Drug & supplement interaction

Licorice + Acalabrutinib

Acalabrutinib brand name: Calquence.

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

Acalabrutinib falls into 2 drug categories that Licorice can interact with; the most serious is rated moderate. Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.

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

Licorice and Acalabrutinib

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Acalabrutinib

Acalabrutinib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Licorice interacts with.

Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
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 situation with Calquence (acalabrutinib): your body relies on a liver enzyme called CYP3A4 to break it down. Licorice can tug on that same enzyme, but the research points in two directions. Some studies suggest licorice speeds the enzyme up (which could lower acalabrutinib levels and make it work less well against your cancer), while one type of licorice may slow the enzyme down (which could raise levels and bring more side effects like headaches, bruising, infections, or low blood counts).

Honestly, this is mostly theoretical and based on weak evidence, so I don't want to alarm you. But because acalabrutinib is a serious cancer medicine, please don't add a licorice supplement without first checking with your oncologist or pharmacist. Small amounts in food are unlikely to matter.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
  2. Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
  3. Tu, J. H., He, Y. J., Chen, Y., Fan, L., Zhang, W., Tan, Z. R., Huang, Y. F., Guo, D., Hu, D. L., Wang, D., and Hong-Hao Zhou. Effect of glycyrrhizin on the activity of CYP3A enzyme in humans. Eur J Clin Pharmacol 2010;66(8):805-810. PubMed
  4. Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190. PubMed
Moderate

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Acalabrutinib also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
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 basic idea with acalabrutinib (Calquence) and licorice. Your body has a kind of pump called P-glycoprotein that helps move drugs in and out of cells, including out of your gut. Lab studies suggest licorice may rev up that pump. If that happened in real life, it could push a little more acalabrutinib back out before it's absorbed, meaning less of your cancer medicine actually reaches your bloodstream and possibly weaker treatment.

I want to be honest: this comes only from test-tube research, not from people, so it's theoretical and far from certain. Still, because acalabrutinib is treating a serious condition, I wouldn't gamble on it. Please check with your oncology team or pharmacist before using any licorice supplement. DGL licorice and small amounts in food are far less of a concern.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wang H, Dong L, Qu F, et al. Effects of glycyrrhizin on the pharmacokinetics of nobiletin in rats and its potential mechanism. Pharm Biol. 2020 Dec;58(1):352-356. PubMed

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

Licorice Also Interacts With Other Medications

Licorice has 977 moderate, 63 minor known drug interactions in our database — the Acalabrutinib one above is among them. If you take anything else, check it against the full list below.

Moderate 977 Minor 63 No known interaction 1,790 (incl. Acalabrutinib)
Taking anything else?

Check Another of Your Medications Against Licorice

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

From our Q&A

Questions About Licorice or Acalabrutinib

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Licorice or Acalabrutinib, 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 Acalabrutinib

This page covers Licorice only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acalabrutinib page lists 144 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 103 moderate · 38 minor.

From our pharmacist’s overview on the Acalabrutinib page

“For anyone taking acalabrutinib (Calquence) for chronic lymphocytic leukemia or lymphoma, the supplement list below deserves genuine scrutiny. Of 144 ingredients on file, nearly all act on CYP3A4, the liver enzyme that clears the drug, or on P-glycoprotein, a transporter that moves it, so they can push its level too high or leave too l…”

Reviewed by 2 · Jul 18, 2026

Open the Acalabrutinib interaction page

One more smart check

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

We hold 4,721 real supplement products containing Licorice, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Licorice. Your product may carry other ingredients that interact with Acalabrutinib too, on top of Licorice — 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 Licorice and Acalabrutinib 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 Licorice
Top 5%

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

29 days ago today
Medication Acalabrutinib
Top 25%

#431 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 Licorice

What is Licorice?

Licorice
  • Sore throat and cough
  • Heartburn and stomach upset
  • Mouth ulcers and digestive complaints
  • Inflammation
  • Traditional tonic/adrenal support

Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, which can raise blood pressure and lower potassium when taken in large amounts or for a long time, so deglycyrrhizinated (DGL) products are often preferred. Talk to your pharmacist or doctor before using it, especially if you have high blood pressure, heart, or kidney problems.

Read the full Licorice monograph & all interactions
Medication

About Acalabrutinib

What Is Acalabrutinib Used For?

Brand name: Calquence

Acalabrutinib treats certain blood cancers in adults. These are mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL).

For MCL, it is used with bendamustine and rituximab in people not yet treated who cannot have an autologous stem cell transplant. It is also used alone in people with MCL who have had at least one earlier treatment. Calquence capsules and Calquence tablets carry these same uses.

See full Acalabrutinib drug information
Keep checking

Other Drugs & Licorice

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

0Major
977Moderate
63Minor
1,789No known interaction
977 Moderate 63 Minor 1,789 No interaction
Moderate

977 interactions

Showing 60 of 977 moderate interactions — see all 977 on the Licorice page.

Minor

63 interactions

Showing 60 of 63 minor interactions — see all 63 on the Licorice page.

No interaction 1,789 drugs checked — show the list

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

Showing the 60 most looked-up of 1,789 medications checked with no known interaction — see the full Licorice list.

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

Can you take Licorice with Acalabrutinib?
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 Licorice and Acalabrutinib?
Acalabrutinib belongs to more than one drug category, and Licorice 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 Licorice and Acalabrutinib 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 Acalabrutinib and Licorice?

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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.