Drug & supplement interaction

Theaflavin + Etoposide

Etoposide brand names: VePesid, VP16, Etopophos.

Moderate Interaction
The bottom line Moderate

Theaflavin has a moderate interaction with Etoposide. In vitro, theaflavin inhibits organic anion-transporting polypeptide (OATP)2B1.

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

Theaflavin and Etoposide

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

Moderate

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

Why this applies to Etoposide

Etoposide falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP) — the group Theaflavin interacts with.

In vitro, theaflavin inhibits organic anion-transporting polypeptide (OATP)2B1. OATP2B1 is expressed in the small intestine and liver and is responsible for the uptake of drugs and other compounds. This interaction has not been shown in humans. However, theaflavin might reduce the absorption of drugs that are OATP2B1 substrates. Use with caution.
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 gist with theaflavin (the antioxidant in black tea) and etoposide. Theaflavin can block a little transporter called OATP2B1 that helps pull certain drugs into your body from the gut. Etoposide leans on that kind of uptake, so in theory, taking concentrated theaflavin around the same time could lower how much etoposide actually gets absorbed. With a cancer medicine, you really don't want it working less than expected, since that could mean less effect against the tumor.

But here's the important part: this was only seen in lab studies, not in people, so we don't truly know if it matters in real life. A regular cup of black tea is very unlikely to be an issue. Concentrated extracts are the bigger question mark. Since etoposide is serious chemo, please run any tea-based supplements past your oncology team before adding them.

References
  1. Kondo A, Narumi K, Okuhara K, et al. Black tea extract and theaflavin derivatives affect the pharmacokinetics of rosuvastatin by modulating organic anion transporting polypeptide (OATP) 2B1 activity. Biopharm Drug Dispos. 2019;40(8):302-306. 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

Theaflavin Also Interacts With Other Medications

Theaflavin has 129 moderate known drug interactions in our database — the Etoposide 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 Theaflavin

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

Everything else you take

See Every Supplement That Interacts With Etoposide

This page covers Theaflavin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etoposide page lists 152 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Grapefruit (major), St. John's Wort (major) and Sweet Orange (major).

By severity: 5 major · 107 moderate · 40 minor.

From our pharmacist’s overview on the Etoposide page

“Chemotherapy is unforgiving of level swings, and swings are exactly what most of this list can cause for etoposide (VePesid, Etopophos). Of the 152 supplements and herbs on file, 121 can change how your liver clears etoposide through the CYP3A4 enzyme, meaning too little drug and an undertreated cancer, or too much and harsher toxicity.”

Reviewed by 2 · Jul 18, 2026

Open the Etoposide interaction page

One more smart check

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

We hold 11 real supplement products containing Theaflavin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Theaflavin. Your product may carry other ingredients that interact with Etoposide too, on top of Theaflavin — 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 Theaflavin and Etoposide 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 Theaflavin
Steady interest

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

29 days ago today
Medication Etoposide
Top half

#1,204 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 Theaflavin

What is Theaflavin?

  • Heart health and cholesterol support
  • Antioxidant support
  • Weight management
  • Blood sugar support
  • General wellness

Theaflavins are antioxidant compounds formed when tea leaves are oxidized to make black tea. Early research suggests they may help with cholesterol and provide antioxidant effects, but high-quality human evidence is limited and doses are not standardized. Drinking black tea is generally safe, but talk to your pharmacist or doctor before taking concentrated extracts.

Read the full Theaflavin monograph & all interactions
Medication

About Etoposide

What Is Etoposide Used For?

Brand names: VePesid, VP16, Etopophos

Etoposide injection (available as Avopef, Etopophos, Toposar, and Etoposide) is used to treat refractory testicular tumors — cancers that have already been treated with surgery, radiation, and other chemotherapy — always in combination with other cancer drugs. It is also used for small cell lung cancer (SCLC) as a first-line treatment, given together with other chemotherapy and, in the case of Avopef, with immunotherapy as well.

Etoposide capsules (VePesid and Etoposide capsules) are approved for small cell lung cancer as first-line treatment in combination with other chemotherapy agents. Capsule forms are not approved for testicular cancer, as the label notes that adequate data on their use in that setting are not available.

See full Etoposide drug information
Keep checking

Other Drugs & Theaflavin

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

0Major
129Moderate
0Minor
2,700No known interaction
Moderate

129 interactions

Showing 60 of 129 moderate interactions — see all 129 on the Theaflavin page.

No interaction 2,700 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 Theaflavin and Etoposide Together: Common Questions

Can you take Theaflavin with Etoposide?
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 Theaflavin and Etoposide 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 Etoposide and Theaflavin?

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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.