Drug & supplement interaction

Tansy Ragwort + Mitapivat

Mitapivat brand name: Pyrukynd.

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

Tansy Ragwort has a moderate interaction with Mitapivat. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in tansy ragwort.

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

Tansy Ragwort and Mitapivat

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Mitapivat

Mitapivat falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Tansy Ragwort interacts with.

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in tansy ragwort.
Tansy ragwort contains PAs. PAs are substrates of CYP3A4. Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites.
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

Let me be upfront here: tansy ragwort isn't something you should be taking at all. It contains pyrrolizidine alkaloids, plant chemicals that your liver can turn into toxic byproducts that harm liver cells and blood vessels. There's no proven benefit, and real poisonings have happened.

The concern with Pyrukynd (mitapivat) is that it can nudge up a liver enzyme called CYP3A4, which is the same enzyme that converts those tansy alkaloids into their harmful form. So in theory, the two together could mean more toxic conversion and a bigger hit to the liver. I'll stress that this is theoretical, based mostly on lab and animal data, not human cases. Still, since you already deal with a blood disorder, please skip tansy ragwort entirely and check any herbal product with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  2. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. 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

Tansy Ragwort Also Interacts With Other Medications

Tansy Ragwort has 86 moderate known drug interactions in our database — the Mitapivat one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Mitapivat)
Taking anything else?

Check Another of Your Medications Against Tansy Ragwort

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

Everything else you take

See Every Supplement That Interacts With Mitapivat

This page covers Tansy Ragwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mitapivat page lists 154 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 · 111 moderate · 40 minor.

Open the Mitapivat interaction page

How much people look this up

Where Tansy Ragwort and Mitapivat 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 Tansy Ragwort
Steady interest

#1,036 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Mitapivat
Steady interest

#2,027 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 Tansy Ragwort

What is Tansy Ragwort?

  • Traditional wound and skin washes
  • Folk remedy for sore throat (gargle)
  • Topical poultice for joint or muscle aches
  • Historical use for menstrual complaints

Tansy ragwort is a toxic weed that contains pyrrolizidine alkaloids, which can seriously damage the liver. It is not recommended as a supplement or home remedy, and there is no reliable evidence that it safely treats any condition. Avoid taking it internally and talk to a pharmacist or doctor before using any herbal product.

Read the full Tansy Ragwort monograph & all interactions
Medication

About Mitapivat

What Is Mitapivat Used For?

Brand name: Pyrukynd

Mitapivat treats two distinct types of anemia in adults. Pyrukynd is used to treat hemolytic anemia (anemia caused by red blood cells breaking down too quickly) in adults with pyruvate kinase (PK) deficiency, a rare inherited red blood cell disorder. Aqvesme is used to treat anemia in adults with alpha- or beta-thalassemia, inherited blood conditions that reduce normal hemoglobin production.

These are separate approvals for separate products — Pyrukynd and Aqvesme are not interchangeable, and each is intended for its specific condition.

See full Mitapivat drug information
Keep checking

Other Drugs & Tansy Ragwort

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Tansy Ragwort page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Tansy Ragwort list.

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

Can you take Tansy Ragwort with Mitapivat?
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 Tansy Ragwort and Mitapivat 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 Mitapivat and Tansy Ragwort?

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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.