Drug & supplement interaction

Rue + Topiramate

Topiramate brand names: Topamax, Trokendi XR, Qudexy XR, Eprontia.

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

Rue has a moderate interaction with Topiramate. 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 Topiramate

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

Moderate

PHOTOSENSITIZING DRUGS

Why this applies to Topiramate

Topiramate 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 pairing rue with your topiramate: this isn't about your seizure medicine being broken down differently or losing its strength. Rue contains plant compounds called furanocoumarins and psoralens, which can make your skin much more sensitive to sunlight. Some medicines can do the same, and topiramate is grouped among them, so using both together could stack that effect and raise your odds of a bad sunburn-type reaction (redness, blistering, or a rash) even after fairly short sun exposure.

I'll be honest, this connection is mostly theoretical and rests on a few scattered case reports, not strong studies. Still, if you're considering rue, please run it by your pharmacist or doctor first, and play it safe with sunscreen and covering up outdoors.

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 Topiramate 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. Topiramate)
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.

From our Q&A

Questions About Rue or Topiramate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rue or Topiramate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Topiramate

This page covers Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Topiramate page lists 125 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 101 moderate · 17 minor.

From our pharmacist’s overview on the Topiramate page

“Most people taking topiramate (Topamax, Trokendi XR) are managing seizures or preventing migraines, and the drug is famous for causing fog and drowsiness all on its own. That is why this list of 125 supplements deserves real vigilance.”

Reviewed by 2 · Jul 18, 2026

Open the Topiramate 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 Topiramate 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 Topiramate 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
Steady interest

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

29 days ago today
Medication Topiramate
Steady interest

#1,551 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 Topiramate

What Is Topiramate Used For?

Brand names: Topamax, Trokendi XR, Qudexy XR, Eprontia

  • Topiramate is used alone or with other medications to treat certain types of seizures including primary generalized tonic-clonic seizures (formerly known as a grand mal seizure; seizure that involves the entire body) and partial onset seizures (seizures that involve only one part of the brain). Topiramate is also used with other medications to control seizures in people who have Lennox-Gastaut syndrome (a disorder that causes seizures and developmental delays). Topiramate is also used to prevent migraine headaches but not to relieve the pain of migraine headaches when they occur. Topiramate is in a class of medications called anticonvulsants. It works by decreasing abnormal excitement in the brain.

See full Topiramate 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 Topiramate, 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 Topiramate supplement interactions › Every supplement checked against Topiramate, ranked by severity Topiramate 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 Topiramate Together: Common Questions

Can you take Rue with Topiramate?
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 Topiramate 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 Topiramate 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.