Drug & supplement interaction

Nutmeg + Pirfenidone

Pirfenidone brand name: Esbriet.

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

Nutmeg has a moderate interaction with Pirfenidone. Theoretically, nutmeg might decrease levels of drugs metabolized by CYP1A2.

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

Nutmeg and Pirfenidone

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Pirfenidone

Pirfenidone falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Nutmeg interacts with.

Theoretically, nutmeg might decrease levels of drugs metabolized by CYP1A2.
Animal research suggests that intraperitoneal injections of myristicin, a constituent of nutmeg, can induce CYP1A2.
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 for Esbriet (pirfenidone). Your body clears this medicine using a liver enzyme called CYP1A2. The concern with nutmeg is that one of its compounds, myristicin, might speed up that enzyme. If that happened, your body could clear pirfenidone faster, leaving less in your system and possibly making it work less well against your lung scarring. Pirfenidone is not a prodrug, so faster clearance means weaker effect, not stronger.

The good news: this is only a theory based on animal studies, where nutmeg was injected, not eaten. Normal cooking amounts of nutmeg are very unlikely to matter. Just steer clear of large "medicinal" doses, which are unsafe anyway, and check with your pharmacist if you're unsure.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jeong HG, Yun CH. Induction of rat hepatic cytochrome P450 enzymes by myristicin. Biochem Biophys Res Commun 1995;217:966-71. 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

Nutmeg Also Interacts With Other Medications

Nutmeg has 527 moderate known drug interactions in our database — the Pirfenidone one above is one of them. If you take anything else, check it against the full list below.

Moderate 527 No known interaction 2,303 (incl. Pirfenidone)
Taking anything else?

Check Another of Your Medications Against Nutmeg

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

Everything else you take

See Every Supplement That Interacts With Pirfenidone

This page covers Nutmeg only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pirfenidone page lists 115 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Alfalfa (moderate) and Angelica Archangelica (moderate).

By severity: 1 major · 80 moderate · 34 minor.

From our pharmacist’s overview on the Pirfenidone page

“Pirfenidone (Esbriet) slows the lung scarring of idiopathic pulmonary fibrosis, and when a drug is doing that kind of work, this is not a list to skim. Most of the 115 ingredients on file touch CYP1A2, the liver enzyme that clears pirfenidone, so they can push its blood level up (more nausea and liver strain) or drag it down and quietl…”

Reviewed by 2 · Jul 18, 2026

Open the Pirfenidone interaction page

One more smart check

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

We hold 182 real supplement products containing Nutmeg, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Nutmeg. Your product may carry other ingredients that interact with Pirfenidone too, on top of Nutmeg — 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 Nutmeg and Pirfenidone 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 Nutmeg
Top half

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

29 days ago today
Medication Pirfenidone
Top 10%

#174 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 Nutmeg

What is Nutmeg?

Nutmeg
  • Digestive upset
  • Diarrhea
  • Sleep and relaxation
  • Pain and inflammation
  • Flavoring spice

Nutmeg is a popular cooking spice that has long been used in traditional medicine for digestion and other complaints, but there is little solid human research to support its medicinal use. In normal cooking amounts it is generally safe, but larger "medicinal" doses can cause serious poisoning, so it should never be taken in high amounts.

Read the full Nutmeg monograph & all interactions
Medication

About Pirfenidone

What Is Pirfenidone Used For?

Brand name: Esbriet

Pirfenidone — available as capsules and tablets under the brand name Esbriet, as well as generic pirfenidone products — is indicated for the treatment of idiopathic pulmonary fibrosis (IPF), a chronic, progressive disease in which scar tissue builds up in the lungs and makes breathing increasingly difficult.

Esbriet capsules and tablets, pirfenidone capsules, and pirfenidone tablets are each specifically approved for IPF. No other uses are supported by the available product labels.

See full Pirfenidone drug information
Keep checking

Other Drugs & Nutmeg

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

0Major
527Moderate
0Minor
2,302No known interaction
527 Moderate 2,302 No interaction
Moderate

527 interactions

Showing 60 of 527 moderate interactions — see all 527 on the Nutmeg page.

No interaction 2,302 drugs checked — show the list

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

Showing the 60 most looked-up of 2,302 medications checked with no known interaction — see the full Nutmeg list.

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

Can you take Nutmeg with Pirfenidone?
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.
How serious is the Nutmeg and Pirfenidone 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 Pirfenidone and Nutmeg?

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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.