Drug & supplement interaction

Thunder God Vine + Fluoxetine

Fluoxetine brand names: Prozac, Sarafem.

Moderate Interaction
The bottom line Moderate

Thunder God Vine has a moderate interaction with Fluoxetine. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of thunder god vine constituents.

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

Thunder God Vine and Fluoxetine

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

Why this applies to Fluoxetine

Fluoxetine falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Thunder God Vine interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of thunder god vine constituents.
Inhibitors of CYP3A4 can increase the concentration of triptolide, a thunder god vine constituent, and its derivative (5R)-5-hydroxytriptolide. In vitro research shows that triptolide and (5R)-5-hydroxytriptolide are about 94% and 64% metabolized by CYP3A4, respectively.
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 these two. Fluoxetine (Prozac) is a fairly strong blocker of an enzyme in your liver called CYP3A4. That same enzyme is what your body uses to break down triptolide, one of the main active compounds in Thunder God Vine. So when fluoxetine slows that enzyme down, the herb may not clear as fast and its levels could climb higher than expected.

Why does that matter? Thunder God Vine can already be toxic if the dose is off, so higher levels could mean a greater chance of side effects like stomach upset, liver irritation, or more serious problems. Keep in mind this is a theoretical concern based on lab studies, not confirmed cases in people. Still, since this herb needs careful supervision anyway, please loop in your doctor or pharmacist before combining the two.

References
  1. Xu Y, Zhang YF, Chen XY, Zhong DF. CYP3A4 inducer and inhibitor strongly affect the pharmacokinetics of triptolide and its derivative in rats. Acta Pharmacol Sin. 2018;39(8):1386-1392. 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

Thunder God Vine Also Interacts With Other Medications

Thunder God Vine has 848 moderate known drug interactions in our database — the Fluoxetine 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 Thunder God Vine

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

From our Q&A

Questions About Thunder God Vine or Fluoxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Thunder God Vine or Fluoxetine, 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 Fluoxetine

This page covers Thunder God Vine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fluoxetine page lists 163 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 127 moderate · 28 minor.

From our pharmacist’s overview on the Fluoxetine page

“Grapefruit is the surprise at the top of fluoxetine's (Prozac) supplement list. In large amounts it can stretch the QT interval, the electrical pause between heartbeats, and fluoxetine, a widely prescribed antidepressant, can do the same, raising the odds of a dangerous rhythm.”

Reviewed by 2 · Jul 18, 2026

Open the Fluoxetine interaction page

How much people look this up

Where Thunder God Vine and Fluoxetine 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 Thunder God Vine
Steady interest

#1,103 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Fluoxetine
Top 5%

#41 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 Thunder God Vine

What is Thunder God Vine?

Thunder God Vine
  • Rheumatoid arthritis
  • Lupus and autoimmune conditions
  • Inflammation
  • Skin conditions like psoriasis
  • Immune-related disorders

Thunder God Vine is a Chinese herb studied mainly for rheumatoid arthritis and other autoimmune conditions, with some promising but limited evidence. It can be toxic if prepared or dosed improperly, and may cause serious side effects, so it should only be used under medical supervision. Avoid it during pregnancy and breastfeeding.

Read the full Thunder God Vine monograph & all interactions
Medication

About Fluoxetine

What Is Fluoxetine Used For?

Brand names: Prozac, Sarafem

Fluoxetine is approved to treat four conditions: major depressive disorder (MDD), obsessive-compulsive disorder (OCD), bulimia nervosa (a binge-eating and purging disorder), and panic disorder — with or without agoraphobia (fear of situations that feel hard to escape).

It works for adults across all four conditions, and for children and teens with depression (ages 8–18) and OCD (ages 7–17).

See full Fluoxetine drug information
Keep checking

Other Drugs & Thunder God Vine

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

0Major
848Moderate
0Minor
1,981No known interaction
Moderate

848 interactions

Showing 60 of 848 moderate interactions — see all 848 on the Thunder God Vine page.

No interaction 1,981 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 Thunder God Vine and Fluoxetine Together: Common Questions

Can you take Thunder God Vine with Fluoxetine?
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 Thunder God Vine and Fluoxetine 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 Fluoxetine and Thunder God Vine?

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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.