Drug & supplement interaction

Siberian Cocklebur + Olutasidenib

Olutasidenib brand name: Rezlidihia.

Major Interaction
The bottom line Major

Siberian Cocklebur has a major interaction with Olutasidenib. 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 Olutasidenib

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

Major

HEPATOTOXIC DRUGS

Why this applies to Olutasidenib

Olutasidenib 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 these two. Olutasidenib (Rezlidihia) is a cancer medicine that already carries a known risk of liver problems, so much so that doctors check liver blood tests regularly while you're on it. Siberian cocklebur has its own track record of harming the liver, including reports of serious damage and even liver failure.

Stack one liver stressor on top of another and you may raise the odds of liver injury. Warning signs include yellowing skin or eyes, dark urine, belly pain on the right side, nausea, or unusual tiredness. This is rated a major, likely interaction, so please don't add cocklebur without talking to your oncologist or pharmacist first. They watch your liver numbers closely for good reason.

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 Olutasidenib one above is one of them. If you take anything else, check it against the full list below.

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.

Everything else you take

See Every Supplement That Interacts With Olutasidenib

This page covers Siberian Cocklebur only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Olutasidenib page lists 180 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), St. John's Wort (major) and Wine (major).

By severity: 6 major · 137 moderate · 37 minor.

From our pharmacist’s overview on the Olutasidenib page

“Olutasidenib (Rezlidihia) treats a form of acute myeloid leukemia, where keeping drug levels steady genuinely matters, so I'd approach this list with real care. Six of the 180 ingredients rate major, and they split into two problems: products that change how much olutasidenib reaches your blood, and products that strain the liver.”

Reviewed by 2 · Jul 18, 2026

Open the Olutasidenib 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 Olutasidenib 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 Olutasidenib 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 25%

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

29 days ago today
Medication Olutasidenib
Steady interest

#2,504 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 Olutasidenib

What Is Olutasidenib Used For?

Brand name: Rezlidihia

Olutasidenib (brand name Rezlidhia) treats adults with acute myeloid leukemia (AML) that has come back (relapsed) or has not responded to other treatment (refractory).

It is only for leukemia with a susceptible IDH1 mutation. An FDA-approved test on blood or bone marrow must confirm the mutation first.

See full Olutasidenib 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
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
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

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Pharmacist Counseling Corner

Taking Siberian Cocklebur and Olutasidenib Together: Common Questions

Can you take Siberian Cocklebur with Olutasidenib?
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 Olutasidenib 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 Olutasidenib 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.