Drug & supplement interaction

Peppermint + Larotrectinib

Larotrectinib brand name: Vitrakvi.

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

Peppermint has a moderate interaction with Larotrectinib. Theoretically, peppermint might increase the levels of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Peppermint and Larotrectinib

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Larotrectinib

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

Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.
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 gist for larotrectinib (Vitrakvi): your body relies on an enzyme called CYP3A4 to clear this medicine out. Peppermint oil, at concentrated supplement doses, may slow that enzyme down a bit. Larotrectinib is the active drug itself (not a prodrug that needs switching on), so slowing its breakdown could let levels creep higher than expected. That might mean more of its usual side effects, things like dizziness, fatigue, nausea, or changes in liver blood tests.

That said, this is mostly theoretical and based on weak evidence. A little peppermint tea or flavoring almost certainly won't matter. Regular peppermint oil capsules are the bigger question. Since larotrectinib is a serious cancer medicine, please run any peppermint supplement past your oncology team or pharmacist before using it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Dresser GK, Wacher V, Wong S, et al. Evaluation of peppermint oil and ascorbyl palmitate as inhibitors of cytochrome P4503A4 activity in vitro and in vivo. Clin Pharmacol Ther 2002;72:247-55. PubMed
  2. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 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

Peppermint Also Interacts With Other Medications

Peppermint has 730 moderate, 65 minor known drug interactions in our database — the Larotrectinib one above is one of them. If you take anything else, check it against the full list below.

Moderate 730 Minor 65 No known interaction 2,035 (incl. Larotrectinib)
Taking anything else?

Check Another of Your Medications Against Peppermint

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

Everything else you take

See Every Supplement That Interacts With Larotrectinib

This page covers Peppermint only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Larotrectinib page lists 143 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 · 100 moderate · 40 minor.

From our pharmacist’s overview on the Larotrectinib page

“Nearly everything on this page interacts with larotrectinib (Vitrakvi) in one of two directions, raising or lowering how much of the drug ends up in your blood. Larotrectinib treats cancers driven by an NTRK gene fusion, and it is cleared by a liver enzyme called CYP3A4, so herbs that speed that enzyme up can drain the drug's effect wh…”

Reviewed by 2 · Jul 18, 2026

Open the Larotrectinib interaction page

One more smart check

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

We hold 1,980 real supplement products containing Peppermint, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Peppermint. Your product may carry other ingredients that interact with Larotrectinib too, on top of Peppermint — 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 Peppermint and Larotrectinib 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 Peppermint
Top 10%

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

29 days ago today
Medication Larotrectinib
Steady interest

#2,093 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 Peppermint

What is Peppermint?

Peppermint
  • Irritable bowel syndrome (IBS)
  • Indigestion and gas
  • Nausea
  • Tension headache (topical oil)
  • Colds and congestion
  • Freshening breath

Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartburn and is not recommended in concentrated oil form for infants and young children. Check with your pharmacist or doctor before using it regularly, especially during pregnancy or breastfeeding.

Read the full Peppermint monograph & all interactions
Medication

About Larotrectinib

What Is Larotrectinib Used For?

Brand name: Vitrakvi

Vitrakvi is used to treat adult and pediatric patients with solid tumors that have a neurotrophic receptor tyrosine kinase (NTRK) gene fusion — a specific genetic alteration — without a known acquired resistance mutation. It is used when the tumor has spread (is metastatic) or when surgery would likely cause severe harm, and when there are no satisfactory alternative treatments or the cancer has continued to grow after prior treatment.

Patients are selected for Vitrakvi based on an FDA-approved test that confirms the NTRK gene fusion in tumor tissue. This approval was granted under the FDA's accelerated approval pathway, based on overall response rate and duration of response; continued approval may depend on results from confirmatory trials.

See full Larotrectinib drug information
Keep checking

Other Drugs & Peppermint

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

0Major
730Moderate
65Minor
2,034No known interaction
730 Moderate 65 Minor 2,034 No interaction
Moderate

730 interactions

Showing 60 of 730 moderate interactions — see all 730 on the Peppermint page.

Minor

65 interactions

Showing 60 of 65 minor interactions — see all 65 on the Peppermint page.

No interaction 2,034 drugs checked — show the list

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

Showing the 60 most looked-up of 2,034 medications checked with no known interaction — see the full Peppermint list.

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

Can you take Peppermint with Larotrectinib?
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 Peppermint and Larotrectinib 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 Larotrectinib and Peppermint?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.