Drug & supplement interaction

Terminalia Chebula + nitisinone

nitisinone brand names: Orfadin, Nityr.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Terminalia Chebula and nitisinone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Terminalia Chebula and nitisinone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between nitisinone and Terminalia Chebula in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Terminalia Chebula safety at a glance

Terminalia Chebula overall Use caution Generally used in traditional medicine, but human safety data are limited and quality of products varies.
Pregnancy Possibly Unsafe When used orally. One source warns against using Terminalia bellirica and Terminalia chebula during pregnancy; however, the reason for this warning is not descr... Read the full pregnancy detail
Breastfeeding Avoid Safety during breastfeeding is unknown, so it is best avoided.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining nitisinone and Terminalia Chebula? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for nitisinone

Interactions in our licensed database are recorded against drug classes, not just single drug names. nitisinone is filed under 2 classifications — cytochrome p450 2c9 (cyp2c9) inhibitors, oral drugs. Terminalia Chebula has documented interactions with 3 drug classes — the most serious being antidiabetes drugs (moderate), chlorzoxazone (parafon forte, paraflex) (moderate) and omeprazole (prilosec) (moderate) — and none of nitisinone’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Terminalia Chebula Does Interact With Other Medications

Terminalia Chebula has 93 moderate known drug interactions in our database — nitisinone isn’t one of them. If you take anything else, check it against the full list below.

Moderate 93 No known interaction 2,737 (incl. nitisinone)
Taking anything else?

Check Another of Your Medications Against Terminalia Chebula

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

What to actually watch for

No Interaction Found — But Data Suggests Terminalia Chebula and nitisinone May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • A skin rash Additional detail

    Terminalia Chebula

    “In a small clinical study, two adults with hyperlipidemia developed a hypersensitivity rash, one with facial edema, within minutes of oral administration of Triphala (containing an aqueous extract of Terminalia chebula, Terminalia bellirica, and Indian gooseberry), together with guggul extract. It is unclear if this reaction was due to Triphala, guggul, or other factors.”

    Terminalia Chebula · Natural Medicines adverse-effect record, reported in hypercholesterolemia.

    1 source cited
    1. 105741. Donato F, Raffetti E, Toninelli G, Festa A, Scarcella C, Castellano M; TRIGU Project Working Group. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial. Complement Med Res 2021;28(3):216-22 PubMed

    nitisinone

    Listed in the ADVERSE REACTIONS section of the FDA label for nitisinone. Read the label on DailyMed ›

Reported for Terminalia Chebula but not commonly for nitisinone: an allergic reaction and swelling.

Effects for nitisinone come from the ADVERSE REACTIONS section of its FDA label; effects for Terminalia Chebula come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 948 voluntary FDA FAERS reports for nitisinone that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Terminalia Chebula in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. One source warns against using Terminalia bellirica and Terminalia chebula during pregnancy; however, the reason for this warning is not described. Until more is known, avoid use.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With nitisinone

This page covers Terminalia Chebula only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the nitisinone page lists 21 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Cannabinol (cbn) (moderate), Cannabis (moderate), Coffee Charcoal (moderate) and Delta-9-tetrahydrocannabinol (thc) (moderate).

By severity: 1 major · 11 moderate · 9 minor.

From our pharmacist’s overview on the nitisinone page

“For a child or adult with hereditary tyrosinemia type 1, nitisinone (Orfadin, Nityr) is the medication holding a dangerous metabolic disease in check, which is why the 21 supplements on this page warrant genuine care rather than a shrug. Activated charcoal is the single major-rated entry and the one to understand first, since it can so…”

Reviewed by 2 · Jul 18, 2026

Open the nitisinone interaction page

How much people look this up

Where Terminalia Chebula and nitisinone 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 Terminalia Chebula
Steady interest

#1,406 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication nitisinone
Top half

#919 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Terminalia Chebula reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Terminalia Chebula and nitisinone records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Terminalia Chebula

What is Terminalia Chebula?

  • Digestive support and constipation
  • Antioxidant support
  • Oral and throat health
  • General immune support
  • Traditional tonic in Ayurvedic medicine

Terminalia chebula, often called haritaki, is a fruit widely used in Ayurvedic medicine, most commonly for digestion and as a key part of the Triphala blend. Early laboratory and small human studies suggest possible antioxidant and digestive effects, but high-quality evidence in people is limited. Talk with your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or take other medicines.

