Drug & supplement interaction

Syrian Rue + Ropeginterferon alfa-2b-njft

Ropeginterferon alfa-2b-njft brand name: Besremi.

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

Syrian Rue has a moderate interaction with Ropeginterferon alfa-2b-njft. Theoretically, high doses of Syrian rue 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

Syrian Rue and Ropeginterferon alfa-2b-njft

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Ropeginterferon alfa-2b-njft

Ropeginterferon alfa-2b-njft falls under HEPATOTOXIC DRUGS — the group Syrian Rue interacts with.

Theoretically, high doses of Syrian rue might increase the risk of liver damage when taken with hepatotoxic drugs.
Cases of hepatotoxicity and hepatic failure have been reported in patients who ingested a large quantity (up to 100 grams) of Syrian rue seeds.
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 gist with Besremi and Syrian Rue. Besremi is an interferon that can be tough on the liver on its own, which is why your doctor checks your liver enzymes during treatment. Syrian Rue seeds, especially in large amounts, have been linked to liver injury too. The concern is simple: stacking two things that stress the liver may raise your chances of liver problems.

This is a theoretical caution based on how each works, not a proven combo, and the worrisome cases involved swallowing huge quantities of seeds. Still, with Besremi, watch for warning signs like yellowing skin or eyes, dark urine, belly pain, or unusual tiredness. Please don't start or stop anything on your own. Check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Yuruktumen, A., Karaduman, S., Bengi, F., and Fowler, J. Syrian rue tea: a recipe for disaster. Clin Toxicol (Phila) 2008;46(8):749-752. PubMed
  2. Berdai MA, Labib S, Harandou M. Peganum harmala L. Intoxication in a Pregnant Woman. Case Rep Emerg Med 2014;2014:783236.
  3. Ghizlane EA, Manal M, Ines HA, et al. Fatal poisoning of pregnant women by peganum harmala L.: a case reports. Ann Med Surg (Lond) 2021;68:102649. PubMed
  4. Durmaz Çelik N, Ger Akarsu F, Ozkan S, Özdemir AÖ, Aykac Ö, Memmedova F. Herbal teas can be harmful: a case of Peganum harmala induced coma in a patient with Parkinson's disease. Neurocase 2021;27(2):117-119.

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

Syrian Rue Also Interacts With Other Medications

Syrian Rue has 1,121 moderate known drug interactions in our database — the Ropeginterferon alfa-2b-njft one above is one of them. If you take anything else, check it against the full list below.

Moderate 1,121 No known interaction 1,709 (incl. Ropeginterferon alfa-2b-njft)
Taking anything else?

Check Another of Your Medications Against Syrian Rue

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

Everything else you take

See Every Supplement That Interacts With Ropeginterferon alfa-2b-njft

This page covers Syrian Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ropeginterferon alfa-2b-njft page lists 57 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Beer (major), Siberian Cocklebur (major), Wine (major), Alfalfa (moderate) and Angelica Archangelica (moderate).

By severity: 3 major · 53 moderate · 1 minor.

From our pharmacist’s overview on the Ropeginterferon alfa-2b-njft page

“Ropeginterferon alfa-2b-njft (Besremi), the long-acting interferon injected for polycythemia vera, carries liver toxicity as one of its own known risks, so the 57 supplements and herbs on this page deserve genuine care rather than a quick skim. Thirty-eight of them can also stress the liver, and that overlap is what earns all three maj…”

Reviewed by 2 · Jul 18, 2026

Open the Ropeginterferon alfa-2b-njft interaction page

How much people look this up

Where Syrian Rue and Ropeginterferon alfa-2b-njft 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 Syrian Rue
Steady interest

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

29 days ago today
Medication Ropeginterferon alfa-2b-njft
Top 25%

#648 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 Syrian Rue

What is Syrian Rue?

  • Traditional remedy for digestive complaints
  • Used as a sedative or for mood
  • Antimicrobial and antiparasitic folk use
  • Used as a dye and incense
  • Recreational psychoactive use

Syrian Rue (Peganum harmala) is a traditional plant whose seeds contain potent compounds called harmala alkaloids, including MAO-inhibiting harmine and harmaline. There is little reliable human evidence that it safely treats any condition, and it carries real risks of toxicity, so it is not recommended for self-treatment. Talk to a pharmacist or doctor before considering it.

Read the full Syrian Rue monograph & all interactions
Medication

About Ropeginterferon alfa-2b

What Is Ropeginterferon alfa-2b Used For?

Brand name: Besremi

BESREMi is approved to treat two blood disorders in adults: polycythemia vera (a condition where the bone marrow makes too many red blood cells) and essential thrombocythemia (a condition where the bone marrow makes too many platelets).

Both conditions are treated with BESREMi given by subcutaneous (under-the-skin) injection. It works to bring blood cell counts back to safer levels and reduce related risks.

See full Ropeginterferon alfa-2b drug information
Keep checking

Other Drugs & Syrian Rue

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

0Major
1,121Moderate
0Minor
1,708No known interaction
1,121 Moderate 1,708 No interaction
Moderate

1,121 interactions

Showing 60 of 1,121 moderate interactions — see all 1,121 on the Syrian Rue page.

No interaction 1,708 drugs checked — show the list

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

Showing the 60 most looked-up of 1,708 medications checked with no known interaction — see the full Syrian Rue list.

See the full Syrian Rue interactions page
See every supplement checked against Ropeginterferon alfa-2b-njft, 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
Syrian Rue monograph › Uses, safety, and every drug interaction in one place Ropeginterferon alfa-2b-njft supplement interactions › Every supplement checked against Ropeginterferon alfa-2b-njft, ranked by severity Ropeginterferon alfa-2b 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 Syrian Rue and Ropeginterferon alfa-2b-njft Together: Common Questions

Can you take Syrian Rue with Ropeginterferon alfa-2b-njft?
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 Syrian Rue and Ropeginterferon alfa-2b-njft 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 Ropeginterferon alfa-2b-njft and Syrian Rue?

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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.