Drug & supplement interaction

Phellodendron + Avatrombopag Maleate

Avatrombopag Maleate brand name: Doptelet.

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

Avatrombopag Maleate falls into 2 drug categories that Phellodendron can interact with; the most serious is rated moderate. Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2C9.

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

Phellodendron and Avatrombopag Maleate

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

Why Are There 2 Interactions?

Phellodendron interacts with whole categories of medication. Avatrombopag Maleate falls into 2 of those categories, so it can interact with Phellodendron 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 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Avatrombopag Maleate

Avatrombopag Maleate falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Phellodendron interacts with.

Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP2C9.
Phellodendron contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, phellodendron might also inhibit CYP2C9.
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 your platelet medicine, Doptelet. Your liver uses an enzyme called CYP2C9 (along with another one) to clear avatrombopag out of your system. The berberine in phellodendron may slow that enzyme down a bit. On paper, that could let more of the drug hang around, nudging its effect and side effects upward. Avatrombopag isn't a prodrug, so more drug means a stronger push to raise platelets, with possible headache, tiredness, or in rare cases clots.

I want to be honest: this is theoretical, based on lab and pharmacology thinking, not real-world reports. It may well be minor. Still, since this drug carefully raises platelets, mention any phellodendron or berberine product to your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Avatrombopag Maleate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP3A4.
Phellodendron contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, phellodendron might also inhibit CYP3A4.
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 short version for Doptelet (avatrombopag). Your liver uses an enzyme called CYP3A4 to help clear this medicine out of your body. Phellodendron contains berberine, which lab and early human studies suggest can mildly slow that same enzyme down. If it does, more avatrombopag could stay in your system, which in theory could push your platelet count higher than intended.

Since avatrombopag works by raising platelets to lower bleeding risk, too much platelet activity is the concern, along with possible headache, tiredness, or swelling. I want to be honest though: this is a theoretical interaction based mostly on how berberine behaves in the lab, not proven harm in people. Still, before pairing them, run it past your pharmacist or doctor so your counts can be watched.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. 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

Phellodendron Also Interacts With Other Medications

Phellodendron has 1,161 moderate known drug interactions in our database — the Avatrombopag Maleate one above is among them. If you take anything else, check it against the full list below.

Moderate 1,161 No known interaction 1,669 (incl. Avatrombopag Maleate)
Taking anything else?

Check Another of Your Medications Against Phellodendron

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

Everything else you take

See Every Supplement That Interacts With Avatrombopag Maleate

This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Avatrombopag Maleate page lists 156 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: 2 major · 35 moderate · 17 minor.

From our pharmacist’s overview on the Avatrombopag Maleate page

“Avatrombopag maleate (Doptelet) exists to raise a low platelet count, so anything that drags its blood level down invites the bleeding risk it was prescribed to prevent. I would handle this list of 54 supplements with real care, and the two rated major come first.”

Reviewed by 2 · Jul 18, 2026

Open the Avatrombopag Maleate interaction page

One more smart check

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

We hold 393 real supplement products containing Phellodendron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phellodendron. Your product may carry other ingredients that interact with Avatrombopag Maleate too, on top of Phellodendron — 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 Phellodendron and Avatrombopag Maleate 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 Phellodendron
Top 25%

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

29 days ago today
Medication Avatrombopag Maleate
Top 5%

#137 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 Phellodendron

What is Phellodendron?

Phellodendron
  • Digestive complaints and diarrhea
  • Inflammation and joint discomfort
  • Stress and weight management (in combination products)
  • Skin conditions (topical, traditional)
  • Antimicrobial support

Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evidence for most uses is limited, and it is often sold in combination with other herbs, making its individual effects hard to judge. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Phellodendron monograph & all interactions
Medication

About Avatrombopag

What Is Avatrombopag Used For?

Brand name: Doptelet

Avatrombopag treats thrombocytopenia, which means a low platelet count. Platelets are the blood cells that help your blood clot.

Doptelet tablets are used in adults with chronic liver disease who are scheduled for a procedure. They are also used in adults with chronic ITP who didn't respond well enough to a previous treatment, and in children 6 and older with persistent or chronic ITP. Doptelet Sprinkle is used in children 1 to under 6 years old with persistent or chronic ITP.

See full Avatrombopag drug information
Keep checking

Other Drugs & Phellodendron

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

0Major
1,161Moderate
0Minor
1,668No known interaction
1,161 Moderate 1,668 No interaction
Moderate

1,161 interactions

Showing 60 of 1,161 moderate interactions — see all 1,161 on the Phellodendron page.

No interaction 1,668 drugs checked — show the list

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

Showing the 60 most looked-up of 1,668 medications checked with no known interaction — see the full Phellodendron list.

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

Can you take Phellodendron with Avatrombopag Maleate?
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 Phellodendron and Avatrombopag Maleate?
Avatrombopag Maleate belongs to more than one drug category, and Phellodendron 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 Phellodendron and Avatrombopag Maleate 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.