Drug & supplement interaction

Khella + Sulfamethoxazole, Trimethoprim

Sulfamethoxazole, Trimethoprim brand names: Bactrim, Bactrim DS, Cotrim DS, Septra, Septra DS, and others.

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

Sulfamethoxazole, Trimethoprim 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?
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Interaction report

Khella and Sulfamethoxazole, Trimethoprim

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. Sulfamethoxazole, Trimethoprim 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 Sulfamethoxazole, Trimethoprim

Sulfamethoxazole, Trimethoprim 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 gist: Bactrim (the sulfamethoxazole and trimethoprim combo) is a sulfa antibiotic, and sulfa drugs are already known to make your skin more sensitive to sunlight. Khella contains compounds (khellin and visnagin) that can do the same thing. So if you take them together, the worry is that you could burn more easily or react more strongly to the sun, think faster sunburn, redness, or a rash on areas that get sun exposure.

I want to be honest about the strength of this one. It's mostly theoretical and based on anecdotal reports, not strong studies, so it isn't a sure thing. Still, since both can add to sun sensitivity, it's smart to be cautious. Use sunscreen, cover up, and check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
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

Sulfamethoxazole, Trimethoprim 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 pairing khella with Bactrim (sulfamethoxazole and trimethoprim). This isn't about one speeding up or slowing down the other. Instead, both can be tough on the liver, so taking them together may add up. Khella has been shown to raise liver enzymes (the transaminases your doctor checks on bloodwork), and Bactrim, on its own, can occasionally irritate the liver too.

I want to be honest that this is mostly a theoretical, just-in-case concern rather than something proven to happen often. Still, watch for warning signs like yellowing of your skin or eyes, dark urine, belly pain, or feeling unusually tired or nauseated. If any of that shows up, call your doctor. Before combining these, please run it by your pharmacist or physician.

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 Sulfamethoxazole, Trimethoprim one above is among them. If you take anything else, check it against the full list below.

Moderate 617 No known interaction 2,213 (incl. Sulfamethoxazole, Trimethoprim)
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 Sulfamethoxazole, Trimethoprim

This page covers Khella only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sulfamethoxazole, Trimethoprim page lists 174 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: 11 major · 139 moderate · 24 minor.

From our pharmacist’s overview on the Sulfamethoxazole, Trimethoprim page

“The supplement I check first with sulfamethoxazole and trimethoprim (Bactrim, Septra) is PABA, because it feeds bacteria the exact compound this antibiotic works by blocking and can cancel the treatment outright. It is one of 11 major-rated entries among 174 supplements and herbs on file here, a count that calls for genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Sulfamethoxazole, Trimethoprim 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 Sulfamethoxazole, Trimethoprim 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 Sulfamethoxazole, Trimethoprim 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
Top half

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

29 days ago today
Medication Sulfamethoxazole, Trimethoprim
Top 5%

#134 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
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 Sulfamethoxazole, Trimethoprim, 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 Sulfamethoxazole, Trimethoprim supplement interactions › Every supplement checked against Sulfamethoxazole, Trimethoprim, ranked by severity 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 Sulfamethoxazole, Trimethoprim Together: Common Questions

Can you take Khella with Sulfamethoxazole, Trimethoprim?
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 Sulfamethoxazole, Trimethoprim?
Sulfamethoxazole, Trimethoprim 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 Sulfamethoxazole, Trimethoprim 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.