Drug & supplement interaction

Hu Zhang + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

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

Tivozanib Hydrochloride falls into 2 drug categories that Hu Zhang can interact with; the most serious is rated moderate. Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.

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

Hu Zhang and Tivozanib Hydrochloride

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Hu Zhang interacts with.

Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP3A4 enzyme. However, a clinical study in adults with NAFLD found that adding resveratrol 3000 mg daily for 8 weeks did not necessitate dose adjustments to any established medications metabolized by CYP3A4.
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

Your body clears tivozanib (Fotivda) using a liver enzyme called CYP3A4. Hu Zhang contains resveratrol, which in lab studies looks like it can slow that enzyme down. If that happened in real life, tivozanib could build up a bit higher than expected, which might mean more of its usual side effects, such as high blood pressure, fatigue, diarrhea, mouth sores, or hand and foot tenderness.

Here's the honest part: this concern is theoretical, based mostly on test-tube data. One human study using a big resveratrol dose didn't force any dose changes. Still, since tivozanib is a cancer drug with real side effects, please run any Hu Zhang use past your oncology team or pharmacist before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Piver B, Berthou F, Dreano Y, Lucas D. Inhibition of CYP3A, CYP1A and CYP2E1 activities by resveratrol and other non volatile red wine components. Toxicol Lett 2001;125:83-91. PubMed
  2. Yu, C., Shin, Y. G., Kosmeder, J. W., Pezzuto, J. M., and van Breemen, R. B. Liquid chromatography/tandem mass spectrometric determination of inhibition of human cytochrome P450 isozymes by resveratrol and resveratrol-3-sulfate. Rapid Commun.Mass Spectro PubMed
  3. Chachay VS, Macdonald GA, Martin JH, Whitehead JP, O'Moore-Sullivan TM, Lee P, Franklin M, Klein K, Taylor PJ, Ferguson M, Coombes JS, Thomas GP, Cowin GJ, Kirkpatrick CM, Prins JB, Hickman IJ. Resveratrol does not benefit patients with nonalcoholic fatty
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Tivozanib Hydrochloride also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Hu zhang contains the constituent resveratrol. Resveratrol seems to have antiplatelet effects.
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 pairing Hu Zhang with Fotivda (tivozanib). This isn't about how your liver breaks the drug down. It's about bleeding risk. Hu Zhang contains resveratrol, which in lab studies seems to make platelets a little less sticky. Tivozanib itself can already raise blood pressure and, in some people, increase the chance of bleeding or slow wound healing. Stacking a supplement that nudges platelets the same direction could, in theory, add to that.

I'll be honest that this is a theoretical concern based on how resveratrol behaves, not proven in people. Still, with a cancer therapy like this, I'd loop in your oncologist or pharmacist before adding Hu Zhang rather than guessing.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pace-Asciak CR, Rounova O, Hahn SE, et al. Wines and grape juices as modulators of platelet aggregation in healthy human subjects. Clin Chim Acta 1996;246:163-82. PubMed
  2. Bertelli AA, Giovannini L, Bernini W, et al. Antiplatelet activity of cis-resveratrol. Drugs Exp Clin Res 1996;22:61-3.
  3. Pace-Asciak CR, Hahn S, Diamandis EP, et al. The red wine phenolics trans-resveratrol and quercetin block human platelet aggregation and eicosanoid synthesis: implications for protection against coronary heart disease. Clin Chim Acta 1995;235:207-19.
  4. Bertelli A, Bertelli AA, Gozzini A, Giovannini L. Plasma and tissue resveratrol concentrations and pharmacological activity. Drugs Exp Clin Res 1998;24:133-8.
  5. Bertelli AA, Giovannini L, Giannessi D, et al. Antiplatelet activity of synthetic and natural resveratrol in red wine. Int J Tissue React 1995;17:1-3.
  6. Dobrydneva, Y., Williams, R. L., and Blackmore, P. F. trans-Resveratrol inhibits calcium influx in thrombin-stimulated human platelets. Br.J.Pharmacol. 1999;128(1):149-157.
  7. Kirk, R. I., Deitch, J. A., Wu, J. M., and Lerea, K. M. Resveratrol decreases early signaling events in washed platelets but has little effect on platalet in whole food. Blood Cells Mol.Dis. 2000;26(2):144-150.
  8. Zbikowska, H. M. and Olas, B. Antioxidants with carcinostatic activity (resveratrol, vitamin E and selenium) in modulation of blood platelet adhesion. J Physiol Pharmacol. 2000;51(3):513-520.
  9. Olas, B., Wachowicz, B., Saluk-Juszczak, J., and Zielinski, T. Effect of resveratrol, a natural polyphenolic compound, on platelet activation induced by endotoxin or thrombin. Thromb.Res 8-15-2002;107(3-4):141-145. PubMed
  10. Ma, Z. H. and Ma, Q. Y. Resveratrol: a medical drug for acute pancreatitis. World J Gastroenterol. 6-7-2005;11(21):3171-3174. PubMed
  11. Pendurthi, U. R., Williams, J. T., and Rao, L. V. Resveratrol, a polyphenolic compound found in wine, inhibits tissue factor expression in vascular cells : A possible mechanism for the cardiovascular benefits associated with moderate consumption of wine. 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

