Drug & supplement interaction

Tangerine + Zanubrutinib

Zanubrutinib brand name: Brukinsa.

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

Tangerine has a minor interaction with Zanubrutinib. In vitro, tangeretin, a constituent of tangerine, induces a 52% increase in the metabolism of midazolam by cytochrome P450 3A4 (CYP3A4).

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Tangerine and Zanubrutinib

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Zanubrutinib

Zanubrutinib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Tangerine interacts with.

In vitro, tangeretin, a constituent of tangerine, induces a 52% increase in the metabolism of midazolam by cytochrome P450 3A4 (CYP3A4). This suggests that tangeretin may stimulate CYP3A4 activity. However, in humans, drinking tangerine juice 200 mL slightly delayed the absorption, but did not affect the metabolism, of midazolam, a CYP3A4 substrate. Theoretically, tangerine juice might increase CYP3A4 activity and decrease levels of drugs metabolized by this enzyme. However, this effect is unlikely.
Some drugs metabolized by CYP3A4 include amitriptyline (Elavil), amiodarone (Cordarone), citalopram (Celexa), felodipine (Plendil), lansoprazole (Prevacid), ondansetron (Zofran), prednisone (Deltasone, Orasone), sertraline (Zoloft), sibutramine (Meridia), and many others.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: your cancer medicine zanubrutinib (Brukinsa) is cleared from your body by a liver enzyme called CYP3A4. One compound in tangerine, tangeretin, sped up that enzyme a little in lab dish studies, which in theory could lower zanubrutinib levels and make it work less well. But when researchers actually gave people tangerine juice, it did not meaningfully change how a similar drug was processed.

So in real life this is rated minor and unlikely. Eating a tangerine now and then almost certainly won't hurt your treatment. I still wouldn't lean on large amounts of concentrated tangerine peel extracts or supplements while on this drug. Since zanubrutinib treats serious conditions, just run any citrus supplement past your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Backman, J. T., Maenpaa, J., Belle, D. J., Wrighton, S. A., Kivisto, K. T., and Neuvonen, P. J. Lack of correlation between in vitro and in vivo studies on the effects of tangeretin and tangerine juice on midazolam hydroxylation. Clin Pharmacol Ther 2000; PubMed

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

Tangerine Also Interacts With Other Medications

Tangerine has 642 minor known drug interactions in our database — the Zanubrutinib one above is one of them. If you take anything else, check it against the full list below.

Minor 642 No known interaction 2,188 (incl. Zanubrutinib)
Taking anything else?

Check Another of Your Medications Against Tangerine

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

Everything else you take

See Every Supplement That Interacts With Zanubrutinib

This page covers Tangerine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Zanubrutinib page lists 160 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 119 moderate · 38 minor.

From our pharmacist’s overview on the Zanubrutinib page

“Grapefruit is the biggest supplement risk with zanubrutinib (Brukinsa), a targeted therapy for certain blood cancers, and this list deserves genuine care. Grapefruit blocks the enzyme (CYP3A4) that clears the drug, so levels can climb and side effects with them.”

Reviewed by 2 · Jul 18, 2026

Open the Zanubrutinib interaction page

One more smart check

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

We hold 705 real supplement products containing Tangerine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tangerine. Your product may carry other ingredients that interact with Zanubrutinib too, on top of Tangerine — 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 Tangerine and Zanubrutinib 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 Tangerine
Top 25%

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

29 days ago today
Medication Zanubrutinib
Top 25%

#498 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 Tangerine

What is Tangerine?

  • Source of vitamin C
  • Digestive support
  • Aromatherapy and relaxation
  • Cough and phlegm (traditional)
  • Skin and flavoring uses

Tangerine is a sweet citrus fruit that is a good source of vitamin C and other nutrients, and is widely enjoyed as food. While the peel and essential oil are used in traditional medicine and aromatherapy, strong human evidence for specific health benefits beyond basic nutrition is limited. Enjoying tangerines as part of a balanced diet is generally safe for most people.

Read the full Tangerine monograph & all interactions
Medication

About Zanubrutinib

What Is Zanubrutinib Used For?

Brand name: Brukinsa

Brukinsa (zanubrutinib) is used to treat adult patients with certain blood cancers. It treats mantle cell lymphoma (MCL) in patients who have had at least one prior therapy, Waldenström's macroglobulinemia (WM), relapsed or refractory marginal zone lymphoma (MZL) after at least one prior anti-CD20 treatment, and chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

Brukinsa is also used — in combination with another medicine called obinutuzumab — to treat relapsed or refractory follicular lymphoma (FL) in adults who have already received two or more lines of treatment. Several of these uses were granted accelerated FDA approval based on response rates, meaning confirmatory trials are still ongoing.

See full Zanubrutinib drug information
Keep checking

Other Drugs & Tangerine

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

0Major
0Moderate
642Minor
2,187No known interaction
642 Minor 2,187 No interaction
Minor

642 interactions

Showing 60 of 642 minor interactions — see all 642 on the Tangerine page.

No interaction 2,187 drugs checked — show the list

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

Showing the 60 most looked-up of 2,187 medications checked with no known interaction — see the full Tangerine list.

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

Can you take Tangerine with Zanubrutinib?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Tangerine and Zanubrutinib interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Zanubrutinib and Tangerine?

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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.