Drug & supplement interaction

Terminalia + Abrocitinib

Abrocitinib brand name: Cibinqo.

Moderate Interaction
The bottom line Moderate

Abrocitinib falls into 2 drug categories that Terminalia can interact with; the most serious is rated moderate. Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Terminalia and Abrocitinib

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Terminalia interacts with whole categories of medication. Abrocitinib falls into 2 of those categories, so it can interact with Terminalia in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Abrocitinib

Abrocitinib falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Terminalia interacts with.

Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.
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 basic idea: your body uses a liver enzyme called CYP2C9 to help clear abrocitinib (Cibinqo) out of your system. Lab studies suggest that Terminalia arjuna may slow that enzyme down. If it does, abrocitinib could clear out more slowly and build up a bit, which may mean stronger effects and a higher chance of side effects like nausea, headache, acne flare-ups, or a more suppressed immune system that raises infection risk.

I want to be honest about the strength of this, though. It's only based on test-tube research, not real people, so it's theoretical at this point. Concentrated supplement doses are more of a concern than small culinary amounts. Since abrocitinib affects your immune system, please run this past your pharmacist or doctor before combining the two.

References
  1. Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Abrocitinib also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, concomitant use of Terminalia arjuna with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.
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 thing to know about pairing Terminalia with abrocitinib (Cibinqo). The concern on file is about bleeding. In lab studies, Terminalia arjuna bark extract slowed down how platelets clump together, which could nudge you toward easier bruising or bleeding. Abrocitinib itself can already lower your platelet count, especially in the first few weeks, so the idea is that these two effects might add up.

I want to be honest about the strength of this: it's theoretical and based only on test-tube work, not on people taking these together. Still, since abrocitinib affects platelets, it's worth a quick chat with your pharmacist or doctor. Watch for unusual bruising, nosebleeds, or bleeding gums, and please don't stop either one on your own.

References
  1. Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.

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

Terminalia Also Interacts With Other Medications

Terminalia has 932 moderate known drug interactions in our database — the Abrocitinib one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Terminalia

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

Everything else you take

See Every Supplement That Interacts With Abrocitinib

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Abrocitinib page lists 290 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 252 moderate · 35 minor.

From our pharmacist’s overview on the Abrocitinib page

“Bleeding is where I'd focus first with abrocitinib (Cibinqo), an eczema pill that can itself lower platelet counts. Of the 290 supplements and herbs with an interaction on file, 202 have blood-thinning or antiplatelet activity, and two of the three major-rated entries, danshen and piracetam, sit in that group.”

Reviewed by 2 · Jul 18, 2026

Open the Abrocitinib interaction page

One more smart check

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

We hold 306 real supplement products containing Terminalia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Terminalia. Your product may carry other ingredients that interact with Abrocitinib too, on top of Terminalia — 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 Terminalia and Abrocitinib 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
Top 25%

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

29 days ago today
Medication Abrocitinib
Top 25%

#568 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 Terminalia

What is Terminalia?

Terminalia
  • Heart health and circulation
  • Digestive problems (constipation, diarrhea)
  • Cholesterol support
  • Antioxidant and anti-inflammatory support
  • Immune support

Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible benefits for heart and cholesterol health, but the evidence is limited and not strong enough to recommend it as a treatment. Talk to your pharmacist or doctor before using it, especially if you have a heart condition.

Read the full Terminalia monograph & all interactions
Medication

About Abrocitinib

What Is Abrocitinib Used For?

Brand name: Cibinqo

Cibinqo (abrocitinib) is approved to treat adults and children aged 12 and older who have moderate-to-severe atopic dermatitis (eczema) that has not been adequately controlled with other systemic treatments, including biologics — or when those treatments are not appropriate.

Cibinqo is specifically for refractory cases, meaning it is intended for people whose eczema has not responded well enough to other options. It is not recommended to be used alongside other JAK inhibitors, biologic immunomodulators, or other immunosuppressants.

See full Abrocitinib drug information
Keep checking

Other Drugs & Terminalia

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

0Major
932Moderate
0Minor
1,897No known interaction
Moderate

932 interactions

Showing 60 of 932 moderate interactions — see all 932 on the Terminalia page.

No interaction 1,897 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 Terminalia and Abrocitinib Together: Common Questions

Can you take Terminalia with Abrocitinib?
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.
Why are there 2 interactions listed for Terminalia and Abrocitinib?
Abrocitinib belongs to more than one drug category, and Terminalia interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Terminalia and Abrocitinib 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

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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.