Hu Zhang Also Interacts With Other Medications

Hu Zhang has 827 moderate known drug interactions in our database — the Tivozanib Hydrochloride one above is among them. If you take anything else, check it against the full list below.

Moderate 827 No known interaction 2,003 (incl. Tivozanib Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Hu Zhang

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

Everything else you take

See Every Supplement That Interacts With Tivozanib Hydrochloride

This page covers Hu Zhang only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tivozanib Hydrochloride page lists 288 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 7 major · 239 moderate · 42 minor.

From our pharmacist’s overview on the Tivozanib Hydrochloride page

“Tivozanib (Fotivda), an oral targeted therapy for advanced kidney cancer, has a supplement list that calls for genuine vigilance. Seven of the 288 ingredients on file are rated major, and those seven deserve your attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Tivozanib Hydrochloride interaction page

One more smart check

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

We hold 1,014 real supplement products containing Hu Zhang, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hu Zhang. Your product may carry other ingredients that interact with Tivozanib Hydrochloride too, on top of Hu Zhang — 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 Hu Zhang and Tivozanib Hydrochloride 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 Hu Zhang
Top 25%

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

29 days ago today
Medication Tivozanib Hydrochloride
Top 25%

#629 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 Hu Zhang

What is Hu Zhang?

  • Source of resveratrol
  • Heart and circulation support
  • Inflammation
  • Liver and digestive complaints (traditional)
  • Cough and respiratory symptoms (traditional)
  • Skin and joint conditions (traditional topical use)

Hu Zhang (Japanese knotweed root) is a traditional Chinese herb that is one of the richest natural sources of resveratrol and emodin. Some lab and early human research looks interesting for inflammation and heart health, but high-quality evidence in people is limited. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Hu Zhang monograph & all interactions
Medication

About Tivozanib

What Is Tivozanib Used For?

Brand name: Fotivda

Tivozanib, sold as Fotivda, treats adults with relapsed or refractory advanced renal cell carcinoma (RCC), a type of kidney cancer. It is used after two or more earlier systemic (whole-body) therapies.

"Relapsed" means the cancer came back. "Refractory" means it did not respond to earlier treatment.

See full Tivozanib drug information
Keep checking

Other Drugs & Hu Zhang

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

0Major
827Moderate
0Minor
2,002No known interaction
827 Moderate 2,002 No interaction
Moderate

827 interactions

Showing 60 of 827 moderate interactions — see all 827 on the Hu Zhang page.

No interaction 2,002 drugs checked — show the list

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

Showing the 60 most looked-up of 2,002 medications checked with no known interaction — see the full Hu Zhang list.

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

Can you take Hu Zhang with Tivozanib Hydrochloride?
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 Hu Zhang and Tivozanib Hydrochloride?
Tivozanib Hydrochloride belongs to more than one drug category, and Hu Zhang 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 Hu Zhang and Tivozanib Hydrochloride 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 Tivozanib Hydrochloride and Hu Zhang?

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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.