Drug & supplement interaction

Khella + Pyrazinamide

Pyrazinamide brand name: Tebrazid.

Moderate Interaction
The bottom line Moderate

Pyrazinamide falls into 2 drug categories that Khella can interact with; the most serious is rated moderate. Theoretically, concomitant use might result in increased photosensitivity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Khella and Pyrazinamide

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

Why Are There 2 Interactions?

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

Moderate

PHOTOSENSITIZING DRUGS

1 of 2

Why this applies to Pyrazinamide

Pyrazinamide falls under PHOTOSENSITIZING DRUGS — the group Khella interacts with.

Theoretically, concomitant use might result in increased photosensitivity. Khella constituents can cause photosensitivity. Some drugs that cause photosensitivity include amitriptyline (Elavil), quinolones (Ciprofloxacin, others), sulfa drugs (Septra, Bactrim, others), and tetracycline.
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 simple version: both khella and pyrazinamide can make your skin more sensitive to sunlight on their own. Pyrazinamide is already known to cause this kind of sun sensitivity in some people. Khella contains compounds (khellin and visnagin) that can do the same thing. Put them together and the worry is that you could sunburn faster or more severely than usual, even on a mild day.

I want to be honest about how strong this evidence is. It's mostly theoretical and based on anecdotal reports, not solid studies, so it's a possible concern rather than a proven one. If you do take both, simple sun smarts go a long way: sunscreen, a hat, and covering up outdoors. Before adding khella, run it by your pharmacist or doctor first.

References
  1. Ossenkoppele PM, van der Sluis WG, van Vloten WA. [Phototoxic dermatitis following the use of Ammi majus fruit for vitiligo]. Ned Tijdschr Geneeskd 1991;135:478-80.
  2. Dr. Duke's Phytochemical and Ethnobotanical Databases. Available at: http://www.ars-grin.gov/duke/.
Moderate

HEPATOTOXIC DRUGS

2 of 2

Pyrazinamide also falls under HEPATOTOXIC DRUGS.

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 thing to know about pyrazinamide: it's one of the harder-working TB drugs on your liver. It can raise liver enzymes and, in some people, cause real liver irritation on its own. Khella has been reported to bump up those same liver enzymes (transaminases), so stacking the two could, in theory, add stress to your liver.

This concern is mostly theoretical and based on limited data, so I don't want to scare you. But because you're already on a medication that demands close liver monitoring, I'd play it safe. Watch for warning signs like yellowing of your eyes or skin, dark urine, nausea, or pain in the upper right belly, and run any khella use by your doctor or pharmacist first.

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 Pyrazinamide 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 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 Pyrazinamide

This page covers Khella only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pyrazinamide page lists 102 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Alfalfa (moderate).

By severity: 4 major · 86 moderate · 12 minor.

From our pharmacist’s overview on the Pyrazinamide page

“Pyrazinamide is one of the core tuberculosis drugs, and because treatment runs for months while the liver already carries the drug's own strain, the 102 supplements and herbs on file here warrant real caution. Thirty-eight of them add their own liver stress, and three of the four major-rated entries sit in that group, including somethi…”

Reviewed by 2 · Jul 18, 2026

Open the Pyrazinamide 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 Pyrazinamide 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 Pyrazinamide 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 Pyrazinamide
Top half

#1,152 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 Pyrazinamide

What Is Pyrazinamide Used For?

Brand name: Tebrazid

Pyrazinamide tablets are used to treat active tuberculosis (TB) in adults and children. It is always used in combination with other anti-TB medicines — never alone. The standard CDC-recommended approach uses pyrazinamide as part of a 6-month regimen, typically for the first 2 months.

It is also used when initial TB treatment with other drugs has failed. People with drug-resistant TB or with HIV infection may need a treatment plan specifically tailored to their situation, which can include pyrazinamide as a key part of the regimen.

See full Pyrazinamide 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
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
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
Pharmacist Counseling Corner

Taking Khella and Pyrazinamide Together: Common Questions

Can you take Khella with Pyrazinamide?
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 Khella and Pyrazinamide?
Pyrazinamide belongs to more than one drug category, and Khella 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 Khella and Pyrazinamide 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 Pyrazinamide and Khella?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.