Drug & supplement interaction

Quercetin + Paclitaxel

Paclitaxel brand names: Taxol, Abraxane.

Moderate Interaction
The bottom line Moderate

Paclitaxel falls into 4 drug categories that Quercetin can interact with; the most serious is rated moderate. Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Quercetin and Paclitaxel

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Quercetin interacts with whole categories of medication. Paclitaxel falls into 4 of those categories, so it can interact with Quercetin in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 4

Why this applies to Paclitaxel

Paclitaxel falls under P-GLYCOPROTEIN SUBSTRATES — the group Quercetin interacts with.

Theoretically, concomitant use might alter the effects and adverse effects of P-glycoprotein substrates.

There is preliminary evidence that quercetin inhibits the gastrointestinal P-glycoprotein efflux pump, which might increase the bioavailability and serum levels of drugs transported by the pump. A small study in healthy volunteers reported that pretreatment with quercetin increased bioavailability and plasma levels after a single dose of cyclosporine (Neoral, Sandimmune). Also, two small studies have shown that quercetin might decrease the absorption of talinolol, a substrate transported by the gastrointestinal P-glycoprotein efflux pump. However, in another small study, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase). The reason for these discrepancies is not entirely clear. Until more is known, use quercetin cautiously in combination with P-glycoprotein substrates.
Severity Moderate Likelihood Possible Evidence B

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 gist for paclitaxel (Taxol, Abraxane). Your body uses a pump called P-glycoprotein to push certain drugs back out and keep their levels in check. Quercetin, in concentrated supplement doses, may block that pump a bit. In theory, that could let more paclitaxel hang around in your system, which might mean stronger effects and more side effects, things like low blood counts, numbness or tingling in the hands and feet, fatigue, and nausea.

I want to be honest though: this is mostly theoretical, based on small studies with other drugs, not paclitaxel itself. Food amounts of quercetin are unlikely to matter. But since chemo dosing is delicate, please run any quercetin supplement past your oncologist or pharmacist first.

References
  1. DiCenzo R, Frerichs V, Larppanichpoonphol P, et al. Effect of quercetin on the plasma and intracellular concentrations of saquinavir in healthy adults. Pharmacotherapy 2006;26:1255-61. PubMed
  2. Choi JS, Choi BC, Choi KE. Effect of quercetin on the pharmacokinetics of oral cyclosporine. Am J Health Syst Pharm 2004;61:2406-9. PubMed
  3. Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8. PubMed
  4. Wang SY, Duan KM, Li Y, et al. Effect of quercetin on P-glycoprotein transport ability in Chinese healthy subjects. Eur J Clin Nutr 2013;67(4):390-4. PubMed
  5. Nguyen MA, Staubach P, Wolffram S, Langguth P. Effect of single-dose and short-term administration of quercetin on the pharmacokinetics of talinolol in humans - Implications for the evaluation of transporter-mediated flavonoid-drug interactions. Eur J Pha PubMed
  6. Zhao Q, Wei J, Zhang H. Effects of quercetin on the pharmacokinetics of losartan and its metabolite EXP3174 in rats. Xenobiotica 2019;49(5):563-8. PubMed
  7. Bhutani P, Rajanna PK, Paul AT. Impact of quercetin on pharmacokinetics of quetiapine: insights from in-vivo studies in wistar rats. Xenobiotica. 2020:1-7.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 4

Paclitaxel also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
A small clinical study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine (Neoral, Sandimmune), a substrate of CYP3A4. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) and quetiapine (Seroquel), substrates of CYP3A4. Other laboratory research also shows that quercetin inhibits CYP3A4. However, one clinical study shows that quercetin can increase the metabolism of midazolam, a substrate of CYP3A4, and decrease serum concentrations of midazolam by about 24% in some healthy individuals, suggesting possible induction of CYP3A4.
Severity Moderate 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 gist: your body uses a liver enzyme called CYP3A4 to help clear paclitaxel (Taxol, Abraxane) out of your system. Quercetin can nudge that enzyme, mostly by slowing it down. If it slows the breakdown of paclitaxel, more drug could linger in your blood, which may mean stronger effects and more of its usual side effects, things like low blood counts, infections, nerve tingling or numbness in the hands and feet, and fatigue.

Honestly, this concern comes from lab and animal studies and a few small human trials with other drugs, not paclitaxel itself, so it's more theoretical than proven. Still, since chemotherapy leaves little room for error, please don't add a quercetin supplement without first checking with your oncology team or pharmacist.

References
  1. Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000;294:88-95. DOI
  2. DiCenzo R, Frerichs V, Larppanichpoonphol P, et al. Effect of quercetin on the plasma and intracellular concentrations of saquinavir in healthy adults. Pharmacotherapy 2006;26:1255-61. PubMed
  3. Choi JS, Choi BC, Choi KE. Effect of quercetin on the pharmacokinetics of oral cyclosporine. Am J Health Syst Pharm 2004;61:2406-9. PubMed
  4. Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8. PubMed
  5. Duan KM, Wang SY, Ouyang W, Mao YM, Yang LJ. Effect of quercetin on CYP3A activity in Chinese healthy participants. J Clin Pharmacol 2012;52(6):940-6. PubMed
  6. Zhao Q, Wei J, Zhang H. Effects of quercetin on the pharmacokinetics of losartan and its metabolite EXP3174 in rats. Xenobiotica 2019;49(5):563-8. PubMed
  7. Bhutani P, Rajanna PK, Paul AT. Impact of quercetin on pharmacokinetics of quetiapine: insights from in-vivo studies in wistar rats. Xenobiotica. 2020:1-7.
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

3 of 4

Paclitaxel also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.

