Drug & supplement interaction

Spearmint + Ketoconazole

Ketoconazole brand name: Nizoral.

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

Spearmint has a moderate interaction with Ketoconazole. Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.

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

Spearmint and Ketoconazole

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Ketoconazole

Ketoconazole falls under HEPATOTOXIC DRUGS — the group Spearmint interacts with.

Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Animal research suggests that drinking spearmint tea for 30 days can increase markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and cause liver degeneration and necrosis, in a dose-dependent manner. 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 thing to know about ketoconazole: when you take it as a pill, it can be tough on the liver. That's actually why doctors save it for fungal infections that other, gentler medicines can't handle, and why your provider may check your liver bloodwork while you're on it.

Now, spearmint. In animal studies, very concentrated spearmint (think strong tea every day for a month) nudged up liver enzymes and stressed the liver. This hasn't been shown in people, so it's a theoretical caution, not a proven problem. Sipping spearmint tea or using it in cooking is very unlikely to matter. But stacking a high-dose spearmint supplement on top of a liver-stressing drug isn't worth the gamble. Please run any concentrated spearmint product by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Akdogan M, Ozguner M, Aydin G, Gokalp O. Investigation of biochemical and histopathological effects of Mentha piperita Labiatae and Mentha spicata Labiatae on liver tissue in rats. Hum Exp Toxicol 2004;23:21-8.

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

Spearmint Also Interacts With Other Medications

Spearmint has 578 moderate known drug interactions in our database — the Ketoconazole one above is one of them. If you take anything else, check it against the full list below.

Moderate 578 No known interaction 2,252 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Spearmint

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

From our Q&A

Questions About Spearmint or Ketoconazole

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

This page covers Spearmint only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoconazole page lists 182 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), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 135 moderate · 41 minor.

From our pharmacist’s overview on the Ketoconazole page

“Ketoconazole (Nizoral) is already hard on the liver, so treat its 182 interacting supplements with genuine care, starting with the six rated major. Most of the list runs through CYP3A4, the liver enzyme ketoconazole strongly blocks, so it can raise levels of over a hundred herbal ingredients, while grapefruit pushes ketoconazole itself…”

Reviewed by 2 · Jul 18, 2026

Open the Ketoconazole interaction page

One more smart check

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

We hold 408 real supplement products containing Spearmint, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Spearmint. Your product may carry other ingredients that interact with Ketoconazole too, on top of Spearmint — 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 Spearmint and Ketoconazole 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 Spearmint
Top 25%

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

29 days ago today
Medication Ketoconazole
Steady interest

#1,985 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 Spearmint

What is Spearmint?

Spearmint
  • Digestive upset and indigestion
  • Nausea
  • Hormonal acne and unwanted hair (PCOS-related)
  • Memory and focus
  • Mild stress and anxiety
  • Joint discomfort

Spearmint is a common culinary mint that is generally safe in food and tea amounts. Early research suggests possible benefits for digestion, mild hormone-related issues (such as excess facial hair in women), and memory, but the evidence is still limited. Talk to your pharmacist or doctor before using concentrated supplements, especially if you are pregnant or have a health condition.

Read the full Spearmint monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole 2% shampoo and foam are used to treat tinea versicolor (also called pityriasis versicolor) — a fungal infection caused by Pityrosporum orbiculare (also known as Malassezia furfur), a yeast that naturally lives on the skin.

This infection creates light or dark patches, most often on the trunk, neck, arms, and upper thighs. Even after the fungus is cleared, those skin patches may take months to return to their normal color — that's normal, and depends on your skin type and sun exposure. Tinea versicolor can also come back, since the fungus lives on healthy skin even when there's no active infection.

See full Ketoconazole drug information
Keep checking

Other Drugs & Spearmint

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

0Major
578Moderate
0Minor
2,251No known interaction
578 Moderate 2,251 No interaction
Moderate

578 interactions

Showing 60 of 578 moderate interactions — see all 578 on the Spearmint page.

No interaction 2,251 drugs checked — show the list

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

Showing the 60 most looked-up of 2,251 medications checked with no known interaction — see the full Spearmint list.

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

Can you take Spearmint with Ketoconazole?
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 Spearmint and Ketoconazole 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 Ketoconazole and Spearmint?

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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.