Drug & supplement interaction

Rabdosia Rubescens + Valdecoxib

Valdecoxib brand name: Bextra.

Moderate Interaction
The bottom line Moderate

Valdecoxib falls into 2 drug categories that Rabdosia Rubescens can interact with; the most serious is rated moderate. In vitro research shows that oridonin, a constituent of Rabdosia rubescens, induces cytochrome P450 3A4 (CYP3A4) enzyme.

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

Rabdosia Rubescens and Valdecoxib

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. Valdecoxib 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

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Valdecoxib

Valdecoxib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Rabdosia Rubescens interacts with.

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 Valdecoxib (Bextra), a COX-2 anti-inflammatory used for pain and swelling. Your body partly clears it using a liver enzyme called CYP3A4. Lab and animal studies hint that oridonin, a compound in Rabdosia rubescens, may speed up that enzyme. If it does, your system could break down valdecoxib a little faster and you might get less pain and anti-inflammatory relief than usual.

I want to be honest about the strength here: this is only test-tube and animal evidence, and it has never been confirmed in people, so it may not amount to much in real life. Valdecoxib isn't a prodrug, so faster clearance simply means weaker effect, not added side effects. Before combining them, check with your pharmacist or doctor first.

Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Valdecoxib also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

In vitro research shows that oridonin, a constituent of Rabdosia rubescens, induces cytochrome P450 2C9 (CYP2C9) enzyme. So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2C9 in patients taking Rabdosia rubescens. Some drugs metabolized by CYP2C9 include nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.
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 gist for Valdecoxib (Bextra), a COX-2 anti-inflammatory once used for arthritis and pain. Your body relies on a liver enzyme called CYP2C9 to break it down. Lab studies suggest a compound in Rabdosia rubescens, called oridonin, may speed that enzyme up. If that held true in people, your body could clear valdecoxib a little faster, which might mean weaker pain and inflammation relief.

The good news: this is theoretical, based only on test-tube research, and has never been reported in real patients. So I wouldn't lose sleep over it. Valdecoxib is an active drug (not a prodrug), so the direction here is reduced effect rather than more side effects. Still, if you notice your pain creeping back, check in with your pharmacist or doctor.

References
  1. Zhang YW, Zheng XW, Liu YJ, et al. Effect of oridonin on cytochrome P450 expression and activities in HepaRG Cell. Pharmacology. 2018;101(5-6):246-254. 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

Rabdosia Rubescens Also Interacts With Other Medications

Rabdosia Rubescens has 713 moderate, 69 minor known drug interactions in our database — the Valdecoxib 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 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 Valdecoxib

This page covers Rabdosia Rubescens only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Valdecoxib page lists 181 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 7 major · 130 moderate · 44 minor.

Open the Valdecoxib interaction page

How much people look this up

Where Rabdosia Rubescens and Valdecoxib 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

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

29 days ago today
Medication Valdecoxib
Top half

#1,222 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
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
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
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 Rabdosia Rubescens and Valdecoxib Together: Common Questions

Can you take Rabdosia Rubescens with Valdecoxib?
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 Valdecoxib?
Valdecoxib 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 Valdecoxib 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.