In vitro research shows that quercetin inhibits CYP2C8. Inhibition of paclitaxel (Taxol) metabolism via CYP2C8 has been reported in vitro. However, a small study in humans found no effect of quercetin on rosiglitazone (Avandia), which is also a CYP2C8 substrate.
Severity Moderate 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 basic idea with quercetin and paclitaxel. Your body relies on a liver enzyme called CYP2C8 to clear paclitaxel out of your system. In lab (test tube) studies, quercetin appears to slow that enzyme down. If that happened in a real person, paclitaxel could build up a bit higher than expected, which in theory might mean more of its known side effects, things like low blood counts, nerve tingling or numbness in the hands and feet (neuropathy), fatigue, and a higher infection risk.

The important part: this is theoretical, coming mostly from lab work, and a small human study with a similar drug found no real effect. So I wouldn't panic over quercetin in foods. But paclitaxel is serious chemotherapy, so please run any quercetin supplement past your oncologist or pharmacist before using it.

References
  1. Kim KA, Park PW, Kim HK, et al. Effect of quercetin on the pharmacokinetics of rosiglitazone, a CYP2C8 substrate, in healthy subjects. J Clin Pharmacol 2005;45:941-6. PubMed
  2. Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8. PubMed
  3. Vaclavikova R, Horsky S, Simek P, Gut I. Paclitaxel metabolism in rat and human liver microsomes is inhibited by phenolic antioxidants. Naunyn Schmiedebergs Arch Pharmacol 2003;368:200-9. PubMed
Moderate

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

4 of 4

Paclitaxel also falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP).

Theoretically, concomitant use might increase the effects and adverse effects of OATP substrates.

In vitro evidence shows that quercetin can inhibit organic anion-transporting peptide (OATP) 1B1-mediated uptake of estrone-3-sulfate and pravastatin. Furthermore, clinical research in healthy males shows that intake of quercetin along with pravastatin increases the AUC of pravastatin by 24%, prolongs its half-life by 14%, and decreases its apparent clearance by 18%, suggesting that quercetin modestly inhibits the uptake of pravastatin in hepatic cells.
Severity Moderate Likelihood Possible Evidence B

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 gist: paclitaxel is moved around the body partly by transporters called OATPs. Quercetin, in lab studies, can slow those transporters down. We saw this play out modestly in real life with a different drug, pravastatin, where quercetin nudged its levels up by about 24 percent. So the concern with paclitaxel is that high-dose quercetin supplements might let a bit more of the drug linger in your system, which could mean stronger side effects like low blood counts, nerve tingling or numbness in the hands and feet, fatigue, or hair loss.

I want to be honest that this is mostly theoretical for paclitaxel and hasn't been confirmed in cancer patients. Food amounts of quercetin are unlikely to matter. Still, since paclitaxel is potent chemo, please clear any quercetin supplement with your oncology team first.

References
  1. Wu LX, Guo CX, Chen WQ, et al. Inhibition of the organic anion-transporting polypeptide 1B1 by quercetin: an in vitro and in vivo assessment. Br J Clin Pharmacol 2012;73(5):750-7.

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

Quercetin Also Interacts With Other Medications

Quercetin has 1,168 moderate known drug interactions in our database — the Paclitaxel one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Quercetin

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

Everything else you take

See Every Supplement That Interacts With Paclitaxel

This page covers Quercetin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paclitaxel page lists 152 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Grapefruit (major), St. John's Wort (major) and Sweet Orange (major).

By severity: 5 major · 108 moderate · 39 minor.

Open the Paclitaxel interaction page

One more smart check

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

We hold 4,589 real supplement products containing Quercetin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Quercetin. Your product may carry other ingredients that interact with Paclitaxel too, on top of Quercetin — 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 Quercetin and Paclitaxel 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 Quercetin
Top 5%

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

29 days ago today
Medication Paclitaxel
Top half

#1,122 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 Quercetin

What is Quercetin?

Quercetin
  • Seasonal allergies
  • Antioxidant support
  • Heart and blood pressure health
  • Anti-inflammatory support
  • Immune support
  • Exercise recovery

Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood pressure, and inflammation, strong human evidence is limited for most uses. It is generally well tolerated in food amounts, but talk to your pharmacist or doctor before taking high-dose supplements.

Read the full Quercetin monograph & all interactions
Medication

About Paclitaxel (with albumin) Injection

What Is Paclitaxel (with albumin) Injection Used For?

Brand names: Taxol, Abraxane

Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound) is used to treat three types of cancer. It treats metastatic breast cancer in patients whose prior chemotherapy has stopped working or who relapsed within 6 months of completing adjuvant (post-surgery) chemotherapy. It is also used as a first-line treatment for locally advanced or metastatic non-small cell lung cancer (NSCLC) — given together with carboplatin — in patients who cannot have surgery or radiation therapy.

Additionally, it is approved as a first-line treatment for metastatic adenocarcinoma of the pancreas, given in combination with gemcitabine. All three uses apply specifically to Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound), including the brands Abraxane and related albumin-bound formulations.

See full Paclitaxel (with albumin) Injection drug information
Keep checking

Other Drugs & Quercetin

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

0Major
1,168Moderate
0Minor
1,661No known interaction
Moderate

1,168 interactions

Showing 60 of 1,168 moderate interactions — see all 1,168 on the Quercetin page.

No interaction 1,661 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

Keep exploring
Pharmacist Counseling Corner

Taking Quercetin and Paclitaxel Together: Common Questions

Can you take Quercetin with Paclitaxel?
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 4 interactions listed for Quercetin and Paclitaxel?
Paclitaxel belongs to more than one drug category, and Quercetin 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 Quercetin and Paclitaxel 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.