Drug & supplement interaction

Hemp Agrimony + Aprepitant

Aprepitant brand names: Emend, Cinvanti.

Moderate Interaction
The bottom line Moderate

Hemp Agrimony has a moderate interaction with Aprepitant. Hemp agrimony contains hepatotoxic pyrrolizidine alkaloids (PA) which are substrates of cytochrome P450 3A4 (CYP3A4).

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

Hemp Agrimony and Aprepitant

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Aprepitant

Aprepitant falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Hemp Agrimony interacts with.

Hemp agrimony contains hepatotoxic pyrrolizidine alkaloids (PA) which are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.
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 thing to understand about this pairing. Aprepitant (Emend, Cinvanti) can act as a mild inducer of the liver enzyme CYP3A4, meaning it can nudge that enzyme to work a bit faster. The concern isn't that hemp agrimony changes how your aprepitant works. It's the reverse. Hemp agrimony contains pyrrolizidine alkaloids, and CYP3A4 is the enzyme that turns those compounds into liver-damaging byproducts. In theory, speeding up that enzyme could mean more toxic metabolites and a higher chance of liver harm.

I'll be honest, this is based only on lab and animal data, so it's theoretical. But hemp agrimony is already discouraged for internal use because of its liver risks, and most folks taking aprepitant are going through chemotherapy and don't need an extra strain on the liver. Please check with your oncology team or pharmacist before using any hemp agrimony product.

References
  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  2. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. 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

Hemp Agrimony Also Interacts With Other Medications

Hemp Agrimony has 437 moderate known drug interactions in our database — the Aprepitant 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 Hemp Agrimony

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

Everything else you take

See Every Supplement That Interacts With Aprepitant

This page covers Hemp Agrimony only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aprepitant page lists 158 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 · 116 moderate · 39 minor.

From our pharmacist’s overview on the Aprepitant page

“Aprepitant (Emend, Cinvanti) keeps chemotherapy patients from vomiting, so a supplement that undoes it mid-cycle is a problem, and I read this list with genuine vigilance. Nearly all 158 entries touch CYP3A4, the liver enzyme that clears aprepitant.”

Reviewed by 2 · Jul 18, 2026

Open the Aprepitant interaction page

One more smart check

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

We hold 3 real supplement products containing Hemp Agrimony, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hemp Agrimony. Your product may carry other ingredients that interact with Aprepitant too, on top of Hemp Agrimony — 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 Hemp Agrimony and Aprepitant 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 Hemp Agrimony
Steady interest

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

29 days ago today
Medication Aprepitant
Top 25%

#439 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 Hemp Agrimony

What is Hemp Agrimony?

Hemp Agrimony
  • Digestive complaints
  • Cold and flu symptoms
  • Respiratory conditions
  • Mild fever
  • Traditional 'tonic' or detox use

Hemp agrimony is a traditional European herb that has been used for digestion, colds, and as a general tonic, but there is very little reliable human research to support these uses. More importantly, the plant can contain pyrrolizidine alkaloids that may harm the liver, so most experts do not recommend taking it internally. Talk with your pharmacist or doctor before using any product that contains hemp agrimony.

Read the full Hemp Agrimony monograph & all interactions
Medication

About Aprepitant

What Is Aprepitant Used For?

Brand names: Emend, Cinvanti

Aprepitant is used to prevent nausea and vomiting — not to treat it once it has started. It is always used alongside other anti-nausea medicines, not on its own.

EMEND capsules (oral) are approved for adults and children 12 and older to prevent nausea from highly or moderately emetogenic (nausea-causing) chemotherapy. EMEND for oral suspension extends that same use down to children as young as 6 months. CINVANTI (IV injection) is approved for adults only, for chemotherapy-related nausea. APONVIE (IV emulsion) is approved for adults to prevent postoperative nausea and vomiting (PONV) — nausea after surgery. Aprepitant capsules (generic) are approved for adults and children 12 and older for chemotherapy-related nausea, and also for adults to prevent PONV.

See full Aprepitant drug information
Keep checking

Other Drugs & Hemp Agrimony

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

0Major
437Moderate
0Minor
2,392No known interaction
Moderate

437 interactions

Showing 60 of 437 moderate interactions — see all 437 on the Hemp Agrimony page.

No interaction 2,392 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 Hemp Agrimony and Aprepitant Together: Common Questions

Can you take Hemp Agrimony with Aprepitant?
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 Hemp Agrimony and Aprepitant 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.