Terminalia chebula · Combretaceae · Dried fruit · Powder (churna), capsules, tablets, decoctions, and as part of herbal blends like Triphala

An interaction check asks whether these two react with each other — it does not ask whether Terminalia Chebula is a good idea for someone in your situation. Here is what our Terminalia Chebula record says about it on its own.

Terminalia Chebula: dosing

There is no official, standardized dose of Terminalia chebula. Traditional and commercial products vary widely in their strength and form.The safest approach is to follow the directions on the product label and not exceed the recommended amount.

From our Terminalia Chebula monograph — the full record covers uses, side effects and every documented interaction.

Read the full Terminalia Chebula monograph & all interactions
Medication

About Nitisinone

What Is Nitisinone Used For?

Brand names: Orfadin, Nityr

Nitisinone (as Orfadin capsules, Orfadin oral suspension, Nityr tablets, and generic Nitisinone capsules) is used to treat hereditary tyrosinemia type 1 (HT-1) — a rare inherited disease in which the body cannot properly break down the amino acid tyrosine, leading to toxic buildup that damages the liver and kidneys. It is used in both adults and children, always together with a strict low-tyrosine, low-phenylalanine diet.

Harliku tablets are approved for a different rare inherited condition: alkaptonuria (AKU). In adults with AKU, Harliku reduces the level of homogentisic acid (HGA) — a harmful substance that builds up in the urine and body tissues. Harliku is not approved for HT-1, and the other nitisinone products are not approved for AKU.

Most-Reported Side Effects for nitisinone

From FAERS, the FDA’s public side-effect reporting system (948 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Amino acid level increased 133 reports
Liver transplant 118 reports
Hepatocellular carcinoma 61 reports
Alpha 1 foetoprotein increased 52 reports
Treatment noncompliance 51 reports
See full Nitisinone drug information
Keep checking

Other Drugs & Terminalia Chebula

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

0Major
93Moderate
0Minor
2,736No known interaction
93 Moderate 2,736 No interaction
Moderate

93 interactions

Showing 60 of 93 moderate interactions — see all 93 on the Terminalia Chebula page.

No interaction 2,736 drugs checked — show the list

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

Showing the 60 most looked-up of 2,736 medications checked with no known interaction — see the full Terminalia Chebula list.

See the full Terminalia Chebula interactions page
See every supplement checked against nitisinone, ranked by severity
Evidence & sources

Terminalia Chebula References

The 9 references that drive our Terminalia Chebula monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Chevallier A. Encyclopedia of Medicinal Plants. New York, NY: DK Publishing, 1996.
  2. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  3. Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
  4. Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
  5. Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
  6. Donato F, Raffetti E, Toninelli G, Festa A, Scarcella C, Castellano M; TRIGU Project Working Group. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial. Complement Med Res 2021;28(3):216-22 PubMed
  7. Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st
  8. Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. PubMed
  9. Agrawal OD, Kulkarni YA. Treatment with Terminalia chebula extract reduces insulin resistance, hyperglycemia and improves SIRT1 expression in type 2 diabetic rats. Life (Basel) 2023;13(5):1168. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Terminalia Chebula and nitisinone Together: Common Questions

Is it safe to take Terminalia Chebula with nitisinone?
We do not list a known interaction between Terminalia Chebula and nitisinone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Terminalia Chebula and nitisinone have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Terminalia Chebula and nitisinone combination checked?
Interactions in our licensed database are recorded against drug classes. nitisinone is filed under 2 classifications, and Terminalia Chebula has documented interactions with 3 drug classes — none of nitisinone's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Terminalia Chebula interact with any other medications?
Yes. Terminalia Chebula has 93 documented drug interactions in our database — nitisinone is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does nitisinone interact with any supplements?
Yes. nitisinone has documented interactions with 21 supplements in our database — Terminalia Chebula is not one of them. The nitisinone interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Terminalia Chebula monograph Uses, safety profile, and every drug interaction in one place Nitisinone drug information The full plain-English guide to this medication nitisinone supplement interactions Every supplement checked against nitisinone, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About nitisinone and Terminalia Chebula?

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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.