Drug & supplement interaction

Kudzu + Methotrexate Sodium

Methotrexate Sodium brand name: Xatmep.

Moderate Interaction
The bottom line Moderate

Methotrexate Sodium falls into 2 drug categories that Kudzu can interact with; the most serious is rated moderate. Theoretically, concomitant use might have additive hepatotoxic effects.

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

Kudzu and Methotrexate Sodium

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

Why Are There 2 Interactions?

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

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Methotrexate Sodium

Methotrexate Sodium falls under HEPATOTOXIC DRUGS — the group Kudzu interacts with.

Theoretically, concomitant use might have additive hepatotoxic effects.
There is some concern that kudzu can adversely affect the liver.
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: methotrexate is already known to be tough on the liver, especially when taken regularly. Kudzu has its own theoretical concern for liver health. Put the two together and the worry is that their effects on the liver could add up. To be clear, this caution is based on how these substances behave on paper, not on strong studies in people taking them together, so don't panic.

Still, since your liver is doing the heavy lifting here, I'd keep an eye out for things like unusual tiredness, yellowing of the skin or eyes, dark urine, or pain in the upper right belly. If you're on methotrexate and thinking about kudzu, run it by your doctor or pharmacist first, and keep up with your routine liver bloodwork.

References
  1. Kim HJ, Kim H, Ahn JH, Suk JH. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern Complement Med 2015;21(3):180-5. PubMed
  2. Santosh N, Mohan K, Royana S, Yamini TB. Hepatotoxicity of tubers of Indian Kudzu (Pueraria tuberosa) in rats. Food Chem Toxicol. 2010 Apr;48(4):1066-71. PubMed
  3. Teschke R, Zhang L, Long H, Schwarzenboeck A, Schmidt-Taenzer W, Genthner A, Wolff A, Frenzel C, Schulze J, Eickhoff A. Traditional Chinese Medicine and herbal hepatotoxicity: a tabular compilation of reported cases. Ann Hepatol. 2015 Jan-Feb;14(1):7-19. DOI
  4. Wang D, Qiu L, Wu X, Wei H, Xu F. Evaluation of kudzu root extract-induced hepatotoxicity. J Ethnopharmacol. 2015 Dec 24;176:321-6. PubMed
Moderate

METHOTREXATE (Trexall, others)

2 of 2
Theoretically, taking kudzu with methotrexate might increase the risk of methotrexate toxicity.
Preclinical research suggests that kudzu extract greatly reduces the elimination and increases the toxicity of methotrexate. Kudzu might inhibit organic anion transporters (OATs) that are responsible for hepatobiliary and renal excretion of anions, similar to the interaction between methotrexate and non-steroidal anti-inflammatory drugs (NSAIDs).
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 concern with combining kudzu and methotrexate. Your kidneys clear methotrexate from your body using special 'doorways' called organic anion transporters. Lab and animal studies suggest kudzu may block those doorways, which could slow down how fast you get rid of the drug. If methotrexate lingers and builds up, you may see more of its side effects, things like mouth sores, nausea, fatigue, low blood counts, or liver irritation.

I want to be honest about the evidence here. This is based on test-tube and animal research, not on people, so we don't truly know how big a deal it is in real life. Still, methotrexate has a narrow safety window, so I'd play it safe. Please check with your pharmacist or doctor before adding kudzu.

References
  1. Chiang HM, Fang SH, Wen KC, et al. Life-threatening interaction between the root extract of Pueraria lobata and methotrexate in rats. Toxicol Appl Pharmacol 2005;209:263-8.

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

Kudzu Also Interacts With Other Medications

Kudzu has 511 moderate, 72 minor known drug interactions in our database — the Methotrexate Sodium 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 Kudzu

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

Everything else you take

See Every Supplement That Interacts With Methotrexate Sodium

This page covers Kudzu only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methotrexate Sodium page lists 82 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

Open the Methotrexate Sodium interaction page

One more smart check

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

We hold 536 real supplement products containing Kudzu, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kudzu. Your product may carry other ingredients that interact with Methotrexate Sodium too, on top of Kudzu — 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 Kudzu and Methotrexate Sodium 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 Kudzu
Top 25%

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

29 days ago today
Medication Methotrexate Sodium
Steady interest

#1,765 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 Kudzu

What is Kudzu?

Kudzu
  • Alcohol cravings and reduction
  • Menopausal symptoms
  • Heart and blood vessel health
  • Hangover relief
  • Traditional Chinese medicine (Ge Gen)

Kudzu is a fast-growing vine whose root has long been used in traditional Chinese medicine and is now studied mostly for reducing alcohol intake. Early research is promising for cutting back on drinking, but evidence for most other uses is weak. Talk with your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Kudzu monograph & all interactions
Keep checking

Other Drugs & Kudzu

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

0Major
511Moderate
72Minor
2,246No known interaction
Moderate

511 interactions

Showing 60 of 511 moderate interactions — see all 511 on the Kudzu page.

Minor

72 interactions

Showing 60 of 72 minor interactions — see all 72 on the Kudzu page.

No interaction 2,246 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 Kudzu and Methotrexate Sodium Together: Common Questions

Can you take Kudzu with Methotrexate Sodium?
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 Kudzu and Methotrexate Sodium?
Methotrexate Sodium belongs to more than one drug category, and Kudzu 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 Kudzu and Methotrexate Sodium 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.