Drug & supplement interaction

Polypodium Leucotomos + Bedaquiline

Bedaquiline brand name: Sirturo.

Minor Interaction
The bottom line Minor

Polypodium Leucotomos has a minor interaction with Bedaquiline. Theoretically, Polypodium leucotomos might increase levels of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Polypodium Leucotomos and Bedaquiline

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Bedaquiline

Bedaquiline falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Polypodium Leucotomos interacts with.

Theoretically, Polypodium leucotomos might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggests that Polypodium leucotomos can decrease the metabolism of midazolam by a mechanism possibly related to the inhibition of CYP3A4. However, a small study in humans suggests that taking Polypodium leucotomos with midazolam does not affect the metabolism of midazolam.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Your TB medicine bedaquiline is cleared from your body mainly by a liver enzyme called CYP3A4. The thinking here is that Polypodium leucotomos might slow that enzyme down a bit, which could let bedaquiline build up slightly. In theory, higher levels could mean more side effects, like nausea, joint pain, or changes to your heart's rhythm (the QT interval) that this drug is already known to affect.

Here's the reassuring part: this is very weak, mostly lab and animal data. In fact, a small human study showed the fern extract did not meaningfully change levels of a similar CYP3A4 drug. So a real-world problem is unlikely. Still, MDR-TB treatment is serious business, so please run any new supplement past your pharmacist or TB doctor first.

References
  1. Shinya K, Nishimura Y, Ryu K, et al. Short-term administration of Polypodium leucotomos extract does not inhibit CYP3A4-mediated metabolism of midazolam in healthy subjects: an open-label, two-period, fixed-sequence study. Int J Dermatol 2022.

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

Polypodium Leucotomos Also Interacts With Other Medications

Polypodium Leucotomos has 642 minor known drug interactions in our database — the Bedaquiline 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 Polypodium Leucotomos

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

Everything else you take

See Every Supplement That Interacts With Bedaquiline

This page covers Polypodium Leucotomos only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bedaquiline page lists 146 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 98 moderate · 40 minor.

From our pharmacist’s overview on the Bedaquiline page

“Someone months into bedaquiline (Sirturo) for drug-resistant tuberculosis is often exhausted and tempted by anything promising energy or immune support, and that is exactly where this list earns real care. Bedaquiline is cleared by the CYP3A4 enzyme and can stretch the heart's QT interval, and 121 of the 146 interacting ingredients tou…”

Reviewed by 2 · Jul 18, 2026

Open the Bedaquiline interaction page

One more smart check

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

We hold 26 real supplement products containing Polypodium Leucotomos, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Polypodium Leucotomos. Your product may carry other ingredients that interact with Bedaquiline too, on top of Polypodium Leucotomos — 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 Polypodium Leucotomos and Bedaquiline 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 Polypodium Leucotomos
Steady interest

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

29 days ago today
Medication Bedaquiline
Steady interest

#2,304 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 Polypodium Leucotomos

What is Polypodium Leucotomos?

  • Sun sensitivity and sunburn protection
  • Skin conditions like vitiligo and melasma
  • Polymorphic light eruption
  • Skin aging and photoaging
  • Atopic dermatitis support

Polypodium leucotomos is a fern extract taken by mouth, mostly studied as an add-on to (not a replacement for) sunscreen and for certain light-triggered skin conditions. Some early research is promising for reducing sun sensitivity, but the evidence is still limited and it should not replace standard sun protection. Talk with your pharmacist or doctor before starting it.

Read the full Polypodium Leucotomos monograph & all interactions
Medication

About Bedaquiline

What Is Bedaquiline Used For?

Brand name: Sirturo

Sirturo (bedaquiline) is used as part of a combination treatment for pulmonary TB — TB that affects the lungs — caused by bacteria resistant to at least both rifampin and isoniazid. It is approved for adults and for children 2 years and older who weigh at least 8 kg (about 17.6 lbs).

Sirturo is not used for latent TB (TB infection with no active symptoms), TB outside the lungs, drug-sensitive TB, or infections caused by non-tuberculosis mycobacteria. It must always be used alongside other TB medicines — never alone.

See full Bedaquiline drug information
Keep checking

Other Drugs & Polypodium Leucotomos

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

0Major
0Moderate
642Minor
2,187No known interaction
Minor

642 interactions

Showing 60 of 642 minor interactions — see all 642 on the Polypodium Leucotomos page.

No interaction 2,187 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 Polypodium Leucotomos and Bedaquiline Together: Common Questions

Can you take Polypodium Leucotomos with Bedaquiline?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Polypodium Leucotomos and Bedaquiline interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.