Drug & supplement interaction

Golden Ragwort + Sarilumab

Sarilumab brand name: Kevzara.

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

Golden Ragwort has a moderate interaction with Sarilumab. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in golden ragwort.

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

Golden Ragwort and Sarilumab

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Sarilumab

Sarilumab falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Golden Ragwort interacts with.

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in golden ragwort.
Golden ragwort contains PAs. PAs are substrates of CYP3A4. Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites.
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 unusual twist with this pairing: the concern isn't about your Sarilumab (Kevzara) levels going up or down. Instead, it's about the golden ragwort. This plant contains pyrrolizidine alkaloids, which the liver enzyme CYP3A4 can turn into toxic, liver-damaging byproducts. Sarilumab can actually raise the activity of CYP3A4 (because calming inflammation lets that enzyme work more normally), so in theory it could speed up the creation of those harmful metabolites and increase the strain on your liver.

That said, this is a theoretical idea based only on lab and animal data, not real patient reports. The bigger issue is that golden ragwort isn't considered safe to swallow at all because of its liver toxicity. Please skip it and check with your pharmacist or doctor before trying any new supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  2. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. 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

Golden Ragwort Also Interacts With Other Medications

Golden Ragwort has 86 moderate known drug interactions in our database — the Sarilumab one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Sarilumab)
Taking anything else?

Check Another of Your Medications Against Golden Ragwort

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

Everything else you take

See Every Supplement That Interacts With Sarilumab

This page covers Golden Ragwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sarilumab page lists 72 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), Alkanna (moderate), Alpine Ragwort (moderate) and American Ginseng (moderate).

By severity: 71 moderate · 1 minor.

From our pharmacist’s overview on the Sarilumab page

“Sarilumab (Kevzara) works by quieting an overactive immune system in rheumatoid arthritis, and most of the supplements on this page push the other way. Immune stimulants such as ashwagandha, astragalus, and American ginseng could in theory blunt the drug's benefit and let joint symptoms creep back.”

Reviewed by 2 · Jul 18, 2026

Open the Sarilumab interaction page

One more smart check

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

We hold 2 real supplement products containing Golden Ragwort, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Golden Ragwort. Your product may carry other ingredients that interact with Sarilumab too, on top of Golden Ragwort — 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 Golden Ragwort and Sarilumab 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 Golden Ragwort
Top half

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

29 days ago today
Medication Sarilumab
Top 10%

#208 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 Golden Ragwort

What is Golden Ragwort?

  • Menstrual complaints
  • Easing childbirth (traditional)
  • Urinary discomfort
  • Sore throat (folk use)

Golden Ragwort is a flowering plant once used in traditional and folk medicine, mainly for menstrual and female reproductive complaints. It contains pyrrolizidine alkaloids that can cause serious liver damage, so it is not considered safe for internal use, and modern herbalists generally avoid it.

Read the full Golden Ragwort monograph & all interactions
Medication

About Sarilumab Injection

What Is Sarilumab Injection Used For?

Brand name: Kevzara

Kevzara (sarilumab) injection is approved for three conditions. In adults, it treats moderately to severely active rheumatoid arthritis (RA) when at least one other disease-modifying drug hasn't worked well enough or caused intolerance. It also treats polymyalgia rheumatica (PMR) in adults who haven't responded adequately to corticosteroids or who can't tolerate tapering them.

Kevzara is also approved for polyarticular juvenile idiopathic arthritis (pJIA) — a form of childhood arthritis — but only in patients who weigh 63 kg (about 139 lbs) or more. It is not approved for pediatric patients below that weight due to the lack of an appropriate dosage form.

See full Sarilumab Injection drug information
Keep checking

Other Drugs & Golden Ragwort

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Golden Ragwort page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Golden Ragwort list.

See the full Golden Ragwort interactions page
See every supplement checked against Sarilumab, 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
Golden Ragwort monograph › Uses, safety, and every drug interaction in one place Sarilumab supplement interactions › Every supplement checked against Sarilumab, ranked by severity Sarilumab Injection 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 Golden Ragwort and Sarilumab Together: Common Questions

Can you take Golden Ragwort with Sarilumab?
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 Golden Ragwort and Sarilumab 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 Sarilumab and Golden Ragwort?

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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.