Drug & supplement interaction

Gamboge + Ganaxolone

Ganaxolone brand name: Ztalmy.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Gamboge and Ganaxolone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Ganaxolone states a food rule worth keeping to.

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Interaction report

Gamboge and Ganaxolone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ganaxolone and Gamboge in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Gamboge safety at a glance

Gamboge overall Avoid Gamboge resin is a harsh purgative and can be toxic when swallowed.
Pregnancy Possibly Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ganaxolone and Gamboge? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ganaxolone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ganaxolone is filed under 3 classifications — cns depressants, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Gamboge has documented interactions with 5 drug classes — the most serious being corticosteroids (moderate), digoxin (lanoxin) (moderate) and diuretic drugs (moderate) — and none of Ganaxolone’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Gamboge Does Interact With Other Medications

Gamboge has 122 moderate known drug interactions in our database — Ganaxolone isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Gamboge

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

What to actually watch for

What Gamboge Itself Has Been Linked To

This is not an interaction — nothing below involves Ganaxolone. It is the side-effect record for Gamboge on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Gamboge, this list is the first place to look.

  • Stomach pain / Vomiting Additional detail

    “Orally, abdominal pain and vomiting have been reported with gamboge at doses as low as 200 mg. Deaths have been reported after ingestion of 4 grams of gamboge (18).”

    Gamboge · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    1 source cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

    “Orally, abdominal pain and vomiting have been reported with gamboge at doses as low as 200 mg (18).”

    Gamboge · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    1 source cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

Everything above comes from the Natural Medicines adverse-effect record for Gamboge — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Ganaxolone’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Ganaxolone column appears here.

Special populations

Gamboge in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Ganaxolone Products Have a Food Rule — Gamboge Should Not Break It

At least one FDA label for a product containing Ganaxolone says to take it with food. If you take Gamboge on an empty stomach out of habit, keep them separate — and take Ganaxolone with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Ganaxolone products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Administer ZTALMY orally three times daily with food.

From the Dosage and Administration section of the FDA label we read for Ganaxolone — where that label names a specific product, the instruction is that product's. See the Ganaxolone drug page ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Ganaxolone

This page covers Gamboge only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ganaxolone page lists 195 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 147 moderate · 39 minor.

From our pharmacist’s overview on the Ganaxolone page

“Families managing CDKL5 deficiency disorder, the rare childhood epilepsy that ganaxolone (Ztalmy) treats, should read this supplement list carefully rather than skim it. Most entries fall into two camps.”

Reviewed by 2 · Jul 18, 2026

Open the Ganaxolone interaction page

How much people look this up

Where Gamboge and Ganaxolone 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 Gamboge
Steady interest

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

29 days ago today
Medication Ganaxolone
Steady interest

#2,361 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Gamboge reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Gamboge and Ganaxolone records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Gamboge

What is Gamboge?

  • Laxative (purgative)
  • Expelling intestinal worms
  • Traditional wound care
  • Use as a yellow dye/pigment

Gamboge is a bright yellow tree resin used historically as a strong laxative and as an artists' pigment, but it is toxic in even modest amounts and is not a safe dietary supplement. Modern interest centers on its compound gambogic acid in laboratory cancer research, which does not make the raw resin safe to take. We recommend avoiding oral use of gamboge.

Garcinia hanburyi · Clusiaceae · Dried resin (gum-resin) from the bark/latex · Resin powder, traditional pills, paint pigment (not a typical modern supplement)

An interaction check asks whether these two react with each other — it does not ask whether Gamboge is a good idea for someone in your situation. Here is what our Gamboge record says about it on its own.

Gamboge: dosing

There is no established safe dose of gamboge for any health use, and we do not provide one. Because the resin is considered toxic and is not a recognized supplement, there are no reliable, standardized products with proven dosing.If you ever encounter a product that contains gamboge, do not take it without first talking to a pharmacist or doctor. In general, our recommendation is to avoid oral use entirely and choose safer, well-studied options for problems like constipation.

From our Gamboge monograph — the full record covers uses, side effects and every documented interaction.

Read the full Gamboge monograph & all interactions
Medication

About Ganaxolone

What Is Ganaxolone Used For?

Brand name: Ztalmy

Ztalmy (ganaxolone) oral suspension is approved to treat seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder — a rare genetic condition, often called CDD — in patients 2 years of age and older.

Most-Reported Side Effects for Ganaxolone

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Seizure 201 reports
Somnolence 52 reports
Change in seizure presentation 43 reports
Pneumonia 30 reports
Vomiting 24 reports
See full Ganaxolone drug information
Keep checking

Other Drugs & Gamboge

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

0Major
122Moderate
0Minor
2,707No known interaction
Moderate

122 interactions

Showing 60 of 122 moderate interactions — see all 122 on the Gamboge page.

No interaction 2,707 drugs checked — show the list
Evidence & sources

Gamboge References

The 2 references that drive our Gamboge monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Gamboge and Ganaxolone Together: Common Questions

Is it safe to take Gamboge with Ganaxolone?
We do not list a known interaction between Gamboge and Ganaxolone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Should I take Gamboge and Ganaxolone at the same time of day?
At least one FDA label for a product containing Ganaxolone says to take it with food. If you take Gamboge on an empty stomach out of habit, keep them separate and take Ganaxolone with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ganaxolone products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Gamboge and Ganaxolone combination checked?
Interactions in our licensed database are recorded against drug classes. Ganaxolone is filed under 3 classifications, and Gamboge has documented interactions with 5 drug classes — none of Ganaxolone's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Gamboge interact with any other medications?
Yes. Gamboge has 122 documented drug interactions in our database — Ganaxolone is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ganaxolone interact with any supplements?
Yes. Ganaxolone has documented interactions with 195 supplements in our database — Gamboge is not one of them. The Ganaxolone interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ganaxolone and Gamboge?

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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.