Drug & supplement interaction

Goldenseal + Rucaparib Camsylate

Rucaparib Camsylate brand name: Rubraca.

Moderate Interaction
The bottom line Moderate

Rucaparib Camsylate falls into 2 drug categories that Goldenseal can interact with; the most serious is rated moderate. Goldenseal might increase serum levels of drugs metabolized by CYP2D6.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Goldenseal and Rucaparib Camsylate

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Goldenseal interacts with whole categories of medication. Rucaparib Camsylate falls into 2 of those categories, so it can interact with Goldenseal in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

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Why this applies to Rucaparib Camsylate

Rucaparib Camsylate falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Goldenseal interacts with.

Goldenseal might increase serum levels of drugs metabolized by CYP2D6.
Clinical and in vitro research shows that goldenseal can significantly inhibit CYP2D6 enzymes, potentially increasing levels of drugs metabolized by CYP2D6.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with Rubraca (rucaparib) and goldenseal. Goldenseal contains berberine, which can slow down a liver enzyme called CYP2D6. Rucaparib is partly handled by this same enzyme, and it is an active drug, not a prodrug that needs switching on. So if goldenseal blocks that enzyme, more rucaparib could build up in your body than expected.

In practical terms, that might mean stronger side effects from this cancer medicine, things like nausea, fatigue, low blood counts, or stomach upset. The human evidence here is moderate, not rock solid, but since rucaparib is a serious cancer treatment, I wouldn't take chances. Please check with your oncology team or pharmacist before adding goldenseal so they can keep you safe.

References
  1. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  2. Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
  3. Sevior, D. K., Hokkanen, J., Tolonen, A., Abass, K., Tursas, L., Pelkonen, O., and Ahokas, J. T. Rapid screening of commercially available herbal products for the inhibition of major human hepatic cytochrome P450 enzymes using the N-in-one cocktail. Xeno PubMed
Moderate

P-GLYCOPROTEIN SUBSTRATES

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Rucaparib Camsylate also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, goldenseal might increase or decrease serum levels of P-glycoprotein (P-gp) substrates.
There is conflicting evidence about the effect of goldenseal on P-gp. In vitro research suggests that berberine, a constituent of goldenseal, modestly inhibits P-gp efflux. Other evidence suggests that berberine induces P-gp. In healthy volunteers, goldenseal modestly increases peak levels of the P-gp substrate digoxin by about 14%. However, it does not seem to affect other pharmacokinetic parameters such as area under the curve (AUC). This suggests that goldenseal is not a potent inhibitor of P-gp-mediated drug efflux. Until more is known, goldenseal should be used cautiously with P-gp substrates.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with goldenseal and your Rubraca (rucaparib). Rucaparib is moved around your body partly by a transporter called P-glycoprotein, or P-gp for short. Goldenseal can tug on that transporter, but honestly the research is mixed. Some lab work says it slows P-gp down a little, other work says it speeds it up. In real people, goldenseal only nudged levels of a similar drug (digoxin) by about 14%, which is small.

So the worry here is mostly theoretical, not proven for rucaparib. If goldenseal did raise your levels, you might notice more nausea, tiredness, or low blood counts. Since this is a cancer medicine, please don't add or stop goldenseal on your own. Just run it by your oncologist or pharmacist first.

References
  1. Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35:240-5. 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

Goldenseal Also Interacts With Other Medications

Goldenseal has 1,235 moderate, 1 minor known drug interactions in our database — the Rucaparib Camsylate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Goldenseal

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

Everything else you take

See Every Supplement That Interacts With Rucaparib Camsylate

This page covers Goldenseal only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rucaparib Camsylate page lists 105 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), 1,3-dmaa (moderate), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 2 major · 78 moderate · 25 minor.

Open the Rucaparib Camsylate interaction page

One more smart check

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

We hold 1,726 real supplement products containing Goldenseal, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Goldenseal. Your product may carry other ingredients that interact with Rucaparib Camsylate too, on top of Goldenseal — 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 Goldenseal and Rucaparib Camsylate 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 Goldenseal
Top 25%

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

29 days ago today
Medication Rucaparib Camsylate
Steady interest

#1,972 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 Goldenseal

What is Goldenseal?

Goldenseal
  • Digestive upset and diarrhea
  • Colds and respiratory infections
  • Sore throat and mouth sores
  • Skin and eye irritation (topical/traditional)
  • Antimicrobial support

Goldenseal is a popular North American herb that contains berberine, a compound studied for antimicrobial effects. However, strong human evidence for its many traditional uses is largely lacking, and it should be avoided during pregnancy and breastfeeding. Talk to a pharmacist or doctor before using it.

Read the full Goldenseal monograph & all interactions
Medication

About Rucaparib

What Is Rucaparib Used For?

Brand name: Rubraca

Rubraca (rucaparib) is used for two types of cancer in adults who carry a harmful BRCA gene mutation (either inherited or found in the tumor). First, it is used as maintenance treatment — meaning ongoing treatment to keep cancer from coming back — in people with recurrent epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer who responded (fully or partially) to platinum-based chemotherapy.

Second, Rubraca treats metastatic castration-resistant prostate cancer (advanced prostate cancer that has stopped responding to hormone-lowering treatment) in adults who have already received androgen receptor-directed therapy. Patients must be tested with an FDA-approved companion diagnostic to confirm the BRCA mutation before starting Rubraca for prostate cancer.

See full Rucaparib drug information
Keep checking

Other Drugs & Goldenseal

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

0Major
1,235Moderate
1Minor
1,593No known interaction
Moderate

1,235 interactions

Showing 60 of 1,235 moderate interactions — see all 1,235 on the Goldenseal page.

Minor

1 interaction

No interaction 1,593 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 Goldenseal and Rucaparib Camsylate Together: Common Questions

Can you take Goldenseal with Rucaparib Camsylate?
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.
Why are there 2 interactions listed for Goldenseal and Rucaparib Camsylate?
Rucaparib Camsylate belongs to more than one drug category, and Goldenseal interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Goldenseal and Rucaparib Camsylate 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.