Fo-ti + Enasidenib
Enasidenib brand name: Idhifa.
Enasidenib falls into 7 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full interaction reportFo-ti and Enasidenib
These two interact in 7 distinct ways. Each one is explained separately below.
Why Are There 7 Interactions?
Fo-ti interacts with whole categories of medication. Enasidenib falls into 7 of those categories, so it can interact with Fo-ti in 7 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
1 of 7Why this applies to Enasidenib
Enasidenib falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Fo-ti interacts with.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C19. An in vitro study suggests that the degree of CYP2C19 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
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.
Here's the basic idea with enasidenib (Idhifa) and Fo-ti. Your body uses a liver enzyme called CYP2C19 to help process enasidenib. Lab and animal studies hint that Fo-ti may slow this enzyme down, especially the raw, less-processed forms. If that happened in people, enasidenib could build up a bit more than expected, which might mean stronger effects and a higher chance of side effects like nausea, diarrhea, tiredness, or changes in blood counts and liver numbers.
I want to be honest, though: this has only been seen in test tubes and animals, never confirmed in humans, so it's theoretical. On top of that, Fo-ti itself has been tied to liver injury, and enasidenib already needs liver monitoring. Please loop in your oncology team or pharmacist before mixing the two.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 7Enasidenib also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
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.
Here's the idea behind pairing Fo-ti with your leukemia medicine enasidenib (Idhifa). Lab and animal studies hint that Fo-ti, especially the raw root, may slow down a liver enzyme called CYP2D6, which is one of the pathways that helps clear enasidenib from your body. If that enzyme is blocked, the drug could build up a bit more than expected, which in theory might mean stronger side effects like nausea, diarrhea, low appetite, or changes in your blood counts and bilirubin.
I want to be honest though: this is only a theory from test tubes and animals, and it has never actually been seen in people. Still, because enasidenib treats a serious cancer and Fo-ti has been linked to liver injury, please check with your oncologist or pharmacist before adding it.
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
3 of 7Enasidenib also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
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.
Here's the honest picture with Fo-ti and enasidenib (Idhifa). Enasidenib is partly handled by a liver enzyme called CYP1A2, and lab studies hint that Fo-ti could nudge that enzyme one way or the other. Confusingly, the raw root seems to slow CYP1A2 down, while some processed or alcohol-based extracts may speed it up. So in theory, Fo-ti could either raise enasidenib levels (more chance of nausea, diarrhea, or a serious lung/inflammation reaction called differentiation syndrome) or lower them (less cancer-fighting effect).
The key word is theoretical. This has only been seen in test tubes and animals, never confirmed in people. Still, because enasidenib treats a serious leukemia, I'd loop in your oncologist or pharmacist before adding Fo-ti. Fo-ti has also been tied to liver problems, which is one more reason to check first.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
4 of 7Enasidenib also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction has not been reported in humans.
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.
Here's the gist: lab and animal studies hint that Fo-ti may slow down a liver enzyme called CYP2C9, which is one of the enzymes that helps your body process enasidenib (Idhifa). If that enzyme works more slowly, this leukemia medicine could build up a bit higher than expected. In theory, that might mean more of its known side effects, like nausea, low appetite, elevated bilirubin, or its serious warning effect, differentiation syndrome.
The honest part: this is theoretical only and hasn't actually been seen in people, so I don't want to alarm you. Still, enasidenib is a powerful cancer drug, so please don't add Fo-ti without first checking with your oncologist or pharmacist.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
5 of 7Enasidenib also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
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.
Here's the gist for Idhifa (enasidenib): your body partly clears this leukemia medicine using a liver enzyme called CYP3A4. Fo-ti might slow that enzyme down a bit, which could let enasidenib build up a little higher than usual. In theory, that might mean more of its side effects, like nausea, low appetite, elevated bilirubin, or a rare but serious reaction called differentiation syndrome.
Now the honest part: this concern comes only from lab studies, and even those disagree (some animal research found no effect). It has never actually been reported in people. Still, with a cancer drug this important, I'd play it safe. Please check with your oncologist or pharmacist before adding Fo-ti, and don't change your enasidenib on your own.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES
6 of 7Enasidenib also falls under CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
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.
Here's the gist for anyone on Idhifa (enasidenib) wondering about Fo-ti. Enasidenib is partly handled by a liver enzyme called CYP2B6, and lab and animal studies hint that Fo-ti may slow that enzyme down. If that happened in people, your body might clear enasidenib a little less efficiently, so levels could creep up and side effects might be more likely. Think nausea, diarrhea, low appetite, or elevated bilirubin.
