Drug & supplement interaction

Gotu Kola + Neratinib Maleate

Neratinib Maleate brand name: Nerlynx.

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

Gotu Kola has a moderate interaction with Neratinib Maleate. Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.

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

Gotu Kola and Neratinib Maleate

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Neratinib Maleate

Neratinib Maleate falls under HEPATOTOXIC DRUGS — the group Gotu Kola interacts with.

Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
There are at least four case reports of hepatotoxicity associated with the use of gotu kola. However, more information is needed to determine if gotu kola was the causative factor in these cases.
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 concern with pairing gotu kola and Nerlynx (neratinib). This breast cancer medicine can be hard on the liver on its own, and doctors already watch your liver enzymes while you're on it. Diarrhea and liver irritation are well-known side effects. Gotu kola has been tied to a handful of liver injury case reports too, so the worry is that the two together could add up and stress your liver more.

I want to be honest that this is mostly theoretical and based on a few scattered reports, not strong proof. Still, with a serious cancer drug like this one, I'd play it safe. Please loop in your oncology team or pharmacist before adding gotu kola, and don't change your neratinib on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Rev Esp Enferm Dig 2005;97:115-24. PubMed
  2. Dantuluri S, North-lewis P, Karthik SV. Gotu Kola induced hepatotoxicity in a child - need for caution with alternative remedies. Dig Liver Dis. 2011;43(6):500. 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

Gotu Kola Also Interacts With Other Medications

Gotu Kola has 578 moderate known drug interactions in our database — the Neratinib Maleate one above is one of them. If you take anything else, check it against the full list below.

Moderate 578 No known interaction 2,252 (incl. Neratinib Maleate)
Taking anything else?

Check Another of Your Medications Against Gotu Kola

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

Everything else you take

See Every Supplement That Interacts With Neratinib Maleate

This page covers Gotu Kola only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Neratinib Maleate page lists 168 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 124 moderate · 38 minor.

From our pharmacist’s overview on the Neratinib Maleate page

“This list deserves a careful read, not a quick skim. Neratinib (Nerlynx) treats HER2-positive breast cancer, and 121 of the 168 supplements on file can raise or lower its blood level by acting on CYP3A4, the enzyme that clears it.”

Reviewed by 2 · Jul 18, 2026

Open the Neratinib Maleate interaction page

One more smart check

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

We hold 1,832 real supplement products containing Gotu Kola, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Gotu Kola. Your product may carry other ingredients that interact with Neratinib Maleate too, on top of Gotu Kola — 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 Gotu Kola and Neratinib Maleate 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 Gotu Kola
Top 10%

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

29 days ago today
Medication Neratinib Maleate
Top half

#973 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 Gotu Kola

What is Gotu Kola?

Gotu Kola
  • Wound healing
  • Varicose veins and poor circulation
  • Anxiety and stress
  • Memory and mental clarity
  • Skin health and scarring

Gotu kola is a traditional Ayurvedic and Asian herb that people use for wound healing, circulation, skin problems, and as a calming or memory-supporting herb. Some early studies suggest possible benefits for vein health and skin, but the overall evidence is limited and not strong. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or have liver problems.

Read the full Gotu Kola monograph & all interactions
Medication

About Neratinib

What Is Neratinib Used For?

Brand name: Nerlynx

Nerlynx (neratinib) is used on its own as extended adjuvant treatment — meaning ongoing therapy after initial treatment is done — for adults with early-stage HER2-positive breast cancer who have already completed trastuzumab-based therapy.

Nerlynx is also used in combination with another chemotherapy drug, capecitabine, for adults with advanced or metastatic (spread) HER2-positive breast cancer who have already received two or more prior HER2-targeted regimens in the metastatic setting.

See full Neratinib drug information
Keep checking

Other Drugs & Gotu Kola

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

0Major
578Moderate
0Minor
2,251No known interaction
578 Moderate 2,251 No interaction
Moderate

578 interactions

Showing 60 of 578 moderate interactions — see all 578 on the Gotu Kola page.

No interaction 2,251 drugs checked — show the list

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

Showing the 60 most looked-up of 2,251 medications checked with no known interaction — see the full Gotu Kola list.

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

Can you take Gotu Kola with Neratinib Maleate?
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 Gotu Kola and Neratinib Maleate 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 Neratinib Maleate and Gotu Kola?

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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.