Drug & supplement interaction

Hemp Agrimony + Ivosidenib

Ivosidenib brand name: Tibsovo.

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

Hemp Agrimony has a moderate interaction with Ivosidenib. 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 Ivosidenib

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Ivosidenib

Ivosidenib 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 key thing about this pairing: it's really about the herb, not so much your cancer medicine. Hemp agrimony naturally contains compounds called pyrrolizidine alkaloids that can be hard on the liver. Ivosidenib (Tibsovo) speeds up an enzyme called CYP3A4, and that same enzyme can turn those plant compounds into more toxic byproducts. So in theory, taking ivosidenib could make the herb's liver-damaging potential worse, not change how well your leukemia or bile duct treatment works.

I want to be honest that this is theoretical, based on lab work rather than studies in people. Still, hemp agrimony isn't recommended internally to begin with, and people on ivosidenib already need careful liver monitoring. Please check with your oncology team or pharmacist before using any product containing it.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Ivosidenib one above is one of them. If you take anything else, check it against the full list below.

Moderate 437 No known interaction 2,393 (incl. Ivosidenib)
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 Ivosidenib

This page covers Hemp Agrimony only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ivosidenib page lists 162 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 115 moderate · 39 minor.

From our pharmacist’s overview on the Ivosidenib page

“Ivosidenib (Tibsovo) treats acute myeloid leukemia and bile duct cancer driven by an IDH1 mutation, and the 162 supplements on this list call for genuine vigilance, starting with the 8 rated major. Ivosidenib is cleared by the CYP3A4 enzyme, so grapefruit can drive its blood level up while St.”

Reviewed by 2 · Jul 18, 2026

Open the Ivosidenib 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 Ivosidenib 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 Ivosidenib 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

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

29 days ago today
Medication Ivosidenib
Top half

#726 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 Ivosidenib

What Is Ivosidenib Used For?

Brand name: Tibsovo

Tibsovo (ivosidenib) is used to treat adults who have a susceptible IDH1 mutation, confirmed by an FDA-approved test. It treats newly diagnosed acute myeloid leukemia (AML) in adults 75 or older, or those who cannot tolerate intensive chemotherapy — either alone or combined with a medicine called azacitidine. It also treats relapsed or refractory AML (AML that has come back or stopped responding to treatment) and relapsed or refractory myelodysplastic syndromes (MDS).

Tibsovo is also approved for adults with previously treated, locally advanced or metastatic cholangiocarcinoma (bile duct cancer that has spread) who carry an IDH1 mutation.

See full Ivosidenib 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
437 Moderate 2,392 No 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

We also checked Hemp Agrimony against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,392 medications checked with no known interaction — see the full Hemp Agrimony list.

See the full Hemp Agrimony interactions page
See every supplement checked against Ivosidenib, 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
Hemp Agrimony monograph › Uses, safety, and every drug interaction in one place Ivosidenib supplement interactions › Every supplement checked against Ivosidenib, ranked by severity Ivosidenib 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 Hemp Agrimony and Ivosidenib Together: Common Questions

Can you take Hemp Agrimony with Ivosidenib?
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 Ivosidenib 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 Ivosidenib and Hemp Agrimony?

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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.