Drug & supplement interaction

Puravive + Pralsetinib

Pralsetinib brand name: Gavreto.

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

Pralsetinib falls into 3 drug categories that Puravive can interact with; the most serious is rated moderate. Puravive contains Panax ginseng. Panax ginseng is thought to have an additive effect with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Puravive and Pralsetinib

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Puravive interacts with whole categories of medication. Pralsetinib falls into 3 of those categories, so it can interact with Puravive in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

Qt Interval-Prolonging Drugs

1 of 3

Why this applies to Pralsetinib

Pralsetinib falls under Qt Interval-Prolonging Drugs — the group Puravive interacts with.

Puravive contains Panax ginseng. Panax ginseng is thought to have an additive effect with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias. However, research findings on this matter are conflicting. Clinical studies indicate that short-term use of Panax ginseng can increase the QT interval (source: https://pubmed.ncbi.nlm.nih.gov/27240158/). However, no changes in the QT interval have been observed with prolonged use (source: https://pubmed.ncbi.nlm.nih.gov/11978148/).
Severity Moderate Likelihood Possible Evidence C

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 heart of it: Pralsetinib (Gavreto) can lengthen something called the QT interval, which is a measure of your heart's electrical timing. Puravive contains Panax ginseng, which some studies suggest may also stretch out that interval a little. Stack the two and, in theory, you could nudge up the risk of an irregular heartbeat.

I want to be honest about the evidence here. It's mixed. One short-term study showed ginseng affecting QT, while longer use showed no change, so this is more of a caution than a sure thing. Still, because Pralsetinib already carries its own QT warning, I'd loop in your oncologist or pharmacist before adding Puravive. Please don't change your cancer treatment on your own.

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

Cytochrome P450 3A4 (Cyp3A4) Substrates

2 of 3

Pralsetinib also falls under Cytochrome P450 3A4 (Cyp3A4) Substrates.

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 Puravive and your pralsetinib (Gavreto). Puravive contains Panax ginseng, and ginseng can nudge an enzyme in your liver called CYP3A4. Pralsetinib is one of the cancer drugs that this same enzyme helps break down. So in theory, ginseng could change your pralsetinib levels.

The tricky part is the direction isn't clear. In some studies ginseng slowed this enzyme (which could let pralsetinib build up and bring on more nausea, fatigue, swelling, or blood pressure changes), while in others it sped it up (which could weaken how well the drug fights your cancer). The evidence here is weak and mostly theoretical, but because this is a serious cancer medicine, I'd want you to clear any Puravive with your oncologist or pharmacist first rather than guess.

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

P-Glycoprotein Substrates

3 of 3

Pralsetinib also falls under P-Glycoprotein Substrates.

Puravive contains quercetin. Theoretically, concurrent use of quercetin and P-glycoprotein substrates might alter the effects and adverse effects of the drugs. There is preliminary evidence suggesting that quercetin inhibits the P-glycoprotein efflux pump in the gastrointestinal tract. This inhibition could potentially increase the bioavailability and serum levels of drugs transported by this pump. For example, a small study in healthy volunteers found that pretreatment with quercetin increased bioavailability and plasma levels following a single dose of cyclosporine (Neoral, Sandimmune) (source: https://pubmed.ncbi.nlm.nih.gov/15581264/). However, other small studies have shown that quercetin might decrease the absorption of talinolol, another substrate of the gastrointestinal P-glycoprotein efflux pump. Interestingly, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase) in another small study (source: https://pubmed.ncbi.nlm.nih.gov/16945047/). The reason for these discrepancies is not entirely clear. Until more is known, it is advisable to use quercetin cautiously in combination with P-glycoprotein substrates.
Severity Minor Likelihood Possible Evidence C

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 deal with combining Puravive and your cancer medication, Gavreto (pralsetinib). Puravive contains quercetin, and there's some early lab and small-study evidence that quercetin can block a gut transporter called P-glycoprotein. Pralsetinib is carried by that same pump, so in theory blocking it could let a bit more of the drug get absorbed into your bloodstream. Higher levels could mean stronger side effects like high blood pressure, fatigue, swelling, constipation, or changes in your blood counts and liver labs.

I want to be honest though: this is mostly theoretical, the evidence is weak, and the studies even point in different directions. Still, pralsetinib is a serious cancer drug, so please don't add Puravive without first running it by your oncologist or pharmacist.

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 356 moderate, 881 minor known drug interactions in our database — the Pralsetinib one above is among them. If you take anything else, check it against the full list below.

Moderate 356 Minor 881 No known interaction 1,593 (incl. Pralsetinib)
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 Pralsetinib

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 Pralsetinib, 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 Pralsetinib

This page covers Puravive only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pralsetinib page lists 181 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), Beer (major) and Cesium (major).

By severity: 11 major · 134 moderate · 36 minor.

From our pharmacist’s overview on the Pralsetinib page

“With pralsetinib (Gavreto), a targeted therapy for RET-driven lung and thyroid cancers, I would treat this list as required reading rather than background noise. Most of the interactions change how much of the drug the body actually gets: grapefruit can push its levels higher, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Pralsetinib interaction page

How much people look this up

Where Puravive and Pralsetinib 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

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

29 days ago today
Medication Pralsetinib
Steady interest

#1,803 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 Pralsetinib

What Is Pralsetinib Used For?

Brand name: Gavreto

Gavreto (pralsetinib) is used to treat adults with metastatic RET fusion-positive non-small cell lung cancer (NSCLC) — a type of lung cancer that has spread and carries a specific genetic alteration detected by an FDA-approved test.

Gavreto is also approved for adults and children aged 12 and older with advanced or metastatic RET fusion-positive thyroid cancer who need systemic (whole-body) treatment and whose cancer no longer responds to radioactive iodine (when radioactive iodine is an appropriate option). This thyroid cancer use is under accelerated approval, meaning continued approval depends on results from confirmatory clinical trials.

See full Pralsetinib 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
356Moderate
881Minor
1,592No known interaction
356 Moderate 881 Minor 1,592 No interaction
Moderate

356 interactions

Showing 60 of 356 moderate interactions — see all 356 on the Puravive page.

Minor

881 interactions

Showing 60 of 881 minor interactions — see all 881 on the Puravive page.

No interaction 1,592 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 1,592 medications checked with no known interaction — see the full Puravive list.

See the full Puravive interactions page
See every supplement checked against Pralsetinib, 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 Pralsetinib supplement interactions › Every supplement checked against Pralsetinib, ranked by severity Pralsetinib 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 Pralsetinib Together: Common Questions

Can you take Puravive with Pralsetinib?
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 3 interactions listed for Puravive and Pralsetinib?
Pralsetinib belongs to more than one drug category, and Puravive 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 Puravive and Pralsetinib 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.