Drug & supplement interaction

Ginger + Alpelisib

Alpelisib brand name: Piqray.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Ginger has a moderate interaction with Alpelisib. Ginger might increase or decrease the levels of CYP3A4 substrates.

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

Ginger and Alpelisib

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Alpelisib

Alpelisib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Ginger interacts with.

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction 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 honest picture: your body uses an enzyme called CYP3A4 to help clear alpelisib (Piqray) from your system, and ginger may nudge that enzyme in either direction. Lab studies pull both ways. Some suggest ginger slows CYP3A4, which could let alpelisib build up and make side effects like high blood sugar, diarrhea, rash, mouth sores, or nausea more pronounced. Other lab work hints ginger speeds the enzyme up, which could lower drug levels and weaken its cancer-fighting punch.

The key thing to know is this is based on test-tube and animal data, not solid human studies, so it's more of a theoretical caution than a proven problem. Everyday culinary ginger in food is very unlikely to matter. Before using concentrated ginger supplements alongside this cancer medicine, please check with your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  2. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  3. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. 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

Ginger Also Interacts With Other Medications

Ginger has 873 moderate, 133 minor known drug interactions in our database — the Alpelisib one above is one of them. If you take anything else, check it against the full list below.

Moderate 873 Minor 133 No known interaction 1,824 (incl. Alpelisib)
Taking anything else?

Check Another of Your Medications Against Ginger

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

From our Q&A

Questions About Ginger or Alpelisib

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

This page covers Ginger only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alpelisib page lists 139 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), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 96 moderate · 40 minor.

From our pharmacist’s overview on the Alpelisib page

“Alpelisib (Piqray) treats PIK3CA-mutated breast cancer, and a drug doing that job leaves little room for supplements that shift its blood level. Yet that is what most of this list does: 121 of the 139 ingredients on file can raise or lower alpelisib through CYP3A4, the liver enzyme that clears it.”

Reviewed by 2 · Jul 18, 2026

Open the Alpelisib interaction page

One more smart check

Taking Ginger as Part of a Dietary Supplement Product? Check It for Interactions

We hold 9,640 real supplement products containing Ginger, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ginger. Your product may carry other ingredients that interact with Alpelisib too, on top of Ginger — 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 Ginger and Alpelisib 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 Ginger
Top 5%

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

29 days ago today
Medication Alpelisib
Steady interest

#1,852 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 Ginger

What is Ginger?

Ginger
  • Nausea and vomiting
  • Motion sickness
  • Morning sickness in pregnancy
  • Digestive upset
  • Menstrual cramps
  • Joint pain and inflammation

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pregnancy, and chemotherapy. It is generally safe in food and supplement amounts for most people, though it may cause mild stomach upset. Talk with your pharmacist or doctor before using ginger supplements, especially if you are pregnant, have a bleeding disorder, or take other medicines.

Read the full Ginger monograph & all interactions
Medication

About Alpelisib

What Is Alpelisib Used For?

Brand name: Piqray

Alpelisib is approved for two distinct uses, each tied to a specific brand. Piqray is used in combination with another drug called fulvestrant to treat adults with hormone receptor (HR)-positive, HER2-negative, advanced or metastatic breast cancer whose tumors carry a PIK3CA mutation — and only after the cancer has progressed on or after a hormone-based treatment. A companion diagnostic test is required before starting Piqray.

Vijoice is used to treat adults and children 2 years of age and older who have severe manifestations of PIK3CA-Related Overgrowth Spectrum (PROS) — a rare condition where PIK3CA gene mutations cause abnormal tissue, vascular, and bone overgrowth — and who need systemic (whole-body) therapy. Vijoice's approval for PROS was granted under the FDA's accelerated approval pathway based on response data, and continued approval may depend on confirmatory trials.

See full Alpelisib drug information
Keep checking

Other Drugs & Ginger

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

0Major
873Moderate
133Minor
1,823No known interaction
873 Moderate 133 Minor 1,823 No interaction
Moderate

873 interactions

Showing 60 of 873 moderate interactions — see all 873 on the Ginger page.

Minor

133 interactions

Showing 60 of 133 minor interactions — see all 133 on the Ginger page.

No interaction 1,823 drugs checked — show the list

We also checked Ginger against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,823 medications checked with no known interaction — see the full Ginger list.

See the full Ginger interactions page
See every supplement checked against Alpelisib, ranked by severity
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

Keep exploring
Ginger monograph › Uses, safety, and every drug interaction in one place Alpelisib supplement interactions › Every supplement checked against Alpelisib, ranked by severity Alpelisib drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ginger and Alpelisib Together: Common Questions

Can you take Ginger with Alpelisib?
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 Ginger and Alpelisib 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.