Drug & supplement interaction

Hops + Zanubrutinib

Zanubrutinib brand name: Brukinsa.

Minor Interaction
The bottom line Minor

Hops has a minor interaction with Zanubrutinib. Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.

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

Hops and Zanubrutinib

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Zanubrutinib

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

Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
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 for Brukinsa (zanubrutinib): your body relies on a liver enzyme called CYP3A4 to break it down. Lab and animal studies hint that certain hops compounds (lupulones) might speed that enzyme up a little. If that happened, your body could clear zanubrutinib a bit faster, which in theory might make it slightly less effective at controlling your lymphoma or leukemia.

The good news is this is mostly a theoretical concern. In a real human study, a standardized hops extract lowered levels of a similar CYP3A4 drug by under 8 percent, which experts considered too small to matter. Still, since zanubrutinib is a cancer therapy, please run any hops supplement by your oncologist or pharmacist before starting it.

References
  1. Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
  2. van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. 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

Hops Also Interacts With Other Medications

Hops has 289 moderate, 573 minor known drug interactions in our database — the Zanubrutinib 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 Hops

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

Everything else you take

See Every Supplement That Interacts With Zanubrutinib

This page covers Hops only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Zanubrutinib page lists 160 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 · 119 moderate · 38 minor.

From our pharmacist’s overview on the Zanubrutinib page

“Grapefruit is the biggest supplement risk with zanubrutinib (Brukinsa), a targeted therapy for certain blood cancers, and this list deserves genuine care. Grapefruit blocks the enzyme (CYP3A4) that clears the drug, so levels can climb and side effects with them.”

Reviewed by 2 · Jul 18, 2026

Open the Zanubrutinib interaction page

One more smart check

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

We hold 1,325 real supplement products containing Hops, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hops. Your product may carry other ingredients that interact with Zanubrutinib too, on top of Hops — 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 Hops and Zanubrutinib 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 Hops
Top 25%

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

29 days ago today
Medication Zanubrutinib
Top 25%

#481 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 Hops

What is Hops?

Hops
  • Sleep problems and insomnia
  • Anxiety and restlessness
  • Menopausal symptoms
  • Mild digestive complaints
  • Flavoring in beer and food

Hops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used short-term, though they may cause drowsiness, and should be avoided during pregnancy and breastfeeding because their safety is unknown.

Read the full Hops monograph & all interactions
Medication

About Zanubrutinib

What Is Zanubrutinib Used For?

Brand name: Brukinsa

Brukinsa (zanubrutinib) is used to treat adult patients with several blood cancers. These include chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), Waldenström's macroglobulinemia (WM), mantle cell lymphoma (MCL) after at least one prior treatment, relapsed or refractory marginal zone lymphoma (MZL) after at least one prior anti-CD20 regimen, and relapsed or refractory follicular lymphoma (FL) in combination with obinutuzumab after two or more prior lines of treatment.

Some of these uses — MCL, MZL, and FL — are approved under accelerated approval, meaning they are based on tumor response rates rather than confirmed long-term survival benefit. Continued approval for those uses may depend on results from confirmatory trials.

See full Zanubrutinib drug information
Keep checking

Other Drugs & Hops

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

0Major
289Moderate
573Minor
1,967No known interaction
Moderate

289 interactions

Showing 60 of 289 moderate interactions — see all 289 on the Hops page.

Minor

573 interactions

Showing 60 of 573 minor interactions — see all 573 on the Hops page.

No interaction 1,967 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 Hops and Zanubrutinib Together: Common Questions

Can you take Hops with Zanubrutinib?
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 Hops and Zanubrutinib 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 Zanubrutinib and Hops?

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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.