Drug & supplement interaction

Picrorhiza + Neratinib Maleate

Neratinib Maleate brand name: Nerlynx.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Picrorhiza and Neratinib Maleate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Neratinib Maleate states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Picrorhiza and Neratinib Maleate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Neratinib Maleate and Picrorhiza in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Picrorhiza safety at a glance

Picrorhiza overall Use caution Generally used in traditional medicine, but human safety data are limited, so use with care.
Pregnancy Avoid Not enough safety information; avoid use during pregnancy.
Breastfeeding Avoid Not enough safety information; avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Neratinib Maleate and Picrorhiza? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Neratinib Maleate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Neratinib Maleate is filed under 3 classifications — hepatotoxic drugs, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Picrorhiza has documented interactions with 2 drug classes — the most serious being antidiabetes drugs (moderate) and immunosuppressants (moderate) — and none of Neratinib Maleate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Picrorhiza Does Interact With Other Medications

Picrorhiza has 207 moderate known drug interactions in our database — Neratinib Maleate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 207 No known interaction 2,623 (incl. Neratinib Maleate)
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.

What to actually watch for

No Interaction Found — But Data Suggests Picrorhiza and Neratinib Maleate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Diarrhea / Reduced appetite / Vomiting reported in 54.4% of FDA reports for Neratinib Maleate Additional detail

    Picrorhiza

    “Orally, picrorhiza may cause vomiting, rash, anorexia, diarrhea, itching, and giddiness.”

    Picrorhiza · Natural Medicines adverse-effect record, reported in anorexia.

    1 source cited
    1. 11858. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89-95.

    “Orally, picrorhiza may cause vomiting, anorexia, and diarrhea.”

    Picrorhiza · Natural Medicines adverse-effect record, reported in anorexia.

    1 source cited
    1. 11858. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89-95.

    Neratinib Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Neratinib Maleate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • A skin rash Additional detail

    Picrorhiza

    “Orally, picrorhiza may cause rash and itching.”

    Picrorhiza · Natural Medicines adverse-effect record, reported in pruritus.

    1 source cited
    1. 11858. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89-95.

    Neratinib Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Neratinib Maleate. Read the label on DailyMed ›

Reported for Picrorhiza but not commonly for Neratinib Maleate: itching.

Effects for Neratinib Maleate come from the ADVERSE REACTIONS section of its FDA label; effects for Picrorhiza come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 2,294 voluntary FDA FAERS reports for Neratinib Maleate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Neratinib Maleate Products Have a Food Rule — Picrorhiza Should Not Break It

At least one FDA label for a product containing Neratinib Maleate says to take it with food. If you take Picrorhiza on an empty stomach out of habit, keep them separate — and take Neratinib Maleate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Neratinib Maleate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

( 2.1 , 2.2 ) Extended adjuvant treatment of early-stage breast cancer: 240 mg (6 tablets) given orally once daily, with food, continuously until disease recurrence or for up to one year.

From the Dosage and Administration section of the FDA label we read for Neratinib Maleate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Neratinib Maleate

This page covers Picrorhiza only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Neratinib Maleate page lists 168 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 124 moderate · 38 minor.

From our pharmacist’s overview on the Neratinib Maleate page

“This list deserves a careful read, not a quick skim. Neratinib (Nerlynx) treats HER2-positive breast cancer, and 121 of the 168 supplements on file can raise or lower its blood level by acting on CYP3A4, the enzyme that clears it.”

Reviewed by 2 · Jul 18, 2026

Open the Neratinib Maleate 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. Even though Picrorhiza itself has no known interaction with Neratinib Maleate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Picrorhiza and Neratinib 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 Picrorhiza
Top half

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

29 days ago today
Medication Neratinib Maleate
Steady interest

#2,042 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Picrorhiza reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Picrorhiza and Neratinib Maleate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Picrorhiza kurroa · Plantaginaceae · Roots and rhizomes · Capsules, tablets, powder (churna), liquid extracts, and traditional herbal formulas

An interaction check asks whether these two react with each other — it does not ask whether Picrorhiza is a good idea for someone in your situation. Here is what our Picrorhiza record says about it on its own.

