Drug & supplement interaction

Rue + Pirfenidone

Pirfenidone brand name: Esbriet.

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

Rue has a moderate interaction with Pirfenidone. Theoretically, rue might increase the risk for phototoxicity when used with photosensitizing drugs.

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

Rue and Pirfenidone

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

Moderate

PHOTOSENSITIZING DRUGS

Why this applies to Pirfenidone

Pirfenidone falls under PHOTOSENSITIZING DRUGS — the group Rue interacts with.

Theoretically, rue might increase the risk for phototoxicity when used with photosensitizing drugs.
Rue contains photosensitizing furanocoumarins and psoralens and has been associated with multiple reports of phototoxic reactions. There is also one case report of an increased phototoxic response to psoralen and ultraviolet A (PUVA) therapy associated with ingestion of rue.
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 thing to know about pirfenidone (Esbriet): it already makes your skin much more sensitive to sunlight on its own. Bad sunburns and rashes are one of its most common side effects, so people on it are usually told to cover up and use sunscreen. Rue carries its own sun-sensitizing compounds (furanocoumarins and psoralens) and has been linked to phototoxic skin reactions.

Stacking the two could, in theory, make your skin react even more strongly to the sun, meaning faster or more severe burns and rashes. I'll be honest, this is based on weak, anecdotal evidence rather than solid studies, so it's a caution, not a proven danger. Still, why pile on extra risk? Please check with your pharmacist or doctor before using rue.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Puig L. Pharmacodynamic interaction with phototoxic plants during PUVA therapy. Br J Dermatol 1997;136:973-4. PubMed
  2. Radotra I, Gardiner S, Barnes D. A phytophototoxic injury at a burns unit: the ungraceful after-effects of the "common rue" plant. J Burn Care Res. 2018;39(6):1064-6. PubMed
  3. Avallone G, Mastorino L, Agostini A, et al. Ruta graveolens phytophotodermatitis. Dermatol Online J 2021;27(7). 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

Rue Also Interacts With Other Medications

Rue has 334 moderate known drug interactions in our database — the Pirfenidone one above is one of them. If you take anything else, check it against the full list below.

Moderate 334 No known interaction 2,496 (incl. Pirfenidone)
Taking anything else?

Check Another of Your Medications Against Rue

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

Everything else you take

See Every Supplement That Interacts With Pirfenidone

This page covers Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pirfenidone page lists 115 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Alfalfa (moderate) and Angelica Archangelica (moderate).

By severity: 1 major · 80 moderate · 34 minor.

From our pharmacist’s overview on the Pirfenidone page

“Pirfenidone (Esbriet) slows the lung scarring of idiopathic pulmonary fibrosis, and when a drug is doing that kind of work, this is not a list to skim. Most of the 115 ingredients on file touch CYP1A2, the liver enzyme that clears pirfenidone, so they can push its blood level up (more nausea and liver strain) or drag it down and quietl…”

Reviewed by 2 · Jul 18, 2026

Open the Pirfenidone interaction page

One more smart check

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

We hold 47 real supplement products containing Rue, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rue. Your product may carry other ingredients that interact with Pirfenidone too, on top of Rue — 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 Rue and Pirfenidone 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 Rue
Top half

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

29 days ago today
Medication Pirfenidone
Top 10%

#178 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 Rue

What is Rue?

Rue
  • Menstrual cramps
  • Digestive upset
  • Muscle spasms and pain
  • Headache
  • Insect repellent (topical)
  • Traditional folk remedy

Rue is a strong-smelling herb from southern Europe with a long history in folk medicine, but there is very little reliable human research to support its health uses. It can be toxic in larger amounts and is considered unsafe during pregnancy, so most people should avoid it or use it only under professional guidance.

Read the full Rue monograph & all interactions
Medication

About Pirfenidone

What Is Pirfenidone Used For?

Brand name: Esbriet

Pirfenidone — available as capsules and tablets under the brand name Esbriet, as well as generic pirfenidone products — is indicated for the treatment of idiopathic pulmonary fibrosis (IPF), a chronic, progressive disease in which scar tissue builds up in the lungs and makes breathing increasingly difficult.

Esbriet capsules and tablets, pirfenidone capsules, and pirfenidone tablets are each specifically approved for IPF. No other uses are supported by the available product labels.

See full Pirfenidone drug information
Keep checking

Other Drugs & Rue

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

0Major
334Moderate
0Minor
2,495No known interaction
334 Moderate 2,495 No interaction
Moderate

334 interactions

Showing 60 of 334 moderate interactions — see all 334 on the Rue page.

No interaction 2,495 drugs checked — show the list

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

Showing the 60 most looked-up of 2,495 medications checked with no known interaction — see the full Rue list.

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

Can you take Rue with Pirfenidone?
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 Rue and Pirfenidone 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 Pirfenidone and Rue?

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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.