Drug & supplement interaction

Quillaia + Emapalumab-Lzsg

Emapalumab-Lzsg brand name: Gamifant.

Moderate Interaction
The bottom line Moderate

Quillaia has a moderate interaction with Emapalumab-Lzsg. Theoretically, concomitant use of quillaia with immunosuppressant drugs might decrease the effectiveness of these drugs.

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

Quillaia and Emapalumab-Lzsg

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Emapalumab-Lzsg

Emapalumab-Lzsg falls under IMMUNOSUPPRESSANTS — the group Quillaia interacts with.

Theoretically, concomitant use of quillaia with immunosuppressant drugs might decrease the effectiveness of these drugs.
In vitro research shows that some quillaia constituents have immunostimulant effects.
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 quillaia and Gamifant (emapalumab). Gamifant is a lab-made antibody that calms an overactive immune system in HLH by blocking a protein called interferon-gamma. Quillaia's saponins, on the other hand, have shown the opposite tendency in test-tube studies, gently nudging the immune system to be more active. In theory, that could work against what Gamifant is trying to do and chip away at how well it controls the inflammation.

I want to be straight with you: this is a theoretical concern based only on lab research, not on real patients taking the two together. Still, since Gamifant treats a very serious condition, I wouldn't add a quillaia supplement without first running it by the treating doctor or pharmacist.

References
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. Wu JY, Gardner BH, Murphy CI, et al. Saponin adjuvant enhancement of antigen-specific immune responses to an experimental HIV-1 vaccine. J Immunol 1992;148:1519-25. DOI
  4. Fleck JD, Betti AH, da Silva FP, et al. Saponins from Quillaja saponaria and Quillaja brasiliensis: particular chemical characteristics and biological activities. Molecules 2019;24(1). pii: E171. PubMed

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

Quillaia Also Interacts With Other Medications

Quillaia has 120 moderate known drug interactions in our database — the Emapalumab-Lzsg 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 Quillaia

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

Everything else you take

See Every Supplement That Interacts With Emapalumab-Lzsg

This page covers Quillaia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Emapalumab-Lzsg page lists 53 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate), Andrographis (moderate) and Ashwagandha (moderate).

By severity: 52 moderate · 1 minor.

From our pharmacist’s overview on the Emapalumab-Lzsg page

“Emapalumab-lzsg (Gamifant) quiets an immune system that has turned dangerously overactive in a rare condition called hemophagocytic lymphohistiocytosis. All 53 supplement interactions on file share a single theme, a possible boost to immune activity that could work against the drug.”

Reviewed by 2 · Jul 18, 2026

Open the Emapalumab-Lzsg interaction page

How much people look this up

Where Quillaia and Emapalumab-Lzsg 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 Quillaia
Steady interest

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

29 days ago today
Medication Emapalumab-Lzsg
Top half

#955 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 Quillaia

What is Quillaia?

  • Cough and chest congestion
  • Foaming agent in beverages
  • Vaccine adjuvant (in pharmaceutical manufacturing)
  • Washing and cleansing (traditional soap)
  • Skin conditions

Quillaia (soap bark tree) is a plant whose bark contains foaming compounds called saponins, and it is widely used as an emulsifier in foods and drinks. As a supplement or herbal remedy its benefits are not well proven, and large amounts can be irritating or toxic, so it should be used cautiously and only as directed.

Read the full Quillaia monograph & all interactions
Medication

About Emapalumab-lzsg Injection

What Is Emapalumab-lzsg Injection Used For?

Brand name: Gamifant

Gamifant is used to treat primary hemophagocytic lymphohistiocytosis (HLH) — a rare, life-threatening condition where the immune system becomes dangerously overactivated — in adults and children whose disease has not responded to, has come back during, or has progressed on standard HLH therapy, or who cannot tolerate it.

Gamifant is also used for HLH/macrophage activation syndrome (MAS) in adults and children with known or suspected Still's disease, including systemic Juvenile Idiopathic Arthritis (sJIA), when glucocorticoids (steroid medicines) have not worked well enough, cannot be tolerated, or when MAS keeps coming back.

See full Emapalumab-lzsg Injection drug information
Keep checking

Other Drugs & Quillaia

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

0Major
120Moderate
0Minor
2,709No known interaction
Moderate

120 interactions

Showing 60 of 120 moderate interactions — see all 120 on the Quillaia page.

No interaction 2,709 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 Quillaia and Emapalumab-Lzsg Together: Common Questions

Can you take Quillaia with Emapalumab-Lzsg?
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.
How serious is the Quillaia and Emapalumab-Lzsg 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 Emapalumab-Lzsg and Quillaia?

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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.