Picrorhiza: dosing

There is no well-established standard dose of Picrorhiza. The amount used can vary widely depending on the form (powder, capsule, or extract) and how concentrated the product is.The safest approach is to follow the dosing directions on the product label and not to exceed them.

From our Picrorhiza monograph — the full record covers uses, side effects and every documented interaction.

Read the full Picrorhiza monograph & all interactions
Medication

About Neratinib

What Is Neratinib Used For?

Brand name: Nerlynx

Nerlynx (neratinib) is used on its own as extended adjuvant treatment — meaning ongoing therapy after initial treatment is done — for adults with early-stage HER2-positive breast cancer who have already completed trastuzumab-based therapy.

Nerlynx is also used in combination with another chemotherapy drug, capecitabine, for adults with advanced or metastatic (spread) HER2-positive breast cancer who have already received two or more prior HER2-targeted regimens in the metastatic setting.

See full Neratinib 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
207Moderate
0Minor
2,622No known interaction
207 Moderate 2,622 No interaction
Moderate

207 interactions

Showing 60 of 207 moderate interactions — see all 207 on the Picrorhiza page.

No interaction 2,622 drugs checked — show the list

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

Showing the 60 most looked-up of 2,622 medications checked with no known interaction — see the full Picrorhiza list.

See the full Picrorhiza interactions page
See every supplement checked against Neratinib Maleate, ranked by severity
Evidence & sources

Picrorhiza References

The 7 references that drive our Picrorhiza monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Sharma ML, Rao CS, Duda PL. Immunostimulatory activity of Picrorhiza kurroa leaf extract. J Ethnopharmacol 1994;41:185-92. PubMed
  2. Bedi KL, Zutshi U, Chopra CL, Amla V. Picrorhiza kurroa, an ayurvedic herb, may potentiate photochemotherapy in vitiligo. J Ethnopharmacol 1989;27:347-52. PubMed
  3. Vaidya AB, Antarkar DS, Doshi JC, et al. Picrorhiza kurroa (Kutaki) Royle ex Benth as a hepatoprotective agent--experimental & clinical studies. J Postgrad Med 1996;42:105-8.
  4. 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.
  5. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89-95.
  6. Joy, K. L. and Kuttan, R. Anti-diabetic activity of Picrorrhiza kurroa extract. J Ethnopharmacol 11-1-1999;67(2):143-148. PubMed
  7. Brockwell C, Ampikaipakan S, Sexton DW, Price D, Freeman D, Thomas M, Ali M, Wilson AM. Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2014;9:715-21. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Picrorhiza and Neratinib Maleate Together: Common Questions

Is it safe to take Picrorhiza with Neratinib Maleate?
We do not list a known interaction between Picrorhiza and Neratinib Maleate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Picrorhiza and Neratinib Maleate have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Picrorhiza and Neratinib Maleate at the same time of day?
At least one FDA label for a product containing Neratinib Maleate says to take it with food. If you take Picrorhiza on an empty stomach out of habit, keep them separate and take Neratinib Maleate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Neratinib Maleate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Picrorhiza and Neratinib Maleate combination checked?
Interactions in our licensed database are recorded against drug classes. Neratinib Maleate is filed under 3 classifications, and Picrorhiza has documented interactions with 2 drug classes — none of Neratinib Maleate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Picrorhiza interact with any other medications?
Yes. Picrorhiza has 207 documented drug interactions in our database — Neratinib Maleate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Neratinib Maleate interact with any supplements?
Yes. Neratinib Maleate has documented interactions with 168 supplements in our database — Picrorhiza is not one of them. The Neratinib Maleate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Picrorhiza monograph Uses, safety profile, and every drug interaction in one place Neratinib drug information The full plain-English guide to this medication Neratinib Maleate supplement interactions Every supplement checked against Neratinib Maleate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 7 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Neratinib Maleate and Picrorhiza?

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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.