Drug & supplement interaction

Hibiscus Sabdariffa + Paclitaxel

Paclitaxel brand names: Taxol, Abraxane.

Minor Interaction
The bottom line Minor

Paclitaxel falls into 2 drug categories that Hibiscus Sabdariffa can interact with; the most serious is rated minor. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.

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

Hibiscus Sabdariffa and Paclitaxel

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

Why Are There 2 Interactions?

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Paclitaxel

Paclitaxel falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Hibiscus Sabdariffa interacts with.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP3A4. This interaction has not been reported in humans.
Severity Minor 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 gist: your body clears paclitaxel partly through a liver enzyme called CYP3A4. In lab dish studies, hibiscus extract appears to slow that same enzyme down a bit. If that held true in people, paclitaxel could be cleared a little more slowly and build up, which in theory could mean stronger side effects like low blood counts, numbness or tingling in the hands and feet, fatigue, or hair loss.

The important part: this is only theoretical, based on test-tube work, and has never actually been seen in real patients. A cup of tart hibiscus tea is unlikely to be a problem. Still, since you're on chemotherapy, please run any concentrated hibiscus supplement past your oncologist or pharmacist before using it.

References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

2 of 2

Paclitaxel also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, Hibiscus sabdariffa might reduce the metabolism of CYP2C8 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C8. This interaction has not been reported in humans.
Severity Minor 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 gist: your body relies on a liver enzyme called CYP2C8 to help break down and clear paclitaxel. In lab (test tube) studies, hibiscus extract slowed that same enzyme down. If that were to happen in a person, paclitaxel could clear a little more slowly and build up, which in theory might mean more of its usual side effects, things like low blood counts, numbness or tingling in the hands and feet, fatigue, and hair loss.

The important part: this is purely theoretical and has never actually been reported in people. Occasional cups of tart hibiscus tea are unlikely to be a problem, but concentrated supplements are less predictable. Since you're going through chemo, please mention any hibiscus product to your oncology pharmacist or doctor so they can keep an eye on things.

References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.

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

Hibiscus Sabdariffa Also Interacts With Other Medications

Hibiscus Sabdariffa has 2 major, 266 moderate, 818 minor known drug interactions in our database — the Paclitaxel 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 Hibiscus Sabdariffa

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

Everything else you take

See Every Supplement That Interacts With Paclitaxel

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paclitaxel page lists 152 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Grapefruit (major), St. John's Wort (major) and Sweet Orange (major).

By severity: 5 major · 108 moderate · 39 minor.

Open the Paclitaxel interaction page

How much people look this up

Where Hibiscus Sabdariffa and Paclitaxel 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 Hibiscus Sabdariffa
Top half

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

29 days ago today
Medication Paclitaxel
Steady interest

#1,633 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 Hibiscus Sabdariffa

What is Hibiscus Sabdariffa?

Hibiscus Sabdariffa
  • High blood pressure
  • Heart and cholesterol health
  • Digestive upset
  • Antioxidant support
  • Fever and general wellness

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and while hibiscus tea is generally well tolerated in food amounts, concentrated supplements should be used cautiously and avoided in pregnancy. Talk to your pharmacist or doctor before using it for a medical condition.

Read the full Hibiscus Sabdariffa monograph & all interactions
Medication

About Paclitaxel (with albumin) Injection

What Is Paclitaxel (with albumin) Injection Used For?

Brand names: Taxol, Abraxane

Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound) is used to treat three types of cancer. It treats metastatic breast cancer in patients whose prior chemotherapy has stopped working or who relapsed within 6 months of completing adjuvant (post-surgery) chemotherapy. It is also used as a first-line treatment for locally advanced or metastatic non-small cell lung cancer (NSCLC) — given together with carboplatin — in patients who cannot have surgery or radiation therapy.

Additionally, it is approved as a first-line treatment for metastatic adenocarcinoma of the pancreas, given in combination with gemcitabine. All three uses apply specifically to Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound), including the brands Abraxane and related albumin-bound formulations.

See full Paclitaxel (with albumin) Injection drug information
Keep checking

Other Drugs & Hibiscus Sabdariffa

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

2Major
266Moderate
818Minor
1,743No known interaction
Major

2 interactions

Moderate

266 interactions

Showing 60 of 266 moderate interactions — see all 266 on the Hibiscus Sabdariffa page.

Minor

818 interactions

Showing 60 of 818 minor interactions — see all 818 on the Hibiscus Sabdariffa page.

No interaction 1,743 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 Hibiscus Sabdariffa and Paclitaxel Together: Common Questions

Can you take Hibiscus Sabdariffa with Paclitaxel?
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.
Why are there 2 interactions listed for Hibiscus Sabdariffa and Paclitaxel?
Paclitaxel belongs to more than one drug category, and Hibiscus Sabdariffa 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 Hibiscus Sabdariffa and Paclitaxel 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

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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.