Drug & supplement interaction

Sweet Annie + Dapsone

Dapsone brand names: Dapsone, Avlosulfon, Aczone.

Moderate Interaction
The bottom line Moderate

Dapsone falls into 2 drug categories that Sweet Annie can interact with; the most serious is rated moderate. Theoretically, concomitant use might have additive adverse hepatotoxic effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sweet Annie and Dapsone

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

Why Are There 2 Interactions?

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

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Dapsone

Dapsone falls under HEPATOTOXIC DRUGS — the group Sweet Annie interacts with.

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
There is some concern that Sweet Annie can adversely affect the liver.
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 simple version: both Sweet Annie and dapsone can be tough on your liver, so taking them together might add up and put extra strain on it. This isn't about Sweet Annie changing how dapsone works in your blood. It's more about two things that each carry a small liver risk landing on the same organ at once.

With dapsone, you already want to watch for signs like yellowing of the skin or eyes, dark urine, belly pain, unusual tiredness, or feeling unusually short of breath. Adding an herb that may bother the liver could make those easier to trigger. Honestly, the evidence here is thin and mostly theoretical, so don't panic, but please check with your pharmacist or doctor before combining them.

References
  1. Centers for Disease Control and Prevention (CDC). Hepatitis temporally associated with an herbal supplement containing artemisinin-Washington, 2008. MMWR Morb Mortal Wkly Rep 2009;58:854-8.
  2. Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MV. Suspected hepatotoxicity with a supercritical carbon dioxide extract of Artemisia annua in grapeseed oil used in New Zealand. Front Pharmacol. 2019;10:1448. PubMed
  3. Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of herbal tea: a case of acute cholestatic hepatitis due to Artemisia annua tea. Front Med (Lausanne). 2019;6:221. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Dapsone also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Sweet Annie may alter plasma levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research shows that the Sweet Annie constituent artemisinin induces CYP3A4, possibly increasing CYP3A4 activity by 1.9-fold. However, Sweet Annie extract seems to inhibit the activity of CYP3A4 in vitro, suggesting that other constituents of Sweet Annie play a role in its effects on the overall activity of this enzyme. More information is needed to determine whether taking Sweet Annie extract affects the metabolism of CYP3A4 substrates.
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 honest picture with Sweet Annie and Dapsone. Your body uses a liver enzyme called CYP3A4 to help process dapsone. Sweet Annie's main compound, artemisinin, sends mixed signals to this enzyme in lab tests. One part of the plant may speed the enzyme up, while the whole extract seems to slow it down, so we honestly can't predict which way it would push your dapsone levels in real life.

Why this matters: if dapsone ran higher than expected, you could see more of its known issues, like a low red blood cell count (hemolysis) or, rarely, a serious blood problem called methemoglobinemia. This is only test-tube evidence so far, not proven in people. Still, I'd loop in your doctor or pharmacist before combining them, and watch for unusual tiredness, paleness, or shortness of breath.

References
  1. Xing J, Kirby BJ, Whittington D, et al. Evaluation of P450 inhibition and induction by artemisinin antimalarials in human liver microsomes and primary human hepatocytes. Drug Metabl Dispos 2012;40(9):1757-64. PubMed
  2. Kane NF, Kiani BH, Desrosiers MR, Towler MJ, Weathers PJ. Artemisia extracts differ from artemisinin effects on human hepatic CYP450s 2B6 and 3A4 in vitro. J Ethnopharmacol 2022. DOI

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

Sweet Annie Also Interacts With Other Medications

Sweet Annie has 888 moderate known drug interactions in our database — the Dapsone one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Sweet Annie

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

Everything else you take

See Every Supplement That Interacts With Dapsone

This page covers Sweet Annie only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dapsone page lists 215 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), Para-aminobenzoic Acid (paba) (major) and Siberian Cocklebur (major).

By severity: 7 major · 167 moderate · 41 minor.

From our pharmacist’s overview on the Dapsone page

“Dapsone treats serious conditions, from dermatitis herpetiformis to leprosy, and its supplement list is one I'd want a patient to read closely rather than skim. Most entries touch how the body handles dapsone through the CYP3A4 enzyme, so grapefruit can raise its blood level while St.”

Reviewed by 2 · Jul 18, 2026

Open the Dapsone interaction page

One more smart check

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

We hold 243 real supplement products containing Sweet Annie, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sweet Annie. Your product may carry other ingredients that interact with Dapsone too, on top of Sweet Annie — 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 Sweet Annie and Dapsone 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 Sweet Annie
Steady interest

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

29 days ago today
Medication Dapsone
Top 5%

#110 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 Sweet Annie

What is Sweet Annie?

Sweet Annie
  • Malaria (traditional)
  • Fever
  • Inflammation
  • Digestive complaints
  • Antimicrobial support
  • Insect repellent

Sweet Annie (Artemisia annua) is the source of artemisinin, a compound used in prescription antimalarial drugs. While the purified drug is well studied for malaria, the herb itself as a supplement is not proven for the wide range of conditions people use it for, and self-treating malaria with the raw herb is dangerous. Talk to a pharmacist or doctor before using it.

Read the full Sweet Annie monograph & all interactions
Medication

About Dapsone

What Is Dapsone Used For?

Brand names: Dapsone, Avlosulfon, Aczone

Dapsone tablets are used to treat dermatitis herpetiformis (a chronic, intensely itchy blistering skin condition) and leprosy (all forms, except where proven resistance to dapsone exists). For leprosy, dapsone tablets are typically used in combination with other anti-leprosy medicines.

Aczone Gel (dapsone gel, 7.5%) and dapsone gel are indicated for the topical treatment of acne vulgaris in patients 9 years of age and older. This topical form is applied to the skin and is not used for leprosy or dermatitis herpetiformis.

See full Dapsone drug information
Keep checking

Other Drugs & Sweet Annie

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

0Major
888Moderate
0Minor
1,941No known interaction
Moderate

888 interactions

Showing 60 of 888 moderate interactions — see all 888 on the Sweet Annie page.

No interaction 1,941 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 Sweet Annie and Dapsone Together: Common Questions

Can you take Sweet Annie with Dapsone?
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.
Why are there 2 interactions listed for Sweet Annie and Dapsone?
Dapsone belongs to more than one drug category, and Sweet Annie 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 Sweet Annie and Dapsone 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

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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.