Drug & supplement interaction

Guggul + Isavuconazonium Sulfate

Moderate Interaction
The bottom line Moderate

Guggul has a moderate interaction with Isavuconazonium Sulfate. 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 Isavuconazonium Sulfate

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Isavuconazonium Sulfate

Isavuconazonium Sulfate 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 Cresemba (isavuconazonium). Your liver uses an enzyme called CYP3A4 to help process this antifungal. Lab studies suggest the active compounds in guggul (guggulsterones) may speed that enzyme up. If that happens in people, your body could clear the medication faster, leaving less of it in your bloodstream to fight the fungal infection.

With a serious infection like invasive aspergillosis or mucormycosis, you really need steady, effective drug levels, so even a small drop matters. The good news is this is theoretical and based only on test-tube research, not human studies. Still, I wouldn't add concentrated guggul supplements while on Cresemba without first checking with your doctor or pharmacist.

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 Isavuconazonium Sulfate one above is one of them. If you take anything else, check it against the full list below.

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 Isavuconazonium Sulfate

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Isavuconazonium Sulfate page lists 121 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 87 moderate · 32 minor.

From our pharmacist’s overview on the Isavuconazonium Sulfate page

“People taking isavuconazonium sulfate (Cresemba) are treating serious invasive fungal infections, often with an immune system already compromised, and that is exactly why this list calls for real vigilance. All 121 entries involve the same liver enzyme, CYP3A4, which the body uses to process this antifungal.”

Reviewed by 2 · Jul 18, 2026

Open the Isavuconazonium Sulfate 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 Isavuconazonium Sulfate 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 Isavuconazonium Sulfate 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%

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

29 days ago today
Medication Isavuconazonium Sulfate
Top 25%

#296 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 Isavuconazonium

What Is Isavuconazonium Used For?

Cresemba (isavuconazonium sulfate) is used to treat two serious, life-threatening fungal infections: invasive aspergillosis and invasive mucormycosis. These infections can spread through the body and are most dangerous in people with weakened immune systems.

Cresemba for injection is approved for adults and children 1 year of age and older. Cresemba capsules are approved for adults and children 6 years of age and older who weigh at least 16 kilograms (about 35 pounds).

See full Isavuconazonium 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
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
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 Guggul and Isavuconazonium Sulfate Together: Common Questions

Can you take Guggul with Isavuconazonium Sulfate?
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 Isavuconazonium Sulfate 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.