Drug & supplement interaction

Rabdosia Rubescens + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Nintedanib Esylate falls into 2 drug categories that Rabdosia Rubescens can interact with; the most serious is rated moderate. Rabdosia rubescens might increase levels of p-glycoprotein substrates.

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

Rabdosia Rubescens and Nintedanib Esylate

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

Why Are There 2 Interactions?

Rabdosia Rubescens interacts with whole categories of medication. Nintedanib Esylate falls into 2 of those categories, so it can interact with Rabdosia Rubescens in 2 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 2

Why this applies to Nintedanib Esylate

Nintedanib Esylate falls under P-GLYCOPROTEIN SUBSTRATES — the group Rabdosia Rubescens interacts with.

Rabdosia rubescens might increase levels of p-glycoprotein substrates. In vitro research shows that Rabdosia rubescens extract inhibits p-glycoprotein levels and activity. Drugs that might be affected include some chemotherapeutic agents (doxorubicin, etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), digoxin, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
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 for Ofev (nintedanib). Your body uses a tiny pump called P-glycoprotein to move nintedanib out of cells and help carry it out of the system. Lab research suggests Rabdosia rubescens can slow that pump down. If the pump works less, more nintedanib could stay in your body, which may nudge up its more common side effects, things like nausea, diarrhea, stomach pain, vomiting, and changes in liver enzymes.

That said, this is based only on test-tube studies, not on people taking these two together, so it's a theoretical concern rather than a proven problem. Diarrhea is already a frequent issue with Ofev, so anything that could make it worse is worth a quick chat. Please run it by your pharmacist or doctor before adding this herb, and don't change your Ofev dose on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Li F, Fan J, Wu Z, et al. Reversal effects of Rabdosia rubescens extract on multidrug resistance of MCF-7/Adr cells in vitro. Pharm Biol. 2013;51(9):1196-203.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

In vitro research shows that oridonin, a constituent of Rabdosia rubescens, induces cytochrome P450 3A4 (CYP3A4) enzyme. Also, in an animal model, oridonin induces a gene homologous to CYP3A4. So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking Rabdosia rubescens. Some drugs metabolized by CYP3A4 that might be affected are some benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), triazolam (Halcion); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, others), felodipine (Plendil), verapamil (Calan, Verelan, others); cyclosporine (Neoral, Sandimmune); some HIV antivirals such as indinavir (Crixivan), ritonavir (Norvir), saquinavir (Fortovase, Invirase); some HMG CoA reductase inhibitors such as atorvastatin (Lipitor), lovastatin (Mevacor); some macrolide antibiotics such as erythromycin and clarithromycin (Biaxin); quinidine; and many others.
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 for Ofev (nintedanib). Lab research suggests a compound in Rabdosia rubescens, called oridonin, may speed up an enzyme called CYP3A4, which is one of the pathways your body uses to handle nintedanib. If that enzyme works faster, your body could clear the drug a bit quicker, which in theory might lower its levels and make it less effective at slowing lung scarring. Nintedanib isn't a prodrug, so faster breakdown means less benefit, not more.

Important caveat: this is only test-tube and animal data, and it has never actually been seen in people, so don't panic. Still, since nintedanib treats serious lung disease, please check with your pharmacist or doctor before adding this herb rather than changing anything on your own.

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

Rabdosia Rubescens Also Interacts With Other Medications

Rabdosia Rubescens has 713 moderate, 69 minor known drug interactions in our database — the Nintedanib Esylate one above is among them. If you take anything else, check it against the full list below.

Moderate 713 Minor 69 No known interaction 2,048 (incl. Nintedanib Esylate)
Taking anything else?

Check Another of Your Medications Against Rabdosia Rubescens

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

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Rabdosia Rubescens only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

How much people look this up

Where Rabdosia Rubescens and Nintedanib Esylate 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 Rabdosia Rubescens
Steady interest

#1,176 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,979 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 Rabdosia Rubescens

What is Rabdosia Rubescens?

Rabdosia Rubescens
  • Sore throat and respiratory complaints
  • Inflammation
  • Antimicrobial support
  • Digestive complaints
  • Traditional cancer support

Rabdosia rubescens is a Chinese herb traditionally used for sore throats, inflammation, and infections, and its compound oridonin has drawn lab interest for possible anticancer effects. However, strong human evidence is lacking for any use, and safety has not been well studied, so talk with your pharmacist or doctor before trying it.

Read the full Rabdosia Rubescens monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
Keep checking

Other Drugs & Rabdosia Rubescens

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

0Major
713Moderate
69Minor
2,047No known interaction
713 Moderate 69 Minor 2,047 No interaction
Moderate

713 interactions

Showing 60 of 713 moderate interactions — see all 713 on the Rabdosia Rubescens page.

Minor

69 interactions

Showing 60 of 69 minor interactions — see all 69 on the Rabdosia Rubescens page.

No interaction 2,047 drugs checked — show the list

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

Showing the 60 most looked-up of 2,047 medications checked with no known interaction — see the full Rabdosia Rubescens list.

See the full Rabdosia Rubescens interactions page
See every supplement checked against Nintedanib Esylate, 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
Rabdosia Rubescens monograph › Uses, safety, and every drug interaction in one place Nintedanib Esylate supplement interactions › Every supplement checked against Nintedanib Esylate, ranked by severity Nintedanib 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 Rabdosia Rubescens and Nintedanib Esylate Together: Common Questions

Can you take Rabdosia Rubescens with Nintedanib Esylate?
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 Rabdosia Rubescens and Nintedanib Esylate?
Nintedanib Esylate belongs to more than one drug category, and Rabdosia Rubescens 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 Rabdosia Rubescens and Nintedanib Esylate 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.