Drug & supplement interaction

Puravive + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

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

Tivozanib Hydrochloride falls into 2 drug categories that Puravive can interact with; the most serious is rated moderate. Puravive, a dietary supplement, contains several ingredients that may interact with anticoagulant drugs due to their potential mild anticoagulant effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Puravive and Tivozanib Hydrochloride

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Puravive interacts with whole categories of medication. Tivozanib Hydrochloride falls into 2 of those categories, so it can interact with Puravive in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

Anticoagulant/Antiplatelet Drugs

1 of 2

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride falls under Anticoagulant/Antiplatelet Drugs — the group Puravive interacts with.

Puravive, a dietary supplement, contains several ingredients that may interact with anticoagulant drugs due to their potential mild anticoagulant effects. These ingredients include Kudzu, Panax ginseng, Phellodendron, and Propolis. Ginsenosides in Panax ginseng may decrease platelet aggregation in lab studies, but human studies have not confirmed this effect. Animal studies suggest low oral bioavailability of certain compounds in ginseng, which could explain differences between lab and human research. Propolis water extract and caffeic acid phenethyl ester, found in propolis, have also been shown to inhibit platelet aggregation in lab studies. Additionally, in an animal model, propolis taken with warfarin reduced the effectiveness of warfarin, suggesting a potential interaction with anticoagulant drugs. Lastly, Phellodendron contains berberine, which studies show may inhibit platelet aggregation.
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 thing to know about pairing Puravive with Fotivda (tivozanib). Tivozanib itself isn't a blood thinner, but it can raise your risk of bleeding on its own, and it sometimes affects blood pressure and wound healing. A few of Puravive's ingredients (ginseng, propolis, kudzu, and a berberine source called phellodendron) have shown mild blood-thinning activity, mostly in lab dishes rather than in people. Stacking these together could, in theory, nudge your bleeding risk a little higher.

To be honest, the evidence here is on the weaker side and not proven in humans. Still, with a cancer drug like this I'd play it safe. Watch for easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool, and please run Puravive by your oncology team before starting it.

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

Cytochrome P450 3A4 (Cyp3A4) Substrates

2 of 2

Tivozanib Hydrochloride 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 tivozanib (Fotivda). Puravive contains Panax ginseng, which can nudge a liver enzyme called CYP3A4, the same pathway your body uses to clear tivozanib. The tricky part is that ginseng has gone both ways in studies: sometimes it slowed this enzyme, and other times it sped it up. So we honestly can't predict which direction it would push your tivozanib levels.

If ginseng slowed the enzyme, tivozanib could build up and worsen side effects like high blood pressure, fatigue, mouth sores, or diarrhea. If it sped things up, the drug might clear faster and work less well, which matters a lot in cancer care. The evidence here is weak and the listed risk is minor, but tivozanib is too important to gamble with. Please run Puravive past your oncologist or pharmacist before starting it.

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 Tivozanib Hydrochloride 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. Tivozanib Hydrochloride)
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 Tivozanib Hydrochloride

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 Tivozanib Hydrochloride, 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 Tivozanib Hydrochloride

This page covers Puravive only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tivozanib Hydrochloride page lists 288 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Danshen (major), Grapefruit (major) and Piracetam (major).

By severity: 7 major · 239 moderate · 42 minor.

From our pharmacist’s overview on the Tivozanib Hydrochloride page

“Tivozanib (Fotivda), an oral targeted therapy for advanced kidney cancer, has a supplement list that calls for genuine vigilance. Seven of the 288 ingredients on file are rated major, and those seven deserve your attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Tivozanib Hydrochloride interaction page

How much people look this up

Where Puravive and Tivozanib Hydrochloride 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

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

29 days ago today
Medication Tivozanib Hydrochloride
Top half

#1,180 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 Tivozanib

What Is Tivozanib Used For?

Brand name: Fotivda

Fotivda (tivozanib) is used to treat adults with advanced renal cell carcinoma (RCC) — a type of kidney cancer — that is relapsed or refractory (has come back or stopped responding to treatment) after two or more prior systemic therapies (cancer treatments given throughout the body).

See full Tivozanib 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 Tivozanib Hydrochloride, 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 Tivozanib Hydrochloride supplement interactions › Every supplement checked against Tivozanib Hydrochloride, ranked by severity Tivozanib 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 Tivozanib Hydrochloride Together: Common Questions

Can you take Puravive with Tivozanib Hydrochloride?
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 2 interactions listed for Puravive and Tivozanib Hydrochloride?
Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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

Still Have a Question About Tivozanib Hydrochloride and Puravive?

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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.