Drug & supplement interaction

Puravive + Netupitant, Palonosetron (Oral)

Netupitant, Palonosetron (Oral) brand name: Akynzeo.

Minor Interaction
Medically reviewed by · Updated February 2024
The bottom line Minor

Puravive has a minor interaction with Netupitant, Palonosetron (Oral). Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4.

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

Puravive and Netupitant, Palonosetron (Oral)

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

Minor

Cytochrome P450 3A4 (Cyp3A4) Substrates

Why this applies to Netupitant, Palonosetron (Oral)

Netupitant, Palonosetron (Oral) falls under Cytochrome P450 3A4 (Cyp3A4) Substrates — the group Puravive interacts with.

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.
Severity Minor 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 situation with Akynzeo (netupitant plus palonosetron). The netupitant part is handled by a liver enzyme called CYP3A4, and Puravive contains Panax ginseng, which may nudge that enzyme one way or the other. The tricky thing is that ginseng has shown mixed results in studies, sometimes slowing CYP3A4 down and sometimes speeding it up, so we honestly can't predict the direction for sure.

If ginseng slowed the enzyme, netupitant levels could rise, possibly meaning more side effects like headache, constipation, or fatigue. If it sped things up, the medicine might work a little less well at preventing chemo nausea. This is rated minor with weak evidence, so don't panic, but since you're going through chemo, please run it by your oncology pharmacist before adding Puravive.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Puravive Also Interacts With Other Medications

Puravive has 358 moderate, 880 minor known drug interactions in our database — the Netupitant, Palonosetron (Oral) one above is one of them. If you take anything else, check it against the full list below.

Moderate 358 Minor 880 No known interaction 1,592 (incl. Netupitant, Palonosetron (Oral))
Taking anything else?

Check Another of Your Medications Against Puravive

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

From our Q&A

Questions About Puravive or Netupitant, Palonosetron (Oral)

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Puravive or Netupitant, Palonosetron (Oral), not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Netupitant, Palonosetron (Oral)

This page covers Puravive only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Netupitant, Palonosetron (Oral) page lists 158 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 5-htp (moderate).

By severity: 4 major · 113 moderate · 41 minor.

From our pharmacist’s overview on the Netupitant, Palonosetron (Oral) page

“Getting Akynzeo (netupitant and palonosetron) to work is the difference between finishing a chemotherapy cycle comfortably and losing days to nausea, so this list warrants genuine care. Most of it involves a liver enzyme, CYP3A4, that clears netupitant.”

Reviewed by 2 · Jul 18, 2026

Open the Netupitant, Palonosetron (Oral) interaction page

How much people look this up

Where Puravive and Netupitant, Palonosetron (Oral) 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 Puravive
Top half

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

29 days ago today
Medication Netupitant, Palonosetron (Oral)
Top 5%

#64 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 Puravive

What is Puravive?

Puravive
  • Weight management
  • Metabolism support
  • Energy levels
  • General wellness
  • Stress and brain health

Puravive is a branded, multi-ingredient capsule marketed mainly for weight loss by claiming to boost brown fat activity, but there is no published, independent clinical research showing the product itself works for this purpose. Some individual ingredients have been studied in laboratory or small human studies, but those results do not prove the finished blend is safe or effective. Talk to a pharmacist or doctor before trying it, especially if you have health conditions or take medications.

Read the full Puravive monograph & all interactions
Medication

About Netupitant and Palonosetron

What Is Netupitant and Palonosetron Used For?

Brand name: Akynzeo

Netupitant and palonosetron helps prevent nausea and vomiting from cancer chemotherapy in adults. It is used together with dexamethasone, a steroid medicine. It covers both the first day (acute phase) and the days after (delayed phase).

Akynzeo capsules are used for initial and repeat courses of chemotherapy, including highly emetogenic (strongly nausea-causing) chemotherapy. Akynzeo for injection and Akynzeo injection are used for highly emetogenic chemotherapy only. They have not been studied with anthracycline plus cyclophosphamide chemotherapy.

See full Netupitant and Palonosetron drug information
Keep checking

Other Drugs & Puravive

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

0Major
358Moderate
880Minor
1,591No known interaction
358 Moderate 880 Minor 1,591 No interaction
Moderate

358 interactions

Showing 60 of 358 moderate interactions — see all 358 on the Puravive page.

Minor

880 interactions

Showing 60 of 880 minor interactions — see all 880 on the Puravive page.

No interaction 1,591 drugs checked — show the list

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

Showing the 60 most looked-up of 1,591 medications checked with no known interaction — see the full Puravive list.

See the full Puravive interactions page
See every supplement checked against Netupitant, Palonosetron (Oral), 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
Puravive monograph › Uses, safety, and every drug interaction in one place Netupitant, Palonosetron (Oral) supplement interactions › Every supplement checked against Netupitant, Palonosetron (Oral), ranked by severity Netupitant and Palonosetron 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 Puravive and Netupitant, Palonosetron (Oral) Together: Common Questions

Can you take Puravive with Netupitant, Palonosetron (Oral)?
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 Puravive and Netupitant, Palonosetron (Oral) 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.