Drug & supplement interaction

Guggul + Elbasvir, Grazoprevir

Elbasvir, Grazoprevir brand name: Zepatier.

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

Guggul has a moderate interaction with Elbasvir, Grazoprevir. Theoretically, guggul might reduce the effects of CYP3A4 substrates.

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

Guggul and Elbasvir, Grazoprevir

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Elbasvir, Grazoprevir

Elbasvir, Grazoprevir falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Guggul interacts with.

Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Severity Moderate Likelihood Probable Evidence D

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 concern with pairing guggul and Zepatier (elbasvir and grazoprevir). Your body uses a liver enzyme called CYP3A4 to help process both of these antiviral medicines. Lab studies suggest the active compounds in guggul (guggulsterones) may speed up that enzyme, which could clear the medicine out of your body faster and leave less of it to fight the hepatitis C virus.

That matters because with hepatitis C treatment, you want steady, reliable drug levels to fully knock out the virus. Lower levels could mean the treatment works less well. To be fair, this warning is theoretical and based only on lab data, not real patient studies. Still, since clearing the virus is the whole goal, I'd run any guggul supplement past your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. 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

Guggul Also Interacts With Other Medications

Guggul has 756 moderate known drug interactions in our database — the Elbasvir, Grazoprevir one above is one of them. If you take anything else, check it against the full list below.

Moderate 756 No known interaction 2,074 (incl. Elbasvir, Grazoprevir)
Taking anything else?

Check Another of Your Medications Against Guggul

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

Everything else you take

See Every Supplement That Interacts With Elbasvir, Grazoprevir

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Elbasvir, Grazoprevir page lists 140 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 · 41 minor.

From our pharmacist’s overview on the Elbasvir, Grazoprevir page

“Zepatier (elbasvir and grazoprevir) is a fixed-course hepatitis C cure, and success depends on holding steady drug levels through every week of treatment, so this list deserves genuine care. Three of the 140 ingredients on file rate major.”

Reviewed by 2 · Jul 18, 2026

Open the Elbasvir, Grazoprevir interaction page

One more smart check

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

We hold 955 real supplement products containing Guggul, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guggul. Your product may carry other ingredients that interact with Elbasvir, Grazoprevir too, on top of Guggul — 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 Guggul and Elbasvir, Grazoprevir 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 Guggul
Top 25%

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

29 days ago today
Medication Elbasvir, Grazoprevir
Steady interest

#2,639 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 Guggul

What is Guggul?

Guggul
  • High cholesterol
  • Joint pain and arthritis
  • Weight management
  • Acne
  • Skin conditions

Guggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can cause stomach upset and skin rashes. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Guggul monograph & all interactions
Medication

About Elbasvir and Grazoprevir

What Is Elbasvir and Grazoprevir Used For?

Brand name: Zepatier

Zepatier is used to treat chronic hepatitis C virus (HCV) genotype 1 or genotype 4 infection in adults and children 12 years of age and older (or weighing at least 30 kg). It works against both the most common strain of HCV (genotype 1) and genotype 4.

Depending on the specific genotype, prior treatment history, and certain viral characteristics, Zepatier may be prescribed alone or combined with another antiviral medicine called ribavirin. Your prescriber will determine the right regimen and duration for your situation.

See full Elbasvir and Grazoprevir drug information
Keep checking

Other Drugs & Guggul

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

0Major
756Moderate
0Minor
2,073No known interaction
756 Moderate 2,073 No interaction
Moderate

756 interactions

Showing 60 of 756 moderate interactions — see all 756 on the Guggul page.

No interaction 2,073 drugs checked — show the list

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

Showing the 60 most looked-up of 2,073 medications checked with no known interaction — see the full Guggul list.

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

Can you take Guggul with Elbasvir, Grazoprevir?
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 Guggul and Elbasvir, Grazoprevir 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 Elbasvir, Grazoprevir and Guggul?

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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.