Drug & supplement interaction

Tree Turmeric + Ospemifene

Ospemifene brand name: Osphena.

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

Tree Turmeric has a moderate interaction with Ospemifene. 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 Ospemifene

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Ospemifene

Ospemifene 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 Osphena (ospemifene): your body relies on a liver enzyme called CYP3A4 to break it down. The berberine in tree turmeric appears to slow that enzyme down. When that happens, ospemifene can clear more slowly and build up a bit, which may nudge its effects and side effects upward. With ospemifene that could mean things like hot flashes, vaginal discharge, muscle spasms, or sweating becoming more noticeable.

To be fair, this is mostly based on lab work and early human data, so it's more of a caution than a sure thing, and it's rated as moderate. Casual culinary amounts are unlikely to matter much, but concentrated berberine supplements are a different story. Before pairing them, just check with your pharmacist or doctor.

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 Ospemifene one above is one of them. If you take anything else, check it against the full list below.

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

This page covers Tree Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ospemifene page lists 155 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), Tiratricol (major) and Acacia Rigidula (moderate).

By severity: 4 major · 112 moderate · 39 minor.

From our pharmacist’s overview on the Ospemifene page

“Women prescribed ospemifene (Osphena) for painful intercourse after menopause are often the same women reaching for St. John's wort for mood or grapefruit juice at breakfast, and both sit among the four major-rated interactions on this page, so the list deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Ospemifene 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 Ospemifene 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 Ospemifene 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

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

29 days ago today
Medication Ospemifene
Steady interest

#2,475 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 Ospemifene

What Is Ospemifene Used For?

Brand name: Osphena

Osphena (ospemifene) is used to treat two specific symptoms of vulvar and vaginal atrophy — the thinning and drying of vaginal tissues that can happen after menopause. The first is moderate to severe dyspareunia (painful intercourse), and the second is moderate to severe vaginal dryness.

Both of these uses are for postmenopausal women only. Osphena is not used in children or in women who are pregnant or may become pregnant.

See full Ospemifene drug information
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 Ospemifene, 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 Ospemifene supplement interactions › Every supplement checked against Ospemifene, ranked by severity Ospemifene 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 Tree Turmeric and Ospemifene Together: Common Questions

Can you take Tree Turmeric with Ospemifene?
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 Ospemifene 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 Ospemifene 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.