Drug & supplement interaction

Siberian Cocklebur + Fluconazole

Fluconazole brand names: Diflucan, Diflucan Injection.

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

Siberian Cocklebur has a major interaction with Fluconazole. Siberian cocklebur can adversely affect the liver.

Read the full interaction report
SeverityMajor
LikelihoodLikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Siberian Cocklebur and Fluconazole

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

Major

HEPATOTOXIC DRUGS

Why this applies to Fluconazole

Fluconazole falls under HEPATOTOXIC DRUGS — the group Siberian Cocklebur interacts with.

Siberian cocklebur can adversely affect the liver. It has been linked to many cases of hepatotoxicity and some cases of liver failure. Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (TriCor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo).
Severity Major Likelihood Likely Evidence B

Well-controlled human studies have demonstrated the likely existence of this interaction.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing Siberian cocklebur and fluconazole (Diflucan): both can be tough on the liver. Cocklebur has been linked to real cases of liver injury, and even liver failure, partly because of natural toxins it contains. Fluconazole, like other antifungals in its family, can also occasionally stress the liver. Put them together and you may stack the risk of liver damage on top of each other.

What might that look like? Watch for things like yellowing of the skin or eyes, dark urine, belly pain on the upper right side, nausea, or unusual tiredness. This isn't a guaranteed problem, but it's a serious one if it happens. Please talk with your pharmacist or doctor before combining these, and don't stop your fluconazole on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Gurley ES, Rahman M, Hossain MJ, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One 2010 Mar 18;5(3):e9756. PubMed
  2. Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34. PubMed
  3. Karabiber H, Almis H, Selimoglu MA, Yakinci C, Yilmaz S. Xanthium strumarium poisoning requiring liver transplantation. J Pediatr Gastroenterol Nutr. 2014;58(1):e6-9.

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

Siberian Cocklebur Also Interacts With Other Medications

Siberian Cocklebur has 661 major, known drug interactions in our database — the Fluconazole one above is one of them. If you take anything else, check it against the full list below.

Major 661 No known interaction 2,169 (incl. Fluconazole)
Taking anything else?

Check Another of Your Medications Against Siberian Cocklebur

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

From our Q&A

Questions About Siberian Cocklebur or Fluconazole

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

This page covers Siberian Cocklebur only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fluconazole page lists 81 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Wine (major), Adrafinil (moderate) and Ashwagandha (moderate).

By severity: 4 major · 54 moderate · 23 minor.

From our pharmacist’s overview on the Fluconazole page

“Fluconazole (Diflucan) treats fungal infections, and I would pair it with supplements carefully. Nearly half of the 81 ingredients with an interaction on file, 38 of them, put extra strain on the liver, which is already busy processing the antifungal.”

Reviewed by 2 · Jul 18, 2026

Open the Fluconazole interaction page

One more smart check

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

We hold 84 real supplement products containing Siberian Cocklebur, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Siberian Cocklebur. Your product may carry other ingredients that interact with Fluconazole too, on top of Siberian Cocklebur — 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 Siberian Cocklebur and Fluconazole 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 Siberian Cocklebur
Top half

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

29 days ago today
Medication Fluconazole
Top half

#906 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 Siberian Cocklebur

What is Siberian Cocklebur?

  • Nasal congestion and sinus problems
  • Allergic rhinitis (hay fever)
  • Headache
  • Skin conditions and itching
  • Joint and muscle discomfort

Siberian cocklebur is a fruit used in traditional Chinese and other Asian herbal medicine, mainly for nasal congestion, sinus issues, and allergies. Human evidence is very limited, and the plant contains naturally toxic compounds that can cause serious poisoning, so it should only be used under expert guidance, if at all.

Read the full Siberian Cocklebur monograph & all interactions
Medication

About Fluconazole

What Is Fluconazole Used For?

Brand names: Diflucan, Diflucan Injection

Fluconazole treats infections caused by Candida and Cryptococcus fungi. Diflucan tablets and oral suspension, fluconazole tablets, and fluconazole oral suspension and tablets are approved for vaginal yeast infections (vaginal candidiasis), mouth and throat yeast infections (oropharyngeal candidiasis), and esophageal candidiasis. All formulations, including the intravenous injection, are used for cryptococcal meningitis (a fungal infection of the brain lining). In smaller studies, fluconazole was also effective for Candida urinary tract infections, peritonitis (abdominal lining infection), and serious systemic infections such as candidemia (Candida in the bloodstream) and disseminated candidiasis.

Fluconazole is also used as preventive therapy: Diflucan, fluconazole tablets, fluconazole oral suspension, and fluconazole injection are all indicated to reduce the risk of candidiasis in patients undergoing bone marrow transplantation who receive chemotherapy and/or radiation therapy. Note that the oral suspension formulations are not approved for vaginal candidiasis — that indication applies only to Diflucan tablets/suspension and fluconazole tablets/tablet-suspension products.

See full Fluconazole drug information
Keep checking

Other Drugs & Siberian Cocklebur

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

661Major
0Moderate
0Minor
2,168No known interaction
661 Major 2,168 No interaction
Major

661 interactions

Showing 60 of 661 major interactions — see all 661 on the Siberian Cocklebur page.

No interaction 2,168 drugs checked — show the list

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

Showing the 60 most looked-up of 2,168 medications checked with no known interaction — see the full Siberian Cocklebur list.

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

Can you take Siberian Cocklebur with Fluconazole?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Siberian Cocklebur and Fluconazole interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Fluconazole and Siberian Cocklebur?

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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.