Drug & supplement interaction

Sage + Fidaxomicin

Fidaxomicin brand name: Dificid.

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

Sage has a moderate interaction with Fidaxomicin. Theoretically, sage might increase levels of drugs transported by P-glycoprotein.

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

Sage and Fidaxomicin

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

Why this applies to Fidaxomicin

Fidaxomicin falls under P-GLYCOPROTEIN SUBSTRATES — the group Sage interacts with.

Theoretically, sage might increase levels of drugs transported by P-glycoprotein.
In vitro research suggests that common sage (Salvia officinalis) can inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.
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 sage and Fidaxomicin (Dificid). In lab studies, sage appears to block a transporter called P-glycoprotein, which acts like a little pump in your gut wall that pushes certain drugs back out. Fidaxomicin rides along with that same pump, so in theory, slowing the pump could let a bit more of the drug stay in your system.

The good news is this is the kind of antibiotic that mostly stays right in your intestines to fight C. diff, so even a small bump usually isn't a big deal, and you might just notice more nausea, belly discomfort, or vomiting. Honestly though, this is only seen in test-tube research and has never been reported in real people, so I wouldn't lose sleep over it. Food amounts of sage are very unlikely to matter. If you're taking concentrated sage extracts, just give your pharmacist or doctor a quick heads-up.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.

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

Sage Also Interacts With Other Medications

Sage has 1,296 moderate known drug interactions in our database — the Fidaxomicin one above is one of them. If you take anything else, check it against the full list below.

Moderate 1,296 No known interaction 1,534 (incl. Fidaxomicin)
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.

From our Q&A

Questions About Sage or Fidaxomicin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Sage or Fidaxomicin, 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 Fidaxomicin

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fidaxomicin page lists 92 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Oleander (major), St. John's Wort (major), Bacillus Coagulans (moderate) and Bacillus Subtilis (moderate).

By severity: 3 major · 71 moderate · 18 minor.

From our pharmacist’s overview on the Fidaxomicin page

“If you are taking fidaxomicin (Dificid) for a Clostridioides difficile infection, supplements are not a side issue, because anything that weakens this drug risks letting a hard-to-treat infection come back. Three entries rated major top my concerns.”

Reviewed by 2 · Jul 18, 2026

Open the Fidaxomicin 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. Your product may carry other ingredients that interact with Fidaxomicin too, on top of Sage — 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 Sage and Fidaxomicin 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%

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

29 days ago today
Medication Fidaxomicin
Top 25%

#489 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 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.

Read the full Sage monograph & all interactions
Medication

About Fidaxomicin

What Is Fidaxomicin Used For?

Brand name: Dificid

Fidaxomicin treats C. difficile-associated diarrhea (CDAD). This is diarrhea caused by an infection with the bacterium Clostridioides difficile.

Dificid is approved for adults and for children 6 months of age and older. The generic fidaxomicin tablets are approved for adults only. It should only be used when the infection is proven or strongly suspected to be caused by C. difficile.

See full Fidaxomicin drug information Fidaxomicin NDC codes and packages
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 Fidaxomicin, 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
Sage monograph › Uses, safety, and every drug interaction in one place Fidaxomicin supplement interactions › Every supplement checked against Fidaxomicin, ranked by severity Fidaxomicin drug information › The full plain-English guide to this medication Fidaxomicin NDC codes and packages › Every package, labeler and price in the FDA directory 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 Sage and Fidaxomicin Together: Common Questions

Can you take Sage with Fidaxomicin?
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 Sage and Fidaxomicin 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 Fidaxomicin 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.