Drug & supplement interaction

Ipriflavone + Etrasimod

Etrasimod brand name: Velsipity.

Moderate Interaction
The bottom line Moderate

Etrasimod falls into 2 drug categories that Ipriflavone can interact with; the most serious is rated moderate. Ipriflavone is thought to competitively inhibit cytochrome P450 2C9 (CYP2C9).

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

Ipriflavone and Etrasimod

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

Why Are There 2 Interactions?

Ipriflavone interacts with whole categories of medication. Etrasimod falls into 2 of those categories, so it can interact with Ipriflavone 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 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Etrasimod

Etrasimod falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Ipriflavone interacts with.

Ipriflavone is thought to competitively inhibit cytochrome P450 2C9 (CYP2C9). Theoretically, concurrent use of ipriflavone and drugs metabolized by these enzymes might result in decreased drug elimination, increased serum levels, and potential toxicity. Some drugs metabolized by CYP2C9 include amitriptyline (Elavil), diazepam (Valium), estradiol (Estrace), tacrine (Cognex), verapamil (Calan), warfarin (Coumadin), zileuton (Zyflo), 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 situation with Velsipity (etrasimod). This medicine is partly cleared from your body by a liver enzyme called CYP2C9. Ipriflavone may gently block that same enzyme, so on paper, combining the two could slow how fast etrasimod leaves your system. If levels drift a little higher, you might notice more of etrasimod's known effects, like a slower heart rate (especially when you first start it), headache, dizziness, or changes in liver blood tests.

I want to be honest about the strength of this: it's a theoretical concern based only on lab studies, not real patient reports, so I wouldn't lose sleep over it. Still, since etrasimod already affects heart rate, it's worth a quick chat with your pharmacist or doctor before pairing them.

References
  1. Monostory K, Vereczkey L, Levai F, et al. Ipriflavone as an inhibitor of human cytochrome P450 enzymes. Br J Pharmacol 1998;123:605-10. PubMed
Moderate

IMMUNOSUPPRESSANTS

2 of 2

Etrasimod also falls under IMMUNOSUPPRESSANTS.

Concurrent use of ipriflavone and immunosuppressant drugs might have additive effects on inhibiting immune function. Some patients taking ipriflavone experience subclinical lymphocytopenia; avoid concurrent use. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
Severity Moderate Likelihood Possible Evidence A

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 ipriflavone with Velsipity (etrasimod). Etrasimod already works by dialing down your immune system, and one way it does that is by lowering the number of certain white blood cells (lymphocytes) circulating in your blood. That's part of how it calms inflammation in ulcerative colitis.

Ipriflavone can, in some people, quietly nudge those same white cells lower too. Stacked together, that could mean a deeper drop in immune cells than expected, which may raise your risk of catching infections. This concern is real enough that the guidance is to avoid using them at the same time. Please don't change either one on your own. Just check with your pharmacist or doctor first so they can weigh it and, if needed, keep an eye on your bloodwork.

References
  1. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: A randomized controlled trial. JAMA 2001;285:1482-8.

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

Ipriflavone Also Interacts With Other Medications

Ipriflavone has 390 moderate known drug interactions in our database — the Etrasimod 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 Ipriflavone

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

Everything else you take

See Every Supplement That Interacts With Etrasimod

This page covers Ipriflavone only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etrasimod page lists 219 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 176 moderate · 37 minor.

Open the Etrasimod interaction page

One more smart check

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

We hold 204 real supplement products containing Ipriflavone, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ipriflavone. Your product may carry other ingredients that interact with Etrasimod too, on top of Ipriflavone — 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 Ipriflavone and Etrasimod 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 Ipriflavone
Top half

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

29 days ago today
Medication Etrasimod
Top half

#1,407 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 Ipriflavone

What is Ipriflavone?

Ipriflavone
  • Bone density and osteoporosis
  • Postmenopausal bone loss
  • Athletic performance
  • Tinnitus related to bone disorders

Ipriflavone is a synthetic isoflavone studied mainly for bone health and osteoporosis, but high-quality research has not shown that it reliably prevents fractures or builds strong bone. Because it can lower white blood cell counts in some people and its long-term safety is not well established, talk with your pharmacist or doctor before using it.

Read the full Ipriflavone monograph & all interactions
Keep checking

Other Drugs & Ipriflavone

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

0Major
390Moderate
0Minor
2,439No known interaction
Moderate

390 interactions

Showing 60 of 390 moderate interactions — see all 390 on the Ipriflavone page.

No interaction 2,439 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 Ipriflavone and Etrasimod Together: Common Questions

Can you take Ipriflavone with Etrasimod?
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 Ipriflavone and Etrasimod?
Etrasimod belongs to more than one drug category, and Ipriflavone 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 Ipriflavone and Etrasimod 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 Etrasimod and Ipriflavone?

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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.