Drug & supplement interaction

Ipriflavone + Perampanel

Perampanel brand name: Fycompa.

Moderate Interaction
The bottom line Moderate

Perampanel falls into 2 drug categories that Ipriflavone can interact with; the most serious is rated moderate. Ipriflavone is thought to competitively inhibit cytochrome P450 1A2 (CYP1A2).

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

Ipriflavone and Perampanel

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. Perampanel 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 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Perampanel

Perampanel falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Ipriflavone interacts with.

Ipriflavone is thought to competitively inhibit cytochrome P450 1A2 (CYP1A2). 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 CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), Pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline (Slo-bid, Theo-Dur, others), zileuton (Zyflo), Zolmitriptan (Zomig), 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 gist for Perampanel (Fycompa): ipriflavone may gently block a liver enzyme called CYP1A2, which is one of the pathways that helps clear perampanel from your body. If that pathway slows down, perampanel can build up a bit more than expected, and that could mean stronger side effects like dizziness, sleepiness, trouble with balance, or mood and behavior changes (perampanel already carries a warning about irritability and aggression).

That said, this concern comes only from lab-type studies, not real patient cases, so it's more theoretical than proven. I wouldn't panic, but I also wouldn't ignore it. Before pairing these two, check in with your pharmacist or doctor so they can keep an eye on how you feel and adjust if needed.

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

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Perampanel also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

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 gist with ipriflavone and Fycompa (perampanel). Ipriflavone may slow down a liver enzyme called CYP2C9, which helps clear certain medicines. Since perampanel is partly handled by this enzyme, the theory is that ipriflavone could let more of it linger in your blood. Perampanel isn't a prodrug, so higher levels would mean a stronger effect, not a weaker one.

In plain terms, that could nudge up perampanel's typical side effects like dizziness, drowsiness, trouble walking, or mood and irritability changes. I want to be honest though: this is based only on lab testing, not real patients, so it's quite theoretical. Still, since perampanel affects the brain, it's worth a quick chat with your pharmacist or doctor before combining them. Don't change anything on your own.

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

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 Perampanel 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 Perampanel

This page covers Ipriflavone only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Perampanel page lists 230 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 175 moderate · 46 minor.

From our pharmacist’s overview on the Perampanel page

“Perampanel (Fycompa) is a seizure medicine that already causes drowsiness and dizziness on its own, which is why I treat this list of 230 interacting supplements with real care. Most entries do one of two things: they add to its sedating effect, as alcohol and kava do, or they change how the liver handles it.”

Reviewed by 2 · Jul 18, 2026

Open the Perampanel 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 Perampanel 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 Perampanel 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

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

29 days ago today
Medication Perampanel
Steady interest

#1,988 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
Medication

About Perampanel

What Is Perampanel Used For?

Brand name: Fycompa

Perampanel — available as Fycompa and in generic forms — is used to treat partial-onset seizures (seizures that start in one area of the brain) in patients with epilepsy aged 4 years and older. Both the tablet and oral suspension forms carry this indication.

Perampanel tablets and oral suspension are also approved as add-on (adjunctive) therapy for primary generalized tonic-clonic seizures (grand mal seizures involving the whole brain at once) in patients with epilepsy aged 12 years and older. Fycompa oral suspension and tablet share both indications.

See full Perampanel drug information
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 Perampanel Together: Common Questions

Can you take Ipriflavone with Perampanel?
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 Perampanel?
Perampanel 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 Perampanel 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

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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.