Drug & supplement interaction

Gymnema + Idelalisib

Idelalisib brand name: Zydelig.

Minor Interaction
The bottom line Minor

Gymnema has a minor interaction with Idelalisib. Theoretically, gymnema might increase levels of drugs metabolized by CYP3A4.

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

Gymnema and Idelalisib

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Idelalisib

Idelalisib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Gymnema interacts with.

Theoretically, gymnema might increase levels of drugs metabolized by CYP3A4.
One in vitro study using rat liver microsomes shows that gymnema can modestly inhibit the CYP3A4 enzyme. However, other in vitro research using human liver microsomes shows that gymnema does not affect CYP3A4 activity. Animal research also shows that gymnema does not alter the function of CYP3A4. In one study in rats, oral administration of gymnema for 7 days did not alter the clearance of amlodipine, a CYP3A4 substrate.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the honest picture: your body clears idelalisib (Zydelig) using a liver enzyme called CYP3A4, and the concern on file is that Gymnema might slow that enzyme down. If that happened, idelalisib could build up a bit, which in theory could mean stronger effects and more of its known side effects, things like diarrhea, liver enzyme changes, rash, or low blood counts.

But I want you to take a breath here. This worry comes only from one early lab study using rat tissue. Other lab and animal research showed no real effect on CYP3A4. So this is a theoretical, low-likelihood concern, not something proven in people. Since idelalisib is a serious cancer medicine, please still run Gymnema past your oncologist or pharmacist before adding it.

References
  1. Rammohan B, Samit K, Chinmoy D, et al. Human cytochrome P450 enzyme modulation by gymnema sylvestre: a predictive safety evaluation by LC-MS/MS. Pharmacogn Mag. 2016 Jul;12(Suppl 4):S389-S394.
  2. Vaghela M, Sahu N, Kharkar P, Pandita N. In vivo pharmacokinetic interaction by ethanolic extract of gymnema sylvestre with CYP2C9 (tolbutamide), CYP3A4 (amlodipine) and CYP1A2 (phenacetin) in rats. Chem Biol Interact. 2017 Dec 25;278:141-151. PubMed
  3. Vaghela M, Iyer K, Pandita N. In vitro inhibitory effect of gymnema sylvestre extracts and total gymnemic acids fraction on select cytochrome P450 activities in rat liver microsomes. Eur J Drug Metab Pharmacokinet. 2017 Oct 10. 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

Gymnema Also Interacts With Other Medications

Gymnema has 347 moderate, 503 minor known drug interactions in our database — the Idelalisib 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 Gymnema

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

Everything else you take

See Every Supplement That Interacts With Idelalisib

This page covers Gymnema only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Idelalisib page lists 143 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 · 100 moderate · 40 minor.

From our pharmacist’s overview on the Idelalisib page

“Idelalisib (Zydelig) treats certain blood cancers, work that leaves little room for error, so start with the three major-rated entries on this page. Grapefruit raises idelalisib levels and the risk of side effects with them, St.”

Reviewed by 2 · Jul 18, 2026

Open the Idelalisib interaction page

One more smart check

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

We hold 1,084 real supplement products containing Gymnema, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Gymnema. Your product may carry other ingredients that interact with Idelalisib too, on top of Gymnema — 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 Gymnema and Idelalisib 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 Gymnema
Top 25%

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

29 days ago today
Medication Idelalisib
Steady interest

#2,610 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 Gymnema

What is Gymnema?

Gymnema
  • Blood sugar support
  • Type 2 diabetes
  • Sugar cravings
  • Weight management
  • Cholesterol support

Gymnema is an Ayurvedic herb best known for possibly helping lower blood sugar and reducing the taste of sweetness on the tongue. Some early human studies are encouraging for blood sugar support, but the evidence is still limited and not strong enough to replace standard treatment. If you have diabetes or take other medicines, talk with your pharmacist or doctor before using it.

Read the full Gymnema monograph & all interactions
Medication

About Idelalisib

What Is Idelalisib Used For?

Brand name: Zydelig

Zydelig (idelalisib) is approved to treat relapsed chronic lymphocytic leukemia (CLL) — a cancer of the blood and bone marrow — when used together with rituximab. It is specifically for patients who have already received treatment and for whom rituximab alone would be appropriate due to other health conditions.

Zydelig is not approved or recommended as a first-line (initial) treatment for CLL or any other cancer, including small lymphocytic lymphoma (SLL) or follicular lymphoma (FL). It is also not approved in combination with bendamustine and rituximab, or with rituximab alone, for FL, SLL, or other slow-growing non-Hodgkin lymphomas.

See full Idelalisib drug information
Keep checking

Other Drugs & Gymnema

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

0Major
347Moderate
503Minor
1,979No known interaction
Moderate

347 interactions

Showing 60 of 347 moderate interactions — see all 347 on the Gymnema page.

Minor

503 interactions

Showing 60 of 503 minor interactions — see all 503 on the Gymnema page.

No interaction 1,979 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 Gymnema and Idelalisib Together: Common Questions

Can you take Gymnema with Idelalisib?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Gymnema and Idelalisib interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Idelalisib and Gymnema?

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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.