Drug & supplement interaction

Tree Turmeric + Cabozantinib

Cabozantinib brand name: Cometriq.

Moderate Interaction
The bottom line Moderate

Tree Turmeric has a moderate interaction with Cabozantinib. Theoretically, tree turmeric might increase the levels and clinical effects of drugs that are substrates of CYP3A4.

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

Tree Turmeric and Cabozantinib

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Cabozantinib

Cabozantinib falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Tree Turmeric interacts with.

Theoretically, tree turmeric might increase the levels and clinical effects of drugs that are substrates of CYP3A4.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of tree turmeric, moderately inhibits CYP3A4.
Severity Moderate Likelihood Probable Evidence A

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for cabozantinib: your liver relies on an enzyme called CYP3A4 to clear it out of your system. Berberine, the active ingredient in tree turmeric, can partly block that enzyme. When the cleanup slows down, more cabozantinib can hang around in your blood than expected.

Cabozantinib is an active drug, not a prodrug, so higher levels usually mean stronger effects and more side effects. With this medicine that can look like worse diarrhea, mouth sores, hand and foot soreness, high blood pressure, or fatigue. The concern here is mostly theoretical and based on lab and early human data, but since cabozantinib is a serious cancer drug, please don't add tree turmeric without checking with your oncologist or pharmacist first.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. 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

Tree Turmeric Also Interacts With Other Medications

Tree Turmeric has 2 major, 1,159 moderate known drug interactions in our database — the Cabozantinib 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 Tree Turmeric

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

Everything else you take

See Every Supplement That Interacts With Cabozantinib

This page covers Tree Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cabozantinib page lists 138 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 94 moderate · 41 minor.

Open the Cabozantinib interaction page

One more smart check

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

We hold 51 real supplement products containing Tree Turmeric, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tree Turmeric. Your product may carry other ingredients that interact with Cabozantinib too, on top of Tree Turmeric — 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 Tree Turmeric and Cabozantinib 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 Tree Turmeric
Top half

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

29 days ago today
Medication Cabozantinib
Top half

#836 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 Tree Turmeric

What is Tree Turmeric?

  • Blood sugar support
  • High cholesterol
  • Digestive complaints
  • Skin and eye conditions
  • Antimicrobial uses
  • Liver support

Tree turmeric (Berberis aristata) is a shrub used in traditional Indian (Ayurvedic) medicine, valued mainly for its berberine content. Early research suggests possible benefits for blood sugar and cholesterol, but high-quality human evidence is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Tree Turmeric monograph & all interactions
Medication

About Cabozantinib

What Is Cabozantinib Used For?

Brand name: Cometriq

Cabozantinib treats several cancers, and the approved uses differ by brand. Cabometyx tablets are used for advanced renal cell carcinoma (kidney cancer), hepatocellular carcinoma (liver cancer) after sorafenib, differentiated thyroid cancer, and certain neuroendocrine tumors.

Cometriq capsules are used for progressive, metastatic medullary thyroid cancer. The two products are not substitutes for each other.

See full Cabozantinib drug information Cabozantinib NDC codes and packages
Keep checking

Other Drugs & Tree Turmeric

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

2Major
1,159Moderate
0Minor
1,668No known interaction
Major

2 interactions

Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Tree Turmeric page.

No interaction 1,668 drugs checked — show the list

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

Showing the 60 most looked-up of 1,668 medications checked with no known interaction — see the full Tree Turmeric 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 Tree Turmeric and Cabozantinib Together: Common Questions

Can you take Tree Turmeric with Cabozantinib?
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 Tree Turmeric and Cabozantinib 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 Cabozantinib and Tree Turmeric?

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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.