Drug & supplement interaction

Tree Turmeric + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

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

Tivozanib Hydrochloride falls into 2 drug categories that Tree Turmeric can interact with; the most serious is rated moderate. Theoretically, tree turmeric might increase the levels and clinical effects of drugs that are substrates of CYP3A4.

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

Tree Turmeric and Tivozanib Hydrochloride

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

Why Are There 2 Interactions?

Tree Turmeric interacts with whole categories of medication. Tivozanib Hydrochloride falls into 2 of those categories, so it can interact with Tree Turmeric 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) SUBSTRATES

1 of 2

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride 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: your body relies on a liver enzyme called CYP3A4 to break down and clear tivozanib (Fotivda). Berberine, the active compound in tree turmeric, appears to slow that enzyme down. When the cleanup crew works slower, more tivozanib can build up in your system than expected, which may push up its effects and side effects.

With tivozanib that could mean more high blood pressure, fatigue, diarrhea, mouth sores, or hand-foot skin reactions. This is a cancer drug where dosing is carefully calibrated, so even modest changes matter. The concern is partly theoretical, but the inhibition is real enough to take seriously. Please don't start or stop anything on your own. Loop in your oncologist or pharmacist before adding tree turmeric.

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
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Tivozanib Hydrochloride also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, tree turmeric might have additive effects when used with anticoagulant and antiplatelet drugs and increase the risk of bleeding.
In vitro and animal research suggest that berberine, a constituent of tree turmeric, can inhibit platelet aggregation.
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 combining tree turmeric (which supplies berberine) with your tivozanib (Fotivda). Tivozanib isn't truly a blood thinner, but like a lot of cancer kinase inhibitors, it can raise your bleeding risk on its own. The concern on file is that berberine, in lab and animal studies, may keep platelets from clumping together, so stacking it on top of tivozanib could theoretically nudge your bleeding risk a little higher.

I want to be honest about the strength of this: it's theoretical, based on test-tube and animal work, not human studies. Still, since tivozanib can already cause nosebleeds, easy bruising, or bleeding gums, it's worth a quick chat with your oncology team before adding tree turmeric. Please don't stop or change anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  2. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.

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 Tivozanib Hydrochloride 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. Tivozanib Hydrochloride)
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 Tivozanib Hydrochloride

This page covers Tree Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tivozanib Hydrochloride page lists 288 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Danshen (major), Grapefruit (major) and Piracetam (major).

By severity: 7 major · 239 moderate · 42 minor.

From our pharmacist’s overview on the Tivozanib Hydrochloride page

“Tivozanib (Fotivda), an oral targeted therapy for advanced kidney cancer, has a supplement list that calls for genuine vigilance. Seven of the 288 ingredients on file are rated major, and those seven deserve your attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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

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

29 days ago today
Medication Tivozanib Hydrochloride
Top half

#1,252 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 Tivozanib

What Is Tivozanib Used For?

Brand name: Fotivda

Fotivda (tivozanib) is used to treat adults with advanced renal cell carcinoma (RCC) — a type of kidney cancer — that is relapsed or refractory (has come back or stopped responding to treatment) after two or more prior systemic therapies (cancer treatments given throughout the body).

See full Tivozanib 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 Tivozanib Hydrochloride, 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 Tivozanib Hydrochloride supplement interactions › Every supplement checked against Tivozanib Hydrochloride, ranked by severity Tivozanib 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 Tivozanib Hydrochloride Together: Common Questions

Can you take Tree Turmeric with Tivozanib Hydrochloride?
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 Tree Turmeric and Tivozanib Hydrochloride?
Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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.