Drug & supplement interaction

Turmeric + Busulfan

Busulfan brand names: Myleran, Busulfex.

Moderate Interaction
The bottom line Moderate

Busulfan falls into 2 drug categories that Turmeric can interact with; the most serious is rated moderate. Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.

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

Turmeric and Busulfan

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

Why Are There 2 Interactions?

Turmeric interacts with whole categories of medication. Busulfan falls into 2 of those categories, so it can interact with 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 Busulfan

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

Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric 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 situation with turmeric and busulfan. Your body uses a liver enzyme called CYP3A4 to help clear busulfan, and turmeric's curcumin can nudge that enzyme in either direction. If it slows the enzyme, busulfan can build up, which may mean more of the harsh side effects this chemo is known for, like a bigger drop in blood counts, mouth sores, nausea, or liver strain. If it speeds the enzyme up instead, busulfan could clear too fast and work less well against the leukemia.

The honest part: this is mostly based on lab and animal studies, so we can't say exactly which way it goes in people. Busulfan is a serious cancer drug with little room for error, so please don't add a concentrated turmeric supplement without first checking with your oncologist or pharmacist. Normal amounts of turmeric in cooking are far less of a concern.

References
  1. Appiah-Opong, R., Commandeur, J. N., Vugt-Lussenburg, B., and Vermeulen, N. P. Inhibition of human recombinant cytochrome P450s by curcumin and curcumin decomposition products. Toxicology 6-3-2007;235(1-2):83-91. PubMed
  2. Hou, X. L., Takahashi, K., Kinoshita, N., Qiu, F., Tanaka, K., Komatsu, K., Takahashi, K., and Azuma, J. Possible inhibitory mechanism of Curcuma drugs on CYP3A4 in 1alpha,25 dihydroxyvitamin D3 treated Caco-2 cells. Int.J Pharm 6-7-2007;337(1-2):169-177.
  3. Valentine, S. P., Le Nedelec, M. J., Menzies, A. R., Scandlyn, M. J., Goodin, M. G., and Rosengren, R. J. Curcumin modulates drug metabolizing enzymes in the female Swiss Webster mouse. Life Sci. 4-11-2006;78(20):2391-2398. PubMed
  4. Nayeri A, Wu S, Adams E, et al. Acute Calcineurin Inhibitor Nephrotoxicity Secondary to Turmeric Intake: A Case Report. Transplant Proc. 2017;49(1):198-200. PubMed
  5. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  6. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
  7. Dibaei M, Hosseini A, Lavasani H, Kiani-Dehkordi B, Rouini M. Assessment of metabolic interaction between curcumin and tramadol using the isolated perfused rat liver. Heliyon 2024;10(15):e35070. PubMed
Moderate

ALKYLATING AGENTS

2 of 2

Busulfan also falls under ALKYLATING AGENTS.

Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research suggests that curcumin, a constituent of turmeric, inhibits mechlorethamine-induced apoptosis of breast cancer cells by up to 70%. Also, animal research shows that curcumin inhibits cyclophosphamide-induced tumor regression. However, some in vitro research shows that curcumin does not affect the apoptosis capacity of etoposide. Also, other laboratory research suggests that curcumin might augment the cytotoxic effects of alkylating agents. Reasons for the discrepancies may relate to the dose of curcumin and the specific chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have on alkylating agents.
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 with turmeric and your busulfan. Busulfan is a strong chemo drug that kills leukemia cells partly by causing oxidative damage inside them. Turmeric's main compound, curcumin, acts as an antioxidant. So in theory, an antioxidant could blunt some of the very damage busulfan is trying to do, which might make the chemo work less well. That's the worry.

But I want to be honest about how shaky this is. The concern comes from lab and animal studies, not from people, and the findings actually point in different directions (some even suggest curcumin could boost the effect). The dose seems to matter too. Because busulfan is such a high-stakes drug, please don't add a concentrated turmeric or curcumin supplement without first clearing it with your oncology team. A sprinkle of turmeric in cooking is a different story and far less likely to matter.

References
  1. Mitchell TM. Correspondence re: Somasundaram et al., Dietary curcumin inhibits chemotherapy-induced apoptosis in models of human breast cancer. Cancer Res. 2003;63(16):5165-6; author reply 5166-7.
  2. Somasundaram S, Edmund NA, Moore DT, Small GW, Shi YY, Orlowski RZ. Dietary curcumin inhibits chemotherapy-induced apoptosis in models of human breast cancer. Cancer Res. 2002;62(13):3868-75.

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

Turmeric Also Interacts With Other Medications

Turmeric has 1,055 moderate, 77 minor known drug interactions in our database — the Busulfan one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Turmeric

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

From our Q&A

Questions About Turmeric or Busulfan

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Turmeric or Busulfan, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Busulfan

This page covers Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Busulfan page lists 148 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 Acerola (moderate).

By severity: 3 major · 104 moderate · 41 minor.

Open the Busulfan interaction page

One more smart check

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

We hold 1,368 real supplement products containing Turmeric, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Turmeric. Your product may carry other ingredients that interact with Busulfan too, on top of 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 Turmeric and Busulfan 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 Turmeric
Top 5%

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

29 days ago today
Medication Busulfan
Top half

#1,335 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 Turmeric

What is Turmeric?

Turmeric
  • Joint pain and arthritis
  • Inflammation
  • Digestive upset
  • Antioxidant support
  • Skin conditions

Turmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is poorly absorbed on its own. For most people, dietary amounts are safe, but talk to your pharmacist or doctor before taking concentrated supplements, especially if you are pregnant, nursing, or have a medical condition.

Read the full Turmeric monograph & all interactions
Medication

About Busulfan

What Is Busulfan Used For?

Brand names: Myleran, Busulfex

Busulfan is used to treat chronic myelogenous leukemia (CML), a cancer of the blood and bone marrow. The specific use depends on the form and product.

Myleran (oral tablet) is used for the palliative treatment of CML — meaning it helps control the disease and relieve symptoms. The intravenous injection forms (Busulfex and Busulfan Injection) are used in combination with another chemotherapy drug, cyclophosphamide, as a conditioning regimen to prepare the body before an allogeneic hematopoietic progenitor cell transplant (a bone marrow or stem cell transplant from a donor) for CML.

See full Busulfan drug information
Keep checking

Other Drugs & Turmeric

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

0Major
1,055Moderate
77Minor
1,697No known interaction
Moderate

1,055 interactions

Showing 60 of 1,055 moderate interactions — see all 1,055 on the Turmeric page.

Minor

77 interactions

Showing 60 of 77 minor interactions — see all 77 on the Turmeric page.

No interaction 1,697 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 Turmeric and Busulfan Together: Common Questions

Can you take Turmeric with Busulfan?
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 Turmeric and Busulfan?
Busulfan belongs to more than one drug category, and 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 Turmeric and Busulfan 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.