Drug & supplement interaction

Sage + Bupivacaine

Bupivacaine brand names: Marcaine, Exparel, Posimir.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Sage and Bupivacaine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Sage and Bupivacaine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Bupivacaine and Sage in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Sage safety at a glance

Sage overall Use caution Generally safe as a food and short-term as tea, but concentrated extracts and the essential oil should be used cautiously.
Pregnancy Likely Unsafe When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects. Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally; sage is thought to reduce the supply of mother's milk. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Bupivacaine and Sage? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Bupivacaine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Bupivacaine is filed under 3 classifications — anesthesia, seizure threshold lowering drugs, oral drugs. Sage has documented interactions with 14 drug classes — the most serious being anticholinergic drugs (moderate), anticonvulsants (moderate) and antidiabetes drugs (moderate) — and none of Bupivacaine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Sage Does Interact With Other Medications

Sage has 1,296 moderate known drug interactions in our database — Bupivacaine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 1,296 No known interaction 1,534 (incl. Bupivacaine)
Taking anything else?

Check Another of Your Medications Against Sage

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

What to actually watch for

What Sage Itself Has Been Linked To

This is not an interaction — nothing below involves Bupivacaine. It is the side-effect record for Sage on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Sage, this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • Seizures Worth acting on Additional detail

    “Orally, sage can cause dizziness or agitation. Thujone, a constituent of common sage (Salvia officinalis), is a neurotoxin and can cause seizures. Camphor and cineol, constituents of common sage and Spanish sage, can also cause neurotoxicity and seizures in high doses. Generalized tonic-clonic seizures have been reported in adults, children, and infants after ingestion of sage oil.”

    Sage · Natural Medicines adverse-effect record, reported in epilepsy.

    6 sources cited
    1. 10810. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
    2. 17177. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
    3. 10812. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
    4. 12868. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
    5. 10334. Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
    6. 72666. Halicioglu, O., Astarcioglu, G., Yaprak, I., and Aydinlioglu, H. Toxicity of Salvia officinalis in a newborn and a child: an alarming report. Pediatr.Neurol. 2011;45(4):259-260. PubMed
  • Anxiety or restlessness / Dizziness Additional detail

    Recorded for Sage in the same Natural Medicines adverse-effect record shown under Seizures above.

  • Stomach pain / Diarrhea / Vomiting / Nausea Additional detail

    “Orally, sage can cause nausea, vomiting, abdominal pain, and diarrhea.

    Topically, sage extract sprayed into the mouth and throat can cause dryness or mild burning of the throat.”

    Sage · Natural Medicines adverse-effect record, reported in diarrhea.

    3 sources cited
    1. 10810. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
    2. 17177. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
    3. 72619. Hubbert, M., Sievers, H., Lehnfeld, R., and Kehrl, W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur
  • A skin rash Additional detail

    “Orally, sage extract has been reported to cause acneiform skin eruptions in one patient in a clinical trial.

    Topically, sage leaves can cause contact dermatitis. Sage extract can cause burning and pain.”

    Sage · Natural Medicines adverse-effect record, reported in dermatitis.

    5 sources cited
    1. 91970. Vandecasteele K, Ost P, Oosterlinck W, et al. Evaluation of the efficacy and safety of Salvia officinalis in controlling hot flashes in prostate cancer patients treated with androgen deprivation. Phytother Res. 2012;26(2):208-13.
    2. 46902. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
    3. 72661. Mayer, E., Gescheidt-Shoshany, H., and Weltfriend, S. Allergic contact dermatitis caused by Salvia officinalis extract. Contact Dermatitis 2011;64(4):237-238. PubMed
    4. 72710. Sertoli, A., Fabbri, P., Campolmi, P., and Panconesi, E. Allergic contact dermatitis to Salvia Officinalis, Inula Viscosa and Conyza Bonariensis. Contact Dermatitis 1978;4(5):314-315.
    5. 10437. Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82. PubMed

Everything above comes from the Natural Medicines adverse-effect record for Sage — expand a row for the licensed statement it rests on. We haven’t matched Bupivacaine to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Bupivacaine.

Special populations

Sage in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects.

Lactation Possibly Unsafe

When used orally; sage is thought to reduce the supply of mother's milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Bupivacaine

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bupivacaine page lists 28 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Fever Bark (major), Biofeedback (moderate), Cannabis (moderate) and Coffee Charcoal (moderate).

By severity: 2 major · 17 moderate · 9 minor.

From our pharmacist’s overview on the Bupivacaine page

“Bupivacaine (Marcaine, Exparel, Posimir) is a numbing medicine injected for surgery, nerve blocks, and epidurals, and this is a supplement list worth studying before a procedure, not after. Two of the 28 documented interactions rate major: activated charcoal, which can pull many drugs out of the body and lower their levels, and fever b…”

Reviewed by 2 · Jul 18, 2026

Open the Bupivacaine interaction page

One more smart check

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

We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Even though Sage itself has no known interaction with Bupivacaine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sage and Bupivacaine 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 Sage
Top 25%

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

29 days ago today
Medication Bupivacaine
Steady interest

#2,662 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Sage reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Sage and Bupivacaine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Sage

What is Sage?

Sage
  • Sore throat and mouth irritation
  • Digestive upset
  • Excessive sweating
  • Memory and thinking
  • Menopause symptoms (hot flashes)
  • General antioxidant support

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.

Salvia officinalis · Lamiaceae · Leaves and essential oil · Tea, capsules, tablets, tincture/extract, essential oil, lozenges, mouth rinse/gargle

An interaction check asks whether these two react with each other — it does not ask whether Sage is a good idea for someone in your situation. Here is what our Sage record says about it on its own.

Sage: dosing

There is no single official or standardized dose of sage, and the right amount depends on the form and the product. Sage tea, gargles, capsules, and extracts all differ in strength.The best approach is to follow the directions on the product label and not exceed the recommended amount.

From our Sage monograph — the full record covers uses, side effects and every documented interaction.

Read the full Sage monograph & all interactions
Keep checking

Other Drugs & Sage

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

0Major
1,296Moderate
0Minor
1,533No known interaction
1,296 Moderate 1,533 No interaction
Moderate

1,296 interactions

Showing 60 of 1,296 moderate interactions — see all 1,296 on the Sage page.

No interaction 1,533 drugs checked — show the list

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

Showing the 60 most looked-up of 1,533 medications checked with no known interaction — see the full Sage list.

See the full Sage interactions page
See every supplement checked against Bupivacaine, ranked by severity
Evidence & sources

Sage References

The 27 references that drive our Sage monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Todorov S, Philianos S, Petkov V, et al. Experimental pharmacological study of three species from genus Salvia. Acta Physiol Pharmacol (Bulg) 1984;10:13-20.
  3. Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
  4. Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82. PubMed
  5. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
  6. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
  7. Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
  8. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
  9. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
  10. Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
  11. Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
  12. Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
  13. Perry, N. S., Houghton, P. J., Sampson, J., Theobald, A. E., Hart, S., Lis-Balchin, M., Hoult, J. R., Evans, P., Jenner, P., Milligan, S., and Perry, E. K. In-vitro activity of S. lavandulaefolia (Spanish sage) relevant to treatment of Alzheimer's diseas
  14. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  15. Kavvadias, D., Monschein, V., Sand, P., Riederer, P., and Schreier, P. Constituents of sage (Salvia officinalis) with in vitro affinity to human brain benzodiazepine receptor. Planta Med. 2003;69(2):113-117.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Sage and Bupivacaine Together: Common Questions

Is it safe to take Sage with Bupivacaine?
We do not list a known interaction between Sage and Bupivacaine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
How was the Sage and Bupivacaine combination checked?
Interactions in our licensed database are recorded against drug classes. Bupivacaine is filed under 3 classifications, and Sage has documented interactions with 14 drug classes — none of Bupivacaine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Sage interact with any other medications?
Yes. Sage has 1,296 documented drug interactions in our database — Bupivacaine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Bupivacaine interact with any supplements?
Yes. Bupivacaine has documented interactions with 28 supplements in our database — Sage is not one of them. The Bupivacaine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Sage monograph Uses, safety profile, and every drug interaction in one place Bupivacaine supplement interactions Every supplement checked against Bupivacaine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 27 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Bupivacaine and Sage?

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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.