serotonin together, possibly making serotonin-related side effects more likely.

To be clear, this is a theoretical concern based on lab and animal data, not real human reports, so I wouldn't lose sleep over it. Still, it's worth knowing the signs to watch for: feeling jittery or agitated, sweating, a fast heartbeat, shivering, or muscle twitching. If anything like that pops up, check in with your doctor or pharmacist. And please loop them in before starting this supplement, especially during cancer care.

References
  1. Hu Z, Zhao P, Liao A, et al. Fermented Wheat Germ Alleviates Depression-like Behavior in Rats with Chronic and Unpredictable Mild Stress. Foods 2023;12(5):920. 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

Fermented Wheat Germ Extract Also Interacts With Other Medications

Fermented Wheat Germ Extract has 302 moderate known drug interactions in our database — the Brexpiprazole 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 Fermented Wheat Germ Extract

Covers the 2,830 medications we’ve checked against Fermented Wheat Germ Extract. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Brexpiprazole

This page covers Fermented Wheat Germ Extract only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Brexpiprazole page lists 177 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Indian Snakeroot (major), Lithium (major) and Rauvolfia Vomitoria (major).

By severity: 6 major · 130 moderate · 41 minor.

From our pharmacist’s overview on the Brexpiprazole page

“Brexpiprazole (Rexulti) treats schizophrenia and is added to antidepressants for depression, and its supplement list warrants real care before you add anything to it. The bulk of the 177 entries change how your liver clears the drug, so grapefruit can push levels up while St.”

Reviewed by 2 · Jul 18, 2026

Open the Brexpiprazole interaction page

How much people look this up

Where Fermented Wheat Germ Extract and Brexpiprazole 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 Fermented Wheat Germ Extract
Steady interest

#1,277 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Brexpiprazole
Steady interest

#1,985 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 Fermented Wheat Germ Extract

What is Fermented Wheat Germ Extract?

  • Cancer supportive care (as a complementary product)
  • Immune support
  • General wellness during cancer treatment
  • Antioxidant support
  • Fatigue during illness

Fermented wheat germ extract is a supplement made by fermenting wheat germ with yeast, and it is most often marketed for people going through cancer treatment. While some early research and a few small studies are interesting, the overall evidence is limited and far from conclusive, so it should never replace standard medical care. Talk with your oncologist or pharmacist before using it, since it is a supplement and not an approved treatment.

Read the full Fermented Wheat Germ Extract monograph & all interactions
Medication

About Brexpiprazole

What Is Brexpiprazole Used For?

Brand name: Rexulti

Brexpiprazole tablets are approved for two uses in adults: as an add-on (adjunctive) treatment alongside antidepressants for major depressive disorder (MDD), and as a treatment for schizophrenia. These uses apply to both the generic brexpiprazole tablets and Rexulti.

Rexulti has one additional approved use: treating agitation associated with dementia due to Alzheimer's disease in adults. Rexulti is also approved for schizophrenia in adolescents ages 13 and older. Note that Rexulti is not approved for dementia-related psychosis without agitation from Alzheimer's disease, and it is not meant to be used on an as-needed basis for Alzheimer's-related agitation.

See full Brexpiprazole drug information
Keep checking

Other Drugs & Fermented Wheat Germ Extract

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

0Major
302Moderate
0Minor
2,527No known interaction
Moderate

302 interactions

Showing 60 of 302 moderate interactions — see all 302 on the Fermented Wheat Germ Extract page.

No interaction 2,527 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 Fermented Wheat Germ Extract and Brexpiprazole Together: Common Questions

Can you take Fermented Wheat Germ Extract with Brexpiprazole?
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 Fermented Wheat Germ Extract and Brexpiprazole 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 Brexpiprazole and Fermented Wheat Germ Extract?

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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.