Drug & supplement interaction

Turmeric + Irinotecan Hydrochloride

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

Irinotecan Hydrochloride falls into 3 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
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Turmeric and Irinotecan Hydrochloride

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

Why Are There 3 Interactions?

Turmeric interacts with whole categories of medication. Irinotecan Hydrochloride falls into 3 of those categories, so it can interact with Turmeric in 3 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 3

Why this applies to Irinotecan Hydrochloride

Irinotecan Hydrochloride 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 gist with irinotecan (Onivyde) and turmeric. Irinotecan is partly handled by a liver enzyme called CYP3A4, and lab and animal studies suggest curcumin (the active part of turmeric) can block that enzyme. If it slows the breakdown of irinotecan, more of the drug could hang around, which may add to its known side effects like severe diarrhea, low white blood cell counts, nausea, and fatigue. Confusingly, some lab work hints turmeric could speed the enzyme up instead, which might weaken the chemo.

This is mostly test-tube and animal data, not proven in people taking irinotecan, so I don't want to alarm you. Still, with cancer treatment I'd play it safe. Please run any turmeric supplement past your oncologist or pharmacist first. Sprinkling it on food is far less of a concern than concentrated capsules.

Contact Dr. Brian directly if you have additional questions on this interaction
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

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

2 of 3

Irinotecan Hydrochloride also falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP).

Theoretically, turmeric might increase blood levels of OATP4C1 substrates.
In vitro research shows that the turmeric constituent curcumin competitively inhibits OATP4C1 transport. This transporter is expressed in the kidney and facilitates the renal excretion of certain drugs. Theoretically, taking turmeric might decrease renal excretion of OATP substrates.
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 of what we have on file for irinotecan and turmeric. There's a transporter called OATP4C1 in your kidneys that helps move certain drugs out of your body through the urine. In lab dish studies, curcumin (the active part of turmeric) seems to block this transporter a little. The theory is that if that transporter slows down, a drug like irinotecan could clear more slowly and build up in your blood.

I want to be straight with you: this is based only on test-tube research, not real patients, so it's quite theoretical. Still, irinotecan is powerful chemotherapy, and higher levels could mean worse diarrhea, low blood counts, nausea, or fatigue. Because the stakes are high, please run any turmeric supplement (not just cooking amounts) past your oncology team before using it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sato T, Yagi A, Yamauchi M, et al. The use of an antioxidant enables accurate evaluation of the interaction of curcumin on organic anion-transporting polypeptides 4C1 by preventing auto-oxidation. Int J Mol Sci 2024;25(2):991. PubMed
Moderate

TOPOISOMERASE I INHIBITORS

3 of 3

Irinotecan Hydrochloride also falls under TOