Drug & supplement interaction

Guggul + Nirogacestat

Nirogacestat brand name: Ogsiveo.

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

Guggul has a moderate interaction with Nirogacestat. 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 Nirogacestat

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Nirogacestat

Nirogacestat 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 Nirogacestat (Ogsiveo). Nirogacestat is a targeted therapy for desmoid tumors, and your liver clears it using an enzyme called CYP3A4. Lab studies suggest guggul (specifically its guggulsterones) can speed that enzyme up. If that happens in people, your body might clear nirogacestat faster than intended, which could leave less of it in your system and potentially weaken how well it works against the tumor. That's a real worry with a cancer treatment.

I'll be honest: this is based only on test-tube research, not on people, so we don't know the true size of the effect. Still, because nirogacestat is such an important medicine, I'd play it safe and check with your oncologist or pharmacist before adding guggul rather than risk it.

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 758 moderate known drug interactions in our database — the Nirogacestat one above is one of them. If you take anything else, check it against the full list below.

Moderate 758 No known interaction 2,072 (incl. Nirogacestat)
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 Nirogacestat

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nirogacestat 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 Nirogacestat page

“Anyone on nirogacestat (Ogsiveo) for desmoid tumors is usually in it for the long haul, and supplements have a way of creeping in over months of treatment. This list warrants genuine caution.”

Reviewed by 2 · Jul 18, 2026

Open the Nirogacestat 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 Nirogacestat 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 Nirogacestat 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%

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

29 days ago today
Medication Nirogacestat
Top half

#746 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 Nirogacestat

What Is Nirogacestat Used For?

Brand name: Ogsiveo

Nirogacestat is used for adults with progressing desmoid tumors who need systemic treatment. That means medicine that works throughout the body, not just surgery or local treatment.

The brand Ogsiveo is the tablet product described here.

See full Nirogacestat 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
758Moderate
0Minor
2,071No known interaction
758 Moderate 2,071 No interaction
Moderate

758 interactions

Showing 60 of 758 moderate interactions — see all 758 on the Guggul page.

No interaction 2,071 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 2,071 medications checked with no known interaction — see the full Guggul list.

See the full Guggul interactions page
See every supplement checked against Nirogacestat, 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 Nirogacestat supplement interactions › Every supplement checked against Nirogacestat, ranked by severity Nirogacestat 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 Nirogacestat Together: Common Questions

Can you take Guggul with Nirogacestat?
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 Nirogacestat 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 Nirogacestat 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.