Drug & supplement interaction

Siberian Cocklebur + Levofloxacin

Levofloxacin brand names: Levaquin, Levaquin Injection, Leva-pak.

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

Levofloxacin falls into 2 drug categories that Siberian Cocklebur can interact with; the most serious is rated major. Siberian cocklebur can adversely affect the kidney.

Read the full interaction report
SeverityMajor
LikelihoodLikely
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Siberian Cocklebur and Levofloxacin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Siberian Cocklebur interacts with whole categories of medication. Levofloxacin falls into 2 of those categories, so it can interact with Siberian Cocklebur in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

NEPHROTOXIC DRUGS

1 of 2

Why this applies to Levofloxacin

Levofloxacin falls under NEPHROTOXIC DRUGS — the group Siberian Cocklebur interacts with.

Siberian cocklebur can adversely affect the kidney. Theoretically, combining Siberian cocklebur with potentially nephrotoxic drugs might have additive harmful effects on kidney function.
Some potentially nephrotoxic drugs include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.
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 levofloxacin. The cocklebur fruit contains naturally toxic compounds that can be hard on your kidneys. Levofloxacin, while usually well tolerated, can also occasionally stress the kidneys, especially in people who are dehydrated, older, or already have some kidney weakness. Put the two together and you may be stacking one kidney risk on top of another.

This is mostly a theoretical additive effect, but because kidney injury is serious, I'd treat it carefully. Watch for warning signs like much less urine, swelling in your legs, or unusual tiredness. Honestly, given how toxic cocklebur can be, please check with your doctor or pharmacist before using it at all alongside your antibiotic.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34. PubMed
  2. 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.
Major

HEPATOTOXIC DRUGS

2 of 2

Levofloxacin also falls under HEPATOTOXIC DRUGS.

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 levofloxacin: both can be hard on the liver. Cocklebur naturally contains a toxic compound and has been tied to real cases of liver injury, even liver failure. Levofloxacin, while usually well tolerated, occasionally stresses the liver too. Stacking two liver-stressors together may raise your odds of trouble.

This isn't about one drug speeding up or slowing down the other. It's an additive risk to the same organ. Watch for warning signs like yellowing skin or eyes, dark urine, belly pain on the right side, nausea, or unusual tiredness. Honestly, given cocklebur's known toxicity, I'd skip it during an antibiotic course. Please check with your pharmacist or doctor before combining them.

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 663 major, known drug interactions in our database — the Levofloxacin one above is among them. If you take anything else, check it against the full list below.

Major 663 No known interaction 2,167 (incl. Levofloxacin)
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 Levofloxacin

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 Levofloxacin, 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 Levofloxacin

This page covers Siberian Cocklebur only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levofloxacin page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Apple (major), Arsenic (major) and Asarabacca (major).

By severity: 13 major · 121 moderate · 21 minor.

From our pharmacist’s overview on the Levofloxacin page

“Levofloxacin (Levaquin) is a potent fluoroquinolone antibiotic, and its supplement list deserves real respect, with 13 of the 155 entries rated major. The most everyday hazards are fruit juices.”

Reviewed by 2 · Jul 18, 2026

Open the Levofloxacin 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 Levofloxacin 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 Levofloxacin 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

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

29 days ago today
Medication Levofloxacin
Top half

#1,080 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 Levofloxacin

What Is Levofloxacin Used For?

Brand names: Levaquin, Levaquin Injection, Leva-pak

Levofloxacin tablets, oral solution and injection treat infections caused by susceptible bacteria in adults. These include several types of pneumonia, skin infections, urinary tract infections, chronic bacterial prostatitis, bronchitis flare-ups and sinus infections. They also include post-exposure treatment for inhalational anthrax and plague.

Levofloxacin tablets are also used in children for inhalational anthrax (post-exposure) and plague. The eye drops are different: they treat bacterial conjunctivitis or corneal ulcer, depending on the product. It only works on bacteria, not viruses.

See full Levofloxacin 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.

663Major
0Moderate
0Minor
2,166No known interaction
663 Major 2,166 No interaction
Major

663 interactions

Showing 60 of 663 major interactions — see all 663 on the Siberian Cocklebur page.

No interaction 2,166 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 2,166 medications checked with no known interaction — see the full Siberian Cocklebur list.

See the full Siberian Cocklebur interactions page
See every supplement checked against Levofloxacin, 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 Levofloxacin supplement interactions › Every supplement checked against Levofloxacin, ranked by severity Levofloxacin 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 Levofloxacin Together: Common Questions

Can you take Siberian Cocklebur with Levofloxacin?
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.
Why are there 2 interactions listed for Siberian Cocklebur and Levofloxacin?
Levofloxacin belongs to more than one drug category, and Siberian Cocklebur interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Siberian Cocklebur and Levofloxacin 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 Levofloxacin 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.