I want to be straight with you, though: this is a theoretical concern based only on test-tube and animal work, and it has not been reported in humans. Interestingly, raw Fo-ti seemed to block the enzyme more than heavily processed extracts. Since enasidenib is a serious cancer drug (and Fo-ti itself carries liver-injury reports), please run any supplement past your oncology team or pharmacist first.
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES
7 of 7Enasidenib also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.
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.
Here's the gist with Fo-ti and Idhifa (enasidenib). Your body uses a liver enzyme called CYP2C8 to help clear enasidenib. Lab studies suggest Fo-ti may slow that enzyme down. If that happened in a person, enasidenib could build up a bit more than expected, which could mean stronger side effects like nausea, diarrhea, lower blood counts, or a rise in bilirubin (yellowing).
I want to be honest about the evidence though: this comes only from test-tube research and has never actually been reported in real patients, so it's theoretical. Still, enasidenib is a serious cancer drug with its own risks, including a dangerous reaction called differentiation syndrome. Please don't start or stop anything on your own. Loop in your oncologist or pharmacist before adding Fo-ti.
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Fo-ti Also Interacts With Other Medications
Fo-ti has 1,256 moderate known drug interactions in our database — the Enasidenib one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Fo-ti
We haven’t checked that one against Fo-ti yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Fo-ti. Pick one to open its full report.
See Every Supplement That Interacts With Enasidenib
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enasidenib page lists 203 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).
By severity: 3 major · 156 moderate · 44 minor.
From our pharmacist’s overview on the Enasidenib page
“Anyone taking enasidenib (Idhifa) for acute myeloid leukemia should treat this supplement list with genuine care, beginning with the major-rated entries: grapefruit, St. John's wort, and activated charcoal.”
Reviewed by 2 · Jul 18, 2026
Taking Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions
We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Enasidenib too, on top of Fo-ti — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Fo-ti and Enasidenib 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.
#211 of 1,452 supplements looked up here in the last 7 days
#2,220 of 2,830 medications looked up here in the last 7 days
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.
About Fo-ti
What is Fo-ti?
- Anti-aging and longevity
- Hair graying and hair loss
- General tonic for vitality
- Constipation
- High cholesterol
Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.
About Enasidenib
What Is Enasidenib Used For?
Brand name: Idhifa
Idhifa (enasidenib) is used to treat adult patients with acute myeloid leukemia (AML) — a fast-moving cancer of the blood and bone marrow — whose disease has come back after treatment (relapsed) or has stopped responding to treatment (refractory). It is specifically for patients whose leukemia has a mutation in the IDH2 gene, which must be confirmed by an FDA-approved test before starting therapy.
Other Drugs & Fo-ti
Browse every other medication we’ve checked against Fo-ti — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,256 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Amoxicillin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Allopurinol ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
Showing 60 of 1,256 moderate interactions — see all 1,256 on the Fo-ti page.
No interaction 1,573 drugs checked — show the list
We also checked Fo-ti against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Lisinopril ›
- Acyclovir ›
- Lamotrigine ›
- Pregabalin ›
- Azithromycin ›
- Gabapentin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Levetiracetam ›
- Daptomycin ›
- Ezetimibe ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Hexobarbitone ›
- Phentermine, Topiramate ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Mitomycin ›
- Hethylphenidate Hcl ›
- Minoxidil ›
- Cefaclor ›
- Azelaic Acid ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Dirithromycin ›
- Vancomycin ›
- Pizotifen ›
- Bentoquatam ›
- Triptorelin ›
- Pentobarbitone ›
- Procainamide ›
- Dextrothyroxine ›
- Tocainide ›
- Rocuronium ›
- Telmisartan ›
- Mitomycin C ›
- Digitoxin ›
- Lomustine ›
- Chenodiol ›
- Lorazepam ›
- Desflurane ›
- Salbutamol Sulfate ›
- Caspofungin ›
- Rituximab ›
Showing the 60 most looked-up of 1,573 medications checked with no known interaction — see the full Fo-ti list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Taking Fo-ti and Enasidenib Together: Common Questions
Can you take Fo-ti with Enasidenib?
Why are there 7 interactions listed for Fo-ti and Enasidenib?
How serious is the Fo-ti and Enasidenib interaction?
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.