Drug & supplement interaction

Thunder God Vine + Pralsetinib

Pralsetinib brand name: Gavreto.

Moderate Interaction
The bottom line Moderate

Thunder God Vine has a moderate interaction with Pralsetinib. Theoretically, thunder god vine might increase the levels and clinical effects of CYP3A4 substrates.

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

Thunder God Vine and Pralsetinib

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Pralsetinib

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

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 gist for Pralsetinib (Gavreto). Your body relies on a liver enzyme called CYP3A4 to break this cancer drug down and clear it out. Lab studies (done in test tubes, not in actual patients) suggest a compound in Thunder God Vine called triptolide can slow that enzyme down. If that happened in the body, pralsetinib could build up to higher than expected levels.

More pralsetinib in your system can mean stronger side effects, things like high blood pressure, swelling, fatigue, low blood counts, or liver enzyme changes. I want to be honest though: this is theoretical and hasn't actually been reported in people. Still, with a serious cancer medicine like this, please don't pair it with Thunder God Vine without first checking with your oncologist or pharmacist.

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 Pralsetinib 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.

Everything else you take

See Every Supplement That Interacts With Pralsetinib

This page covers Thunder God Vine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pralsetinib page lists 181 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), Beer (major) and Cesium (major).

By severity: 11 major · 134 moderate · 36 minor.

From our pharmacist’s overview on the Pralsetinib page

“With pralsetinib (Gavreto), a targeted therapy for RET-driven lung and thyroid cancers, I would treat this list as required reading rather than background noise. Most of the interactions change how much of the drug the body actually gets: grapefruit can push its levels higher, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Pralsetinib interaction page

How much people look this up

Where Thunder God Vine and Pralsetinib 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

#1,043 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pralsetinib
Steady interest

#2,316 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 Pralsetinib

What Is Pralsetinib Used For?

Brand name: Gavreto

Gavreto (pralsetinib) is used to treat adults with metastatic RET fusion-positive non-small cell lung cancer (NSCLC) — a type of lung cancer that has spread and carries a specific genetic alteration detected by an FDA-approved test.

Gavreto is also approved for adults and children aged 12 and older with advanced or metastatic RET fusion-positive thyroid cancer who need systemic (whole-body) treatment and whose cancer no longer responds to radioactive iodine (when radioactive iodine is an appropriate option). This thyroid cancer use is under accelerated approval, meaning continued approval depends on results from confirmatory clinical trials.

See full Pralsetinib 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 Pralsetinib Together: Common Questions

Can you take Thunder God Vine with Pralsetinib?
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 Pralsetinib 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.