Drug & supplement interaction

Tansy Ragwort + Oxcarbazepine

Oxcarbazepine brand names: Trileptal, Oxtellar XR.

Moderate Interaction
The bottom line Moderate

Tansy Ragwort has a moderate interaction with Oxcarbazepine. 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 Oxcarbazepine

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Oxcarbazepine

Oxcarbazepine 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

First and most important: tansy ragwort is a toxic weed, not a true supplement. The pyrrolizidine alkaloids it contains can seriously harm the liver, so it really should not be taken internally at all, no matter what other medications you are on.

Here is the specific concern with oxcarbazepine (Trileptal, Oxtellar XR). Oxcarbazepine can speed up a liver enzyme called CYP3A4. That same enzyme turns the alkaloids in tansy ragwort into harmful, liver-damaging byproducts. So in theory, taking them together could ramp up production of those toxic substances and raise the risk of liver injury. I want to be honest that this is a theoretical idea based on lab and animal data, not human studies. Still, the safest move is to avoid tansy ragwort entirely and check with your pharmacist or doctor before using any herbal product.

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 Oxcarbazepine one above is one of them. If you take anything else, check it against the full list below.

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.

From our Q&A

Questions About Tansy Ragwort or Oxcarbazepine

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

This page covers Tansy Ragwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Oxcarbazepine page lists 122 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 99 moderate · 16 minor.

From our pharmacist’s overview on the Oxcarbazepine page

“People take oxcarbazepine (Trileptal, Oxtellar XR) to keep seizures in check, and I want anyone on it to read the seven major-rated interactions below before adding any supplement. Of the 122 ingredients on file, 78 have sedative effects, so the calming and sleep aids many patients reach for, kava among them, can pile drowsiness on top…”

Reviewed by 2 · Jul 18, 2026

Open the Oxcarbazepine interaction page

How much people look this up

Where Tansy Ragwort and Oxcarbazepine 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

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

29 days ago today
Medication Oxcarbazepine
Top 25%

#539 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 Oxcarbazepine

What Is Oxcarbazepine Used For?

Brand names: Trileptal, Oxtellar XR

Oxcarbazepine treats partial-onset seizures (seizures that start in one area of the brain). Which uses are approved depends on the product and the patient's age.

Trileptal and oxcarbazepine tablets or oral suspension are used alone or added to other seizure medicines in adults. They are used alone in children 4 to 16 years and added to other medicines in children 2 to 16 years. Oxtellar XR and oxcarbazepine extended-release tablets are used for partial-onset seizures in patients 6 years and older.

See full Oxcarbazepine 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
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
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 Tansy Ragwort and Oxcarbazepine Together: Common Questions

Can you take Tansy Ragwort with Oxcarbazepine?
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 Oxcarbazepine 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 Oxcarbazepine 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.