Drug & supplement interaction

Licorice + Zanubrutinib

Zanubrutinib brand name: Brukinsa.

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

Zanubrutinib 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 Zanubrutinib

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. Zanubrutinib 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 Zanubrutinib

Zanubrutinib 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 deal with combining licorice and Brukinsa (zanubrutinib). Your body relies on a liver enzyme called CYP3A4 to break down zanubrutinib, and licorice may nudge that enzyme in either direction depending on the species and dose. Some research suggests glycyrrhizin (found in regular licorice) can mildly speed the enzyme up, which could lower zanubrutinib levels and make it less effective against your lymphoma or leukemia. Other licorice types may slow the enzyme down, letting the drug build up and raising the risk of side effects like bruising, bleeding, infections, or low blood counts.

Honestly, this is mostly theoretical and based on limited evidence, so don't panic. But since zanubrutinib is a serious cancer medicine, please check with your oncologist or pharmacist before using licorice supplements. Small amounts in food are far less of a concern.

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

Zanubrutinib 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 idea behind this pairing. Zanubrutinib (Brukinsa) gets moved around in your gut by a kind of cellular pump called P-glycoprotein. Lab and animal studies suggest licorice may rev up that pump, which could push more of the drug back out before it gets absorbed. In theory, that might mean a bit less zanubrutinib in your system, and a cancer therapy works best when its levels stay steady.

I want to be honest that this is theoretical and only based on test-tube and animal data, not real patients, so don't panic. Still, because this is a serious medication for a serious condition, I wouldn't add concentrated licorice supplements without a heads-up to your oncologist or pharmacist first. Small amounts in food are far less likely to matter.

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

Moderate 976 Minor 63 No known interaction 1,791 (incl. Zanubrutinib)
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 Zanubrutinib

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 Zanubrutinib, 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 Zanubrutinib

This page covers Licorice only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Zanubrutinib page lists 160 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 · 119 moderate · 38 minor.

From our pharmacist’s overview on the Zanubrutinib page

“Grapefruit is the biggest supplement risk with zanubrutinib (Brukinsa), a targeted therapy for certain blood cancers, and this list deserves genuine care. Grapefruit blocks the enzyme (CYP3A4) that clears the drug, so levels can climb and side effects with them.”

Reviewed by 2 · Jul 18, 2026

Open the Zanubrutinib 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 Zanubrutinib 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 Zanubrutinib 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%

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

29 days ago today
Medication Zanubrutinib
Top 25%

#465 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 Zanubrutinib

What Is Zanubrutinib Used For?

Brand name: Brukinsa

Brukinsa (zanubrutinib) is used to treat adult patients with several blood cancers. These include chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), Waldenström's macroglobulinemia (WM), mantle cell lymphoma (MCL) after at least one prior treatment, relapsed or refractory marginal zone lymphoma (MZL) after at least one prior anti-CD20 regimen, and relapsed or refractory follicular lymphoma (FL) in combination with obinutuzumab after two or more prior lines of treatment.

Some of these uses — MCL, MZL, and FL — are approved under accelerated approval, meaning they are based on tumor response rates rather than confirmed long-term survival benefit. Continued approval for those uses may depend on results from confirmatory trials.

See full Zanubrutinib 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
976Moderate
63Minor
1,790No known interaction
976 Moderate 63 Minor 1,790 No interaction
Moderate

976 interactions

Showing 60 of 976 moderate interactions — see all 976 on the Licorice page.

Minor

63 interactions

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

No interaction 1,790 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 1,790 medications checked with no known interaction — see the full Licorice list.

See the full Licorice interactions page
See every supplement checked against Zanubrutinib, 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 Zanubrutinib supplement interactions › Every supplement checked against Zanubrutinib, ranked by severity Zanubrutinib 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 Zanubrutinib Together: Common Questions

Can you take Licorice with Zanubrutinib?
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 Zanubrutinib?
Zanubrutinib 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 Zanubrutinib 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 Zanubrutinib 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.