Drug & supplement interaction

Goldthread + Ibrexafungerp Citrate

Ibrexafungerp Citrate brand name: Brexafemme.

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

Goldthread has a moderate interaction with Ibrexafungerp Citrate. There's very preliminary evidence that berberine, a constituent of goldthread, might inhibit cytochrome P450 3A4 (CYP3A4) enzyme.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Goldthread and Ibrexafungerp Citrate

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Ibrexafungerp Citrate

Ibrexafungerp Citrate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Goldthread interacts with.

There's very preliminary evidence that berberine, a constituent of goldthread, might inhibit cytochrome P450 3A4 (CYP3A4) enzyme. So far, this interaction has not been reported in humans. However, watch for an increase in the levels of drugs metabolized by CYP3A4 in patients taking goldthread. Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), clarithromycin (Biaxin), indinavir (Crixivan), sildenafil (Viagra), triazolam (Halcion), and numerous others. Use goldthread cautiously or avoid in patients taking these drugs.
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

Your body relies on a liver enzyme called CYP3A4 to clear ibrexafungerp (Brexafemme) from your system. Goldthread contains berberine, which lab work hints may slow that enzyme down. If that happens, ibrexafungerp could break down more slowly and build up to higher levels than usual, which might mean more of its common side effects, things like nausea, diarrhea, stomach upset, or dizziness.

The good news is this is mostly a theory. It comes from early lab studies, not real cases in people, so I wouldn't lose sleep over it. Still, since Brexafemme is usually just a short one-day or recurrence-prevention course, it's easy to keep them apart. Before combining them, just give your pharmacist or doctor a quick heads-up so they can guide you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. 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

Goldthread Also Interacts With Other Medications

Goldthread has 642 moderate known drug interactions in our database — the Ibrexafungerp Citrate one above is one of them. If you take anything else, check it against the full list below.

Moderate 642 No known interaction 2,188 (incl. Ibrexafungerp Citrate)
Taking anything else?

Check Another of Your Medications Against Goldthread

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

Everything else you take

See Every Supplement That Interacts With Ibrexafungerp Citrate

This page covers Goldthread only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibrexafungerp Citrate page lists 138 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 · 94 moderate · 41 minor.

From our pharmacist’s overview on the Ibrexafungerp Citrate page

“Ibrexafungerp (Brexafemme) treats vaginal yeast infections, often in a single day of pills, and even that short course can be thrown off by the wrong supplement, so this list warrants real care. Three of the 138 ingredients on file rate major, and they pull in opposite directions.”

Reviewed by 2 · Jul 18, 2026

Open the Ibrexafungerp Citrate interaction page

One more smart check

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

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

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

29 days ago today
Medication Ibrexafungerp Citrate
Steady interest

#1,522 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 Goldthread

What is Goldthread?

Goldthread
  • Digestive upset and diarrhea
  • Mouth sores and sore throat
  • Inflammation
  • Antimicrobial (fighting germs)
  • Blood sugar support
  • Skin and eye complaints

Goldthread is a traditional Chinese and East Asian herb whose root is rich in berberine, a compound being studied for blood sugar, cholesterol, and antimicrobial effects. Strong human evidence for goldthread itself is limited, and it should be avoided in pregnancy and breastfeeding. Talk with your pharmacist or doctor before using it, especially if you take other medicines.

Read the full Goldthread monograph & all interactions
Medication

About Ibrexafungerp

What Is Ibrexafungerp Used For?

Brand name: Brexafemme

  • Ibrexafungerp is used to treat vaginal yeast infections in adults and adolescents. It is also used to reduce the number of recurrent vaginal yeast infections. Ibrexafungerp is in a class of antifungal medications. It works by stopping the growth of the fungi that cause infection.

See full Ibrexafungerp drug information
Keep checking

Other Drugs & Goldthread

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

0Major
642Moderate
0Minor
2,187No known interaction
642 Moderate 2,187 No interaction
Moderate

642 interactions

Showing 60 of 642 moderate interactions — see all 642 on the Goldthread page.

No interaction 2,187 drugs checked — show the list

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

Showing the 60 most looked-up of 2,187 medications checked with no known interaction — see the full Goldthread list.

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

Can you take Goldthread with Ibrexafungerp Citrate?
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 Goldthread and Ibrexafungerp Citrate 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 Ibrexafungerp Citrate and Goldthread?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.