Drug & supplement interaction

Kratom + Sarilumab

Sarilumab brand name: Kevzara.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Kratom and Sarilumab in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Kratom and Sarilumab

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Sarilumab and Kratom in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Kratom safety at a glance

Kratom overall Avoid Kratom carries risks of dependence, serious side effects, and contaminated products, and is not regulated as a safe supplement.
Pregnancy Possibly Unsafe When used orally. There have been multiple case reports of neonatal abstinence syndrome in the infants of those who used kratom during pregnancy. Animal researc... Read the full pregnancy detail
Breastfeeding Avoid Kratom compounds may pass into breast milk and should be avoided while nursing.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Sarilumab and Kratom? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Sarilumab

Interactions in our licensed database are recorded against drug classes, not just single drug names. Sarilumab is filed under 2 classifications — cytochrome p450 3a4 (cyp3a4) inducers, immunosuppressants. Kratom has documented interactions with 11 drug classes — the most serious being cns depressants (moderate), cytochrome p450 1a2 (cyp1a2) substrates (moderate) and cytochrome p450 2d6 (cyp2d6) substrates (moderate) — and none of Sarilumab’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Kratom Does Interact With Other Medications

Kratom has 983 moderate, 12 minor known drug interactions in our database — Sarilumab isn’t one of them. If you take anything else, check it against the full list below.

Moderate 983 Minor 12 No known interaction 1,835 (incl. Sarilumab)
Taking anything else?

Check Another of Your Medications Against Kratom

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

What to actually watch for

No Interaction Found — But Data Suggests Kratom and Sarilumab May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Kratom

    “Orally, kratom has been associated with cases of liver damage. Between 2003 and 2019, there were 11 cases of liver injury reported in the Drug-Induced Liver Injury Network (DILIN) with definite, highly likely, or probable causality attributed to kratom. Of these cases, 8 were reported between 2017 and 2019. The median time from kratom use to the onset of symptoms was 14 days.”

    Kratom · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 104634. Ahmad J, Odin JA, Hayashi PH, et al. Liver injury associated with kratom, a popular opioid-like product: Experience from the U.S. drug induced liver injury network and a review of the literature. Drug Alcohol Depend. 2021;218:108426. PubMed
    2. 103216. Schimmel J, Dart RC. Kratom (Mitragyna speciosa) liver injury: a comprehensive review. Drugs. 2020;80(3):263-83. PubMed
    3. 113075. Reich N, Salvo G, Leong D, Wan V, Kosatsky T. Kratom exposures managed by the British Columbia poison centre, 2012-2019: a descriptive analysis. CMAJ Open 2022;10(3):E755-E761. PubMed
    4. 27133. Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. PubMed
    5. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
    6. 101703. Aldyab M, Ells PF, Bui R, Chapman TD, Lee H. Kratom-Induced Cholestatic Liver Injury Mimicking Anti-Mitochondrial Antibody-Negative Primary Biliary Cholangitis: A Case Report and Review of Literature. Gastroenterology Res. 2019 Aug;12(4):211-215. PubMed

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab. Read the label on DailyMed ›

  • Tiredness reported in 13.8% of FDA reports for Sarilumab Additional detail

    Kratom

    “Orally, kratom has been associated with aggression, agitation, altered mental status, anxiety, delusions, depression, hallucinations, insomnia, irritability, paranoia, restlessness, sedation, and suicidal ideation, in case reports and case series.”

    Kratom · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 27136. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
    2. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
    3. 113067. Li X, Ndungu P, Taneja SB, et al. An evaluation of adverse drug reactions and outcomes attributed to kratom in the US Food and Drug Administration Adverse Event Reporting System from January 2004 through September 2021. Clin Transl Sci 2023.
    4. 113071. Peran D, Stern M, Cernohorsky P, Sykora R, Popela S, Duska F. Mitragyna speciosa (Kratom) poisoning: Findings from ten cases. Toxicon 2023;225:107054. PubMed
    5. 113079. Settle AG, Yang C. A Case of Severe Kratom Addiction Contributing to a Suicide Attempt. Cureus 2022;14(9):e29698. PubMed
    6. 113080. Smith KE, Feldman JD, Dunn KE, et al. Examining the paradoxical effects of kratom: a narrative inquiry. Front Pharmacol 2023;14:1174139. PubMed

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Muscle pain Additional detail

    Kratom

    “Observational research has found that habitual intake of kratom is associated with withdrawal symptoms, including arthralgias, lower extremity hyperreflexia, muscle pain, rigidity, spasms, and tremors.

    In a case report, a 45-year-old adult who had used kratom intermittently for 10 months experienced mild rhabdomyolysis and generalized seizures.”

    Kratom · Natural Medicines adverse-effect record, reported in epilepsy.

    6 sources cited
    1. 27115. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. PubMed
    2. 27130. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
    3. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    4. 113061. Hong S, Zimmerman PE, Rao V, Markwalter DW. Buprenorphine-Naloxone in the Setting of Kratom Withdrawal, Opioid Use Disorder, and Stage IV Lung Adenocarcinoma. J Palliat Med 2023;26(5):734-736. PubMed
    5. 113080. Smith KE, Feldman JD, Dunn KE, et al. Examining the paradoxical effects of kratom: a narrative inquiry. Front Pharmacol 2023;14:1174139. PubMed
    6. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab. Read the label on DailyMed ›

  • Constipation Additional detail

    Kratom

    “Kratom ingestion has been associated with nausea, vomiting, dry mouth, tongue numbness, increased appetite, and constipation. In one Poison Control Center report of 3484 exposures to kratom, the majority of which involved oral single-substance exposures, 25% of cases reported gastrointestinal effects.”

    Kratom · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 27130. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
    2. 27136. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
    3. 95797. Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. PubMed
    4. 95818. Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. PubMed
    5. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    6. 113067. Li X, Ndungu P, Taneja SB, et al. An evaluation of adverse drug reactions and outcomes attributed to kratom in the US Food and Drug Administration Adverse Event Reporting System from January 2004 through September 2021. Clin Transl Sci 2023.

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab. Read the label on DailyMed ›

Reported for Kratom but not commonly for Sarilumab: raised blood pressure, dependence or withdrawal symptoms, confusion and shortness of breath.

Effects for Sarilumab come from the ADVERSE REACTIONS section of its FDA label; effects for Kratom come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 24,738 voluntary FDA FAERS reports for Sarilumab that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Kratom in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. There have been multiple case reports of neonatal abstinence syndrome in the infants of those who used kratom during pregnancy. Animal research suggests that kratom crosses the placenta.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Kratom or Sarilumab

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Kratom or Sarilumab, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sarilumab

This page covers Kratom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sarilumab page lists 72 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), Alkanna (moderate), Alpine Ragwort (moderate) and American Ginseng (moderate).

By severity: 71 moderate · 1 minor.

From our pharmacist’s overview on the Sarilumab page

“Sarilumab (Kevzara) works by quieting an overactive immune system in rheumatoid arthritis, and most of the supplements on this page push the other way. Immune stimulants such as ashwagandha, astragalus, and American ginseng could in theory blunt the drug's benefit and let joint symptoms creep back.”

Reviewed by 2 · Jul 18, 2026

Open the Sarilumab interaction page

One more smart check

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

We hold 8 real supplement products containing Kratom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kratom. Even though Kratom itself has no known interaction with Sarilumab, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Kratom and Sarilumab 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 Kratom
Top 25%

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

29 days ago today
Medication Sarilumab
Top 10%

#265 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Kratom reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Kratom and Sarilumab records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Kratom

What is Kratom?

Kratom
  • Pain relief
  • Opioid withdrawal symptoms
  • Anxiety and stress
  • Low energy or fatigue
  • Mood enhancement

Kratom is a Southeast Asian plant whose leaves act on the brain's opioid receptors and can produce both stimulant-like and opioid-like effects. It is not approved or proven safe by health regulators, carries real risks of dependence and serious harm, and its legal status varies widely. Talk to a pharmacist or doctor before considering it.

Mitragyna speciosa · Rubiaceae · Leaves · Dried leaf powder, capsules, tablets, brewed tea, liquid extracts, and concentrated gummies

An interaction check asks whether these two react with each other — it does not ask whether Kratom is a good idea for someone in your situation. Here is what our Kratom record says about it on its own.

Kratom: dosing

There is no established safe or standardized dose for kratom. The strength of products varies widely, and the amount of active compounds can differ greatly from one batch to another, even within the same brand.Because of these unknowns and the real risks of dependence and harm, we cannot recommend a specific amount. Avoid mixing it with alcohol, opioids, sedatives, or other substances.

From our Kratom monograph — the full record covers uses, side effects and every documented interaction.

Read the full Kratom monograph & all interactions
Medication

About Sarilumab Injection

What Is Sarilumab Injection Used For?

Brand name: Kevzara

Kevzara (sarilumab) injection is approved for three conditions. In adults, it treats moderately to severely active rheumatoid arthritis (RA) when at least one other disease-modifying drug hasn't worked well enough or caused intolerance. It also treats polymyalgia rheumatica (PMR) in adults who haven't responded adequately to corticosteroids or who can't tolerate tapering them.

Kevzara is also approved for polyarticular juvenile idiopathic arthritis (pJIA) — a form of childhood arthritis — but only in patients who weigh 63 kg (about 139 lbs) or more. It is not approved for pediatric patients below that weight due to the lack of an appropriate dosage form.

Most-Reported Side Effects for Sarilumab

From FAERS, the FDA’s public side-effect reporting system (26,260 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Arthralgia 5,168 reports
Rheumatoid arthritis 4,646 reports
Joint swelling 4,578 reports
Fatigue 3,555 reports
Rash 3,349 reports
See full Sarilumab Injection drug information
Keep checking

Other Drugs & Kratom

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

0Major
983Moderate
12Minor
1,834No known interaction
983 Moderate 12 Minor 1,834 No interaction
Moderate

983 interactions

Showing 60 of 983 moderate interactions — see all 983 on the Kratom page.

Minor

12 interactions

No interaction 1,834 drugs checked — show the list

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

Showing the 60 most looked-up of 1,834 medications checked with no known interaction — see the full Kratom list.

See the full Kratom interactions page
See every supplement checked against Sarilumab, ranked by severity
Evidence & sources

Kratom References

The 77 references that drive our Kratom monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. PubMed
  2. Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197.
  3. Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. PubMed
  4. Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction 2008;103(6):1048-1050.
  5. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
  6. Nelsen JL, Lapoint J, Hodgman MJ, Aldous KM. Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure. J Med Toxicol 2010;6(4):424-426. PubMed
  7. Sheleg SV, Collins GB. A coincidence of addiction to "Kratom" and severe primary hypothyroidism. J Addict Med 2011;5(4):300-301. PubMed
  8. Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. PubMed
  9. Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356. PubMed
  10. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
  11. Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. PubMed
  12. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
  13. FDA Adverse Event Reporting System: Kratom Deaths. February 6, 2018. https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/CDERFOIAElectronicReadingRoom/UCM595575.pdf. Accessed March 6, 2018.
  14. Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. PubMed
  15. Kruegel AC, Grundmann O. The medicinal chemistry and neuropharmacology of kratom: A preliminary discussion of a promising medicinal plant and analysis of its potential for abuse.Neuropharmacology. 2017. pii: S0028-3908(17)30393-3. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Kratom and Sarilumab Together: Common Questions

Is it safe to take Kratom with Sarilumab?
We do not list a known interaction between Kratom and Sarilumab. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Kratom and Sarilumab have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Kratom and Sarilumab combination checked?
Interactions in our licensed database are recorded against drug classes. Sarilumab is filed under 2 classifications, and Kratom has documented interactions with 11 drug classes — none of Sarilumab's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Kratom interact with any other medications?
Yes. Kratom has 995 documented drug interactions in our database — Sarilumab is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Sarilumab interact with any supplements?
Yes. Sarilumab has documented interactions with 72 supplements in our database — Kratom is not one of them. The Sarilumab interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Kratom monograph Uses, safety profile, and every drug interaction in one place Sarilumab Injection drug information The full plain-English guide to this medication Sarilumab supplement interactions Every supplement checked against Sarilumab, 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 References The 77 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Sarilumab and Kratom?

Our pharmacists answer your medication & supplement questions — free.

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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.