Drug & supplement interaction

Hemp Agrimony + Isoniazid, Rifampin

Isoniazid, Rifampin brand name: Rifamate.

Moderate Interaction
The bottom line Moderate

Isoniazid, Rifampin falls into 2 drug categories that Hemp Agrimony can interact with; the most serious is rated moderate. Hemp agrimony contains hepatotoxic pyrrolizidine alkaloids (PA).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hemp Agrimony and Isoniazid, Rifampin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Hemp Agrimony interacts with whole categories of medication. Isoniazid, Rifampin falls into 2 of those categories, so it can interact with Hemp Agrimony in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Isoniazid, Rifampin

Isoniazid, Rifampin falls under HEPATOTOXIC DRUGS — the group Hemp Agrimony interacts with.

Hemp agrimony contains hepatotoxic pyrrolizidine alkaloids (PA). Theoretically, using hemp agrimony with hepatotoxic drugs might have additive adverse effects on the liver. Some drugs that can adversely affect the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many 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 know about Rifamate: both isoniazid and rifampin are already known to be hard on the liver. That's why your doctor checks your liver enzymes while you're on it. Hemp agrimony is a separate concern because it can contain pyrrolizidine alkaloids, plant compounds that may injure the liver too.

Put the two together and you've got a possible double hit on the same organ. The worry isn't a chemical that changes how your medicine works, it's added strain on the liver. Watch for warning signs like yellowing of your skin or eyes, dark urine, belly pain, nausea, or unusual tiredness. To be fair, this is a theoretical concern based on how each one behaves, not proven cases. Still, given hemp agrimony's liver risk, I'd avoid it here and check with your doctor or pharmacist first.

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
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

2 of 2

Isoniazid, Rifampin also falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS.

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 Rifamate (which combines isoniazid and rifampin): the rifampin part is a strong booster of a liver enzyme called CYP3A4. Hemp agrimony can contain pyrrolizidine alkaloids, plant compounds that this same enzyme turns into byproducts that can be hard on the liver. So in theory, taking rifampin could speed up the creation of those harmful breakdown products from hemp agrimony, raising the worry of liver injury.

This matters because both isoniazid and rifampin already stress the liver on their own. Watch for warning signs like yellowing skin or eyes, dark urine, nausea, belly pain, or unusual tiredness. Just remember, this is based only on lab-type reasoning, not human studies. Still, I'd skip hemp agrimony here and run it past your doctor or pharmacist first.

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 439 moderate known drug interactions in our database — the Isoniazid, Rifampin one above is among 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 Isoniazid, Rifampin

This page covers Hemp Agrimony only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Isoniazid, Rifampin page lists 145 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Asarabacca (major), Beer (major) and Grapefruit (major).

By severity: 8 major · 117 moderate · 20 minor.

From our pharmacist’s overview on the Isoniazid, Rifampin page

“Rifamate combines isoniazid and rifampin, the backbone of tuberculosis treatment, and both drugs are hard on the liver, which is why this list of 145 supplement and herbal interactions deserves genuine respect. Eight entries rate major, and the largest cluster, 38 ingredients, adds to that same liver strain, with alcohol in beer or win…”

Reviewed by 2 · Jul 18, 2026

Open the Isoniazid, Rifampin 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 Isoniazid, Rifampin 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 Isoniazid, Rifampin 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
Top half

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

29 days ago today
Medication Isoniazid, Rifampin
Top 25%

#294 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
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
439Moderate
0Minor
2,390No known interaction
Moderate

439 interactions

Showing 60 of 439 moderate interactions — see all 439 on the Hemp Agrimony page.

No interaction 2,390 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 Isoniazid, Rifampin Together: Common Questions

Can you take Hemp Agrimony with Isoniazid, Rifampin?
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.
Why are there 2 interactions listed for Hemp Agrimony and Isoniazid, Rifampin?
Isoniazid, Rifampin belongs to more than one drug category, and Hemp Agrimony interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Hemp Agrimony and Isoniazid, Rifampin 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.