Drug & supplement interaction

Tree Turmeric + Fentanyl citrate

Fentanyl citrate brand name: Innovar.

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

Fentanyl citrate falls into 3 drug categories that Tree Turmeric can interact with; the most serious is rated moderate. Theoretically, use of tree turmeric along with CNS depressants might increase the risk of additive therapeutic and adverse effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Tree Turmeric and Fentanyl citrate

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Tree Turmeric interacts with whole categories of medication. Fentanyl citrate falls into 3 of those categories, so it can interact with Tree Turmeric in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 3

Why this applies to Fentanyl citrate

Fentanyl citrate falls under CNS DEPRESSANTS — the group Tree Turmeric interacts with.

Theoretically, use of tree turmeric along with CNS depressants might increase the risk of additive therapeutic and adverse effects.
Animal research suggests that berberine, a constituent of tree turmeric, can have sedative effects.
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

Fentanyl is a powerful opioid pain medicine that already slows down your brain and body. It can make you drowsy, slow your breathing, and lower your blood pressure. The concern here is that tree turmeric (because of its berberine) may have its own mild calming or sedative effect, based on animal studies only. Stacking the two could, in theory, add to fentanyl's drowsiness and breathing-slowing effects.

I want to be honest: this is a theoretical interaction with weak evidence, not something proven in people. Still, with a drug as potent as fentanyl, even a small extra push toward sedation is worth respecting. Please don't start or stop anything on your own. Run it by your doctor or pharmacist first so they can look at your full picture.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  2. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  3. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  4. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 3

Fentanyl citrate also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, tree turmeric might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of tree turmeric, can inhibit CYP2D6.
Severity Moderate Likelihood Possible Evidence B

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: berberine, the active part of tree turmeric, may slow down a liver enzyme called CYP2D6. The thinking is that drugs handled by this enzyme could build up a bit higher than usual. Fentanyl is a strong opioid, so even modest increases matter.

That said, fentanyl is mostly broken down by a different enzyme (CYP3A4), not CYP2D6, so this particular interaction is largely theoretical and based on limited evidence. Still, with a medicine this potent, I'd play it safe. If levels did creep up, you could see more drowsiness, slowed breathing, confusion, or nausea. Please don't change anything on your own. Check with your pharmacist or doctor before pairing tree turmeric with fentanyl.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  2. 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
  3. 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
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

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

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 key thing to know: your body relies on a liver enzyme called CYP3A4 to break down and clear fentanyl. Berberine, the active compound in tree turmeric, appears to slow that enzyme down. Fentanyl is a powerful opioid that works as-is (it isn't a prodrug), so if it clears more slowly, it can build up in your system and hit harder than expected.

With a drug this potent, even a modest increase matters. That could mean deeper drowsiness, confusion, very slow or shallow breathing, and dangerously low blood pressure. Please don't stop or change either one on your own, but do talk with your doctor or pharmacist before combining them so they can watch you closely or suggest a safer option.

Contact Dr. Brian directly if you have additional questions on this interaction
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, 1,157 moderate known drug interactions in our database — the Fentanyl citrate one above is among them. If you take anything else, check it against the full list below.

Major 2 Moderate 1,157 No known interaction 1,671 (incl. Fentanyl citrate)
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 Fentanyl citrate

This page covers Tree Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fentanyl citrate page lists 223 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 174 moderate · 39 minor.

From our pharmacist’s overview on the Fentanyl citrate page

“The single most important thing to know about fentanyl citrate, an extremely potent opioid pain medicine, is that anything else with a sedating effect can deepen the slowed breathing that makes opioids dangerous. Alcohol, whether beer or wine, carries a major rating for exactly this reason, and 78 of the 223 ingredients on file add sed…”

Reviewed by 2 · Jul 18, 2026

Open the Fentanyl citrate 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 Fentanyl citrate 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 Fentanyl citrate 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
Steady interest

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

29 days ago today
Medication Fentanyl citrate
Steady interest

#2,120 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
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
1,157Moderate
0Minor
1,670No known interaction
2 Major 1,157 Moderate 1,670 No interaction
Major

2 interactions

Moderate

1,157 interactions

Showing 60 of 1,157 moderate interactions — see all 1,157 on the Tree Turmeric page.

No interaction 1,670 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 1,670 medications checked with no known interaction — see the full Tree Turmeric list.

See the full Tree Turmeric interactions page
See every supplement checked against Fentanyl citrate, 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
Tree Turmeric monograph › Uses, safety, and every drug interaction in one place Fentanyl citrate supplement interactions › Every supplement checked against Fentanyl citrate, ranked by severity 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 Tree Turmeric and Fentanyl citrate Together: Common Questions

Can you take Tree Turmeric with Fentanyl citrate?
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 3 interactions listed for Tree Turmeric and Fentanyl citrate?
Fentanyl citrate belongs to more than one drug category, and Tree Turmeric 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 Tree Turmeric and Fentanyl citrate 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 Fentanyl citrate 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.