Drug & supplement interaction

Thunder God Vine + Itraconazole

Itraconazole brand names: Sporanox, Sporanox Injection, Tolsura.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Itraconazole falls into 2 drug categories that Thunder God Vine can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of thunder god vine constituents.

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

Thunder God Vine and Itraconazole

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

Why Are There 2 Interactions?

Thunder God Vine interacts with whole categories of medication. Itraconazole falls into 2 of those categories, so it can interact with Thunder God Vine 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 3A4 (CYP3A4) INHIBITORS

1 of 2

Why this applies to Itraconazole

Itraconazole 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 gist for this pairing: itraconazole is one of the strongest blockers of an enzyme in your body called CYP3A4. That same enzyme is what clears out the active compounds in Thunder God Vine, especially one called triptolide. So when you take them together, itraconazole can slow that breakdown and let those herb compounds build up higher than expected.

Why does that matter? Thunder God Vine can already be hard on the body, and higher levels may mean more chance of side effects like stomach upset, diarrhea, or, more seriously, liver strain. I'll be honest, this concern is theoretical and based mostly on lab studies, not real patient reports. Still, since this herb can be toxic if not dosed carefully, please loop in your doctor or pharmacist before combining the two.

Contact Dr. Brian directly if you have additional questions on this interaction
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
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Itraconazole also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, thunder god vine might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that triptolide, a constituent of thunder god vine, inhibits CYP3A4 enzymes in human microsomes. This interaction has not been reported in humans.
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 with these two together. Your body clears itraconazole using an enzyme called CYP3A4. Thunder God Vine contains a compound (triptolide) that, in lab studies, can slow that same enzyme down. If it slows things in your body too, itraconazole could build up and hit harder than expected. That might mean more nausea, stomach upset, headache, or in rare cases liver strain or heart effects, which itraconazole already carries warnings about.

I want to be honest with you: this is theoretical, based only on test-tube work, and it hasn't actually been reported in real patients. Still, since Thunder God Vine can be toxic on its own, please run this combo by your pharmacist or doctor before mixing them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Song W, Liu M, Wu J, Zhai H, Chen Y, Peng Z. Preclinical Pharmacokinetics of Triptolide: A Potential Antitumor Drug. Curr Drug Metab. 2019;20(2):147-154. 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 Itraconazole one above is among them. If you take anything else, check it against the full list below.

Moderate 848 No known interaction 1,982 (incl. Itraconazole)
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 Itraconazole

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 Itraconazole, 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 Itraconazole

This page covers Thunder God Vine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Itraconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 136 moderate · 40 minor.

From our pharmacist’s overview on the Itraconazole page

“Serious fungal infections are what itraconazole (Sporanox, Tolsura) is for, and the drug travels through CYP3A4, the liver enzyme that also handles a large share of supplements. That overlap is why this list reaches 182 ingredients, and it earns genuine care; start with the six rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Itraconazole interaction page

How much people look this up

Where Thunder God Vine and Itraconazole 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

#1,155 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Itraconazole
Steady interest

#1,946 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 Itraconazole

What Is Itraconazole Used For?

Brand names: Sporanox, Sporanox Injection, Tolsura

Itraconazole capsules (including Sporanox capsules and generic itraconazole capsules) treat serious fungal infections — blastomycosis, histoplasmosis, and aspergillosis — in both people with normal immune systems and those who are immunocompromised. Capsule forms are also approved for nail fungus (onychomycosis) caused by dermatophytes in non-immunocompromised patients. Tolsura (a gelatin-coated capsule formulation) treats blastomycosis, histoplasmosis, and aspergillosis in adults, but is not approved for nail fungus and is not interchangeable with other itraconazole products.

Itraconazole oral solution is specifically approved for oropharyngeal candidiasis (thrush — a fungal infection of the mouth) and esophageal candidiasis (a fungal infection of the food pipe). Only the oral solution has been shown to work for these mouth and throat infections; capsules cannot be substituted for this use.

See full Itraconazole 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
848 Moderate 1,981 No 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

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

Showing the 60 most looked-up of 1,981 medications checked with no known interaction — see the full Thunder God Vine list.

See the full Thunder God Vine interactions page
See every supplement checked against Itraconazole, ranked by severity
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

Keep exploring
Thunder God Vine monograph › Uses, safety, and every drug interaction in one place Itraconazole supplement interactions › Every supplement checked against Itraconazole, ranked by severity Itraconazole drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Thunder God Vine and Itraconazole Together: Common Questions

Can you take Thunder God Vine with Itraconazole?
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 Thunder God Vine and Itraconazole?
Itraconazole belongs to more than one drug category, and Thunder God Vine 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 Thunder God Vine and Itraconazole 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 Itraconazole 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.