Drug & supplement interaction

Khella + Pretomanid

Pretomanid brand name: Pretomanid.

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

Khella has a moderate interaction with Pretomanid. Theoretically, khella might have additive adverse effects on the liver when used with hepatotoxic drugs.

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

Khella and Pretomanid

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Pretomanid

Pretomanid falls under HEPATOTOXIC DRUGS — the group Khella interacts with.

Theoretically, khella might have additive adverse effects on the liver when used with hepatotoxic drugs. Khella can increase liver transaminases. Some drugs that can adversely affect the liver include acetaminophen (Tylenol), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), and many others.
Severity Moderate Likelihood Possible Evidence B

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 concern with combining khella and pretomanid. Pretomanid is already known to be tough on the liver, and it's taken alongside two other drugs (bedaquiline and linezolid) that can stress the liver too. Khella has its own reputation for bumping up liver enzymes (those transaminases your doctor watches on blood tests). Stack them together, and the worry is an additive burden on the liver.

What might that look like? Things like fatigue, nausea, belly pain on the upper right side, dark urine, or yellowing of the skin or eyes. To be fair, this is largely a theoretical, caution-based interaction. Still, since your TB treatment is so important, please don't add khella without first checking with your doctor or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Harvengt C, Desager JP. HDL-cholesterol increase in normolipaemic subjects on khellin: a pilot study. Int J Clin Pharmacol Res 1983;3:363-6.

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

Khella Also Interacts With Other Medications

Khella has 617 moderate known drug interactions in our database — the Pretomanid one above is one of them. If you take anything else, check it against the full list below.

Moderate 617 No known interaction 2,213 (incl. Pretomanid)
Taking anything else?

Check Another of Your Medications Against Khella

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

Everything else you take

See Every Supplement That Interacts With Pretomanid

This page covers Khella only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pretomanid page lists 143 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 10 major · 122 moderate · 11 minor.

From our pharmacist’s overview on the Pretomanid page

“Pretomanid is reserved for highly drug-resistant tuberculosis, and it can stress the liver and lengthen the heart's QT interval, so the supplements on this page deserve genuine care. Ten of the 143 ingredients on file carry a major rating, and nearly all of those either compound the liver risk (alcohol in beer or wine is the plainest e…”

Reviewed by 2 · Jul 18, 2026

Open the Pretomanid interaction page

One more smart check

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

We hold 43 real supplement products containing Khella, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Khella. Your product may carry other ingredients that interact with Pretomanid too, on top of Khella — 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 Khella and Pretomanid 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 Khella
Steady interest

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

29 days ago today
Medication Pretomanid
Steady interest

#2,415 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 Khella

What is Khella?

Khella
  • Asthma and bronchitis
  • Angina and heart-related chest pain
  • Kidney stones
  • Vitiligo and psoriasis
  • Mild high blood pressure

Khella is a Mediterranean herb whose seeds contain compounds like khellin that may relax smooth muscle in the airways and blood vessels. While it has a long history of traditional use for breathing and heart problems, modern evidence in supplement form is limited, and it can cause side effects and sun sensitivity, so talk with your pharmacist or doctor before using it.

Read the full Khella monograph & all interactions
Medication

About Pretomanid

What Is Pretomanid Used For?

Brand name: Pretomanid

Pretomanid Tablet is used only as part of a three-drug regimen — together with bedaquiline and linezolid — to treat adults with pulmonary (lung) tuberculosis that is resistant to multiple antibiotics, including isoniazid, rifamycins, a fluoroquinolone, and a second-line injectable TB drug. It is also used for adults whose TB is resistant to isoniazid and rifampin and who cannot tolerate or are not responding to standard TB therapy.

Pretomanid Tablets are not for drug-sensitive TB, latent (inactive) TB infection, TB outside the lungs, or TB that responds to standard treatment. They should only be used in combination with bedaquiline and linezolid — safety and effectiveness with other drug combinations have not been established.

See full Pretomanid drug information
Keep checking

Other Drugs & Khella

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

0Major
617Moderate
0Minor
2,212No known interaction
617 Moderate 2,212 No interaction
Moderate

617 interactions

Showing 60 of 617 moderate interactions — see all 617 on the Khella page.

No interaction 2,212 drugs checked — show the list

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

Showing the 60 most looked-up of 2,212 medications checked with no known interaction — see the full Khella list.

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

Can you take Khella with Pretomanid?
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.
How serious is the Khella and Pretomanid 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 Pretomanid and Khella?

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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.