Drug & supplement interaction

Picrorhiza + Efgartigimod alfa-fcab

Efgartigimod alfa-fcab brand name: Vyvgart.

Moderate Interaction
The bottom line Moderate

Picrorhiza has a moderate interaction with Efgartigimod alfa-fcab. Picrorhiza seems to have immunostimulating activity.

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

Picrorhiza and Efgartigimod alfa-fcab

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Efgartigimod alfa-fcab

Efgartigimod alfa-fcab falls under IMMUNOSUPPRESSANTS — the group Picrorhiza interacts with.

Picrorhiza seems to have immunostimulating activity. Theoretically, picrorhiza may interfere with immunosuppressant therapy. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
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. Vyvgart (efgartigimod) works by lowering certain antibodies in your immune system to calm conditions like myasthenia gravis. Picrorhiza, on the other hand, has shown immune-stimulating activity in lab and animal studies. So in theory, the herb could nudge your immune system in the opposite direction and work against what Vyvgart is trying to do, which might mean a weaker response and the return of symptoms like muscle weakness, drooping eyelids, or fatigue.

I want to be honest about the evidence here. This concern is theoretical and based only on early lab and animal data, not real-world cases with this drug. Still, since Vyvgart is a serious medication, I'd loop in your neurologist or pharmacist before adding picrorhiza.

References
  1. Sharma ML, Rao CS, Duda PL. Immunostimulatory activity of Picrorhiza kurroa leaf extract. J Ethnopharmacol 1994;41:185-92. PubMed
  2. Baruah CC, Gupta PP, Nath A, et al. Anti-allergic and anti-anaphylactic activity of picroliv--a standardised iridoid glycoside fraction of Picrorhiza kurroa. Pharmacol Res 1998;38:487-92.

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

Picrorhiza Also Interacts With Other Medications

Picrorhiza has 206 moderate known drug interactions in our database — the Efgartigimod alfa-fcab one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Picrorhiza

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

Everything else you take

See Every Supplement That Interacts With Efgartigimod alfa-fcab

This page covers Picrorhiza only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Efgartigimod alfa-fcab page lists 53 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate), Andrographis (moderate) and Ashwagandha (moderate).

By severity: 52 moderate · 1 minor.

From our pharmacist’s overview on the Efgartigimod alfa-fcab page

“Every supplement on this list points the same direction for someone taking efgartigimod alfa-fcab (Vyvgart). The drug works by dialing down part of the immune system to treat generalized myasthenia gravis, and each of these ingredients, echinacea, astragalus, and American ginseng among them, is thought to stimulate immunity, which coul…”

Reviewed by 2 · Jul 18, 2026

Open the Efgartigimod alfa-fcab interaction page

One more smart check

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

We hold 177 real supplement products containing Picrorhiza, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Picrorhiza. Your product may carry other ingredients that interact with Efgartigimod alfa-fcab too, on top of Picrorhiza — 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 Picrorhiza and Efgartigimod alfa-fcab 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 Picrorhiza
Top half

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

29 days ago today
Medication Efgartigimod alfa-fcab
Top 5%

#138 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 Picrorhiza

What is Picrorhiza?

  • Liver support
  • Digestive complaints
  • Asthma and breathing problems
  • Skin conditions
  • Fever
  • Immune support

Picrorhiza (Picrorhiza kurroa) is a bitter Himalayan herb used in Ayurvedic medicine, mainly for liver and digestive complaints. Early lab and small human studies suggest possible liver-protective and anti-inflammatory effects, but high-quality evidence is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Picrorhiza monograph & all interactions
Medication

About Efgartigimod alfa-fcab Injection

What Is Efgartigimod alfa-fcab Injection Used For?

Brand name: Vyvgart

  • Efgartigimod alfa-fcab injection is used to treat a certain form of myasthenia gravis (MG; a disorder of the nervous system that causes muscle weakness). Efgartigimod alfa-fcab is in a group of medications called monoclonal antibodies. It works by reducing a certain natural substance in the body that causes symptoms of myasthenia gravis.

See full Efgartigimod alfa-fcab Injection drug information
Keep checking

Other Drugs & Picrorhiza

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

0Major
206Moderate
0Minor
2,623No known interaction
Moderate

206 interactions

Showing 60 of 206 moderate interactions — see all 206 on the Picrorhiza page.

No interaction 2,623 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Picrorhiza and Efgartigimod alfa-fcab Together: Common Questions

Can you take Picrorhiza with Efgartigimod alfa-fcab?
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 Picrorhiza and Efgartigimod alfa-fcab 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.