Drug & supplement interaction

Rooibos + Enasidenib

Enasidenib brand name: Idhifa.

Moderate Interaction
The bottom line Moderate

Enasidenib falls into 5 drug categories that Rooibos can interact with; the most serious is rated moderate. Theoretically, taking rooibos with CYP2C19 substrates may increase the effects of CYP2C19 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions5
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rooibos and Enasidenib

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

Rooibos interacts with whole categories of medication. Enasidenib falls into 5 of those categories, so it can interact with Rooibos in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 5

Why this applies to Enasidenib

Enasidenib falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Rooibos interacts with.

Theoretically, taking rooibos with CYP2C19 substrates may increase the effects of CYP2C19 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems strongly inhibits CYP2C19 enzyme activity.
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: your body uses a liver enzyme called CYP2C19 to help break down enasidenib. Lab studies (done in test tubes, not people) suggest that compounds in rooibos may slow that enzyme down. If that happened in your body, enasidenib could clear out a little more slowly and build up, which might mean stronger effects and a higher chance of side effects like nausea, low appetite, tiredness, or changes in your blood counts and liver labs.

That said, this is only a theoretical concern based on early lab work, not real patient cases. A cup or two of rooibos tea is unlikely to cause trouble, but concentrated rooibos extracts are a bigger unknown. Since enasidenib is a serious cancer drug, please run any rooibos extracts past your oncology team or pharmacist first.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 5

Enasidenib also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, taking rooibos with CYP1A2 substrates may increase the effects of CYP1A2 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems inhibits CYP1A2 enzyme activity.
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

If you're sipping rooibos while taking Idhifa (enasidenib) for your leukemia, here's the honest picture. Some lab research hints that compounds in rooibos may slow down a liver enzyme called CYP1A2. Enasidenib is partly handled by that same enzyme, so in theory, blocking it a little could let more of the drug build up in your body. That might mean stronger effects and a higher chance of side effects like nausea, low appetite, or changes in your blood counts and liver tests.

That said, this is only a theoretical concern based on test-tube studies, not real people, and a normal cup of tea is far weaker than a concentrated extract. Still, since enasidenib is a serious cancer medicine, please mention your rooibos habit to your oncology team or pharmacist before changing anything.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

3 of 5

Enasidenib also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, taking rooibos with CYP2D6 substrates may increase the effects of CYP2D6 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems inhibits CYP2D6 enzyme activity.
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 with your leukemia medicine, Idhifa (enasidenib). Some of how your body handles this drug involves a liver enzyme called CYP2D6. Lab dish studies (not people) suggest rooibos may gently slow that enzyme down. In theory, that could let a bit more enasidenib linger in your system, which might mean stronger effects or more side effects like nausea, tiredness, or changes in your blood counts and liver tests.

I want to be honest with you though: this is very early, test-tube-only evidence, and a cup of rooibos tea is unlikely to cause real trouble. Concentrated rooibos extracts are the bigger question mark. Since enasidenib is a serious cancer drug, please run any rooibos supplements past your oncology team or pharmacist first.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

4 of 5

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

Theoretically, taking rooibos with CYP2C9 substrates may increase the effects of CYP2C9 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems inhibits CYP2C9 enzyme activity.
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 your leukemia medicine, Idhifa (enasidenib). Your body partly clears this drug using a liver enzyme called CYP2C9. In a test-tube study, an extract of rooibos slowed that same enzyme down. In theory, if that enzyme works more slowly, enasidenib could clear out a bit less easily and build up slightly, which might mean stronger effects or more side effects like nausea, diarrhea, or changes in your blood counts.

That said, this is very early lab-only evidence using a concentrated extract, not normal cups of tea, so it may not happen in real life at all. Enjoying rooibos as a regular drink is unlikely to be a problem, but because this is a serious cancer drug, please check with your oncology team or pharmacist before using rooibos extracts or supplements.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

5 of 5

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

Theoretically, taking rooibos with CYP3A4 substrates may increase the effects of CYP3A4 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems strongly inhibits CYP3A4 enzyme activity.
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 an enzyme called CYP3A4 to help break down enasidenib (Idhifa). Lab studies hint that concentrated rooibos extract may slow that enzyme down. If that happened in real life, enasidenib could build up a bit, which might mean stronger effects and more side effects like nausea, diarrhea, low appetite, or higher bilirubin levels.

That said, I want to be straight with you: this is only a theoretical concern from test-tube research, not from studies in people. A regular cup of rooibos tea is very unlikely to cause trouble. Concentrated extract pills are the bigger question mark. Since enasidenib is a serious cancer drug, just run any rooibos supplements past your oncology team or pharmacist first.

References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.

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

Rooibos Also Interacts With Other Medications

Rooibos has 878 moderate known drug interactions in our database — the Enasidenib 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 Rooibos

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

Everything else you take

See Every Supplement That Interacts With Enasidenib

This page covers Rooibos only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enasidenib page lists 203 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 156 moderate · 44 minor.

From our pharmacist’s overview on the Enasidenib page

“Anyone taking enasidenib (Idhifa) for acute myeloid leukemia should treat this supplement list with genuine care, beginning with the major-rated entries: grapefruit, St. John's wort, and activated charcoal.”

Reviewed by 2 · Jul 18, 2026

Open the Enasidenib interaction page

One more smart check

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

We hold 142 real supplement products containing Rooibos, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rooibos. Your product may carry other ingredients that interact with Enasidenib too, on top of Rooibos — 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 Rooibos and Enasidenib 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 Rooibos
Top half

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

29 days ago today
Medication Enasidenib
Steady interest

#2,257 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 Rooibos

What is Rooibos?

Rooibos
  • Caffeine-free beverage
  • Antioxidant support
  • Heart health
  • Blood sugar support
  • Digestive upset
  • General wellness

Rooibos is a caffeine-free herbal tea from South Africa that is rich in antioxidants and generally considered safe as a beverage. While lab and early studies suggest possible benefits for heart health, blood sugar, and inflammation, strong human evidence is lacking for most medical uses. Enjoy it as a tea, but talk to your pharmacist or doctor before using concentrated extracts for health reasons.

Read the full Rooibos monograph & all interactions
Medication

About Enasidenib

What Is Enasidenib Used For?

Brand name: Idhifa

Idhifa (enasidenib) is used to treat adult patients with acute myeloid leukemia (AML) — a fast-moving cancer of the blood and bone marrow — whose disease has come back after treatment (relapsed) or has stopped responding to treatment (refractory). It is specifically for patients whose leukemia has a mutation in the IDH2 gene, which must be confirmed by an FDA-approved test before starting therapy.

See full Enasidenib drug information
Keep checking

Other Drugs & Rooibos

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

0Major
878Moderate
0Minor
1,951No known interaction
Moderate

878 interactions

Showing 60 of 878 moderate interactions — see all 878 on the Rooibos page.

No interaction 1,951 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 Rooibos and Enasidenib Together: Common Questions

Can you take Rooibos with Enasidenib?
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 5 interactions listed for Rooibos and Enasidenib?
Enasidenib belongs to more than one drug category, and Rooibos 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 Rooibos and Enasidenib 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 Enasidenib and Rooibos?

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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.