Drug & supplement interaction

Sesame + Fosphenytoin

Fosphenytoin brand name: Cerebyx.

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

Sesame has a moderate interaction with Fosphenytoin. Theoretically, sesame might increase the levels and clinical effects of CYP2C9 substrates.

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

Sesame and Fosphenytoin

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

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

Why this applies to Fosphenytoin

Fosphenytoin falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Sesame interacts with.

Theoretically, sesame might increase the levels and clinical effects of CYP2C9 substrates.
In vitro, sesame inhibits CYP2C9. However, this interaction 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 for fosphenytoin (Cerebyx). Once it's in your body, it converts to phenytoin, which is cleared mainly by a liver enzyme called CYP2C9. In test-tube studies, compounds in sesame appear to slow that enzyme down. If that happened in people, phenytoin could build up a bit, which might mean more side effects like dizziness, drowsiness, unsteady walking, slurred speech, or eye twitching.

The important part: this is only seen in lab studies, not in actual patients, so it's theoretical. Phenytoin also has a narrow safety window, so even small shifts can matter. Normal sesame in food is very unlikely to be a problem, but check with your doctor or pharmacist before using concentrated sesame supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. von Moltke LL, Weemhoff JL, Bedir E, et al. Inhibition of human cytochromes P450 by components of Ginkgo biloba. J Pharm Pharmacol 2004;56:1039-44.

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

Sesame Also Interacts With Other Medications

Sesame has 342 moderate, 185 minor known drug interactions in our database — the Fosphenytoin one above is one of them. If you take anything else, check it against the full list below.

Moderate 342 Minor 185 No known interaction 2,303 (incl. Fosphenytoin)
Taking anything else?

Check Another of Your Medications Against Sesame

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

Everything else you take

See Every Supplement That Interacts With Fosphenytoin

This page covers Sesame only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fosphenytoin page lists 205 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 14 major · 172 moderate · 19 minor.

From our pharmacist’s overview on the Fosphenytoin page

“St. John's wort is the entry I would flag first with fosphenytoin (Cerebyx).”

Reviewed by 2 · Jul 18, 2026

Open the Fosphenytoin interaction page

One more smart check

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

We hold 434 real supplement products containing Sesame, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sesame. Your product may carry other ingredients that interact with Fosphenytoin too, on top of Sesame — 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 Sesame and Fosphenytoin 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 Sesame
Top half

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

29 days ago today
Medication Fosphenytoin
Steady interest

#2,150 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 Sesame

What is Sesame?

  • Heart and cholesterol health
  • Blood pressure support
  • Source of healthy fats and minerals
  • Skin and hair care (topical oil)
  • Antioxidant support
  • Cooking and nutrition

Sesame is a nutritious seed and oil widely used in cooking and traditional medicine, and it provides healthy fats, fiber, and antioxidant compounds called lignans. Some early research suggests sesame may modestly help with cholesterol and blood pressure, but the evidence is limited. Sesame is also a common, sometimes serious, food allergen, so people with seed allergies should be careful.

Read the full Sesame monograph & all interactions
Medication

About Fosphenytoin Injection

What Is Fosphenytoin Injection Used For?

Brand name: Cerebyx

Fosphenytoin injection is used to treat generalized tonic-clonic status epilepticus (a prolonged, life-threatening seizure emergency) and to prevent or treat seizures that occur during or after brain surgery. It is given by intravenous (IV) or intramuscular (IM) injection in a hospital or clinical setting.

It can also be used short-term as a substitute for oral phenytoin when a patient cannot take medicine by mouth. This use is temporary — as soon as oral phenytoin is possible again, it should replace the injection.

See full Fosphenytoin Injection drug information
Keep checking

Other Drugs & Sesame

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

0Major
342Moderate
185Minor
2,302No known interaction
342 Moderate 185 Minor 2,302 No interaction
Moderate

342 interactions

Showing 60 of 342 moderate interactions — see all 342 on the Sesame page.

Minor

185 interactions

Showing 60 of 185 minor interactions — see all 185 on the Sesame page.

No interaction 2,302 drugs checked — show the list

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

Showing the 60 most looked-up of 2,302 medications checked with no known interaction — see the full Sesame list.

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

Can you take Sesame with Fosphenytoin?
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 Sesame and Fosphenytoin 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 Fosphenytoin and Sesame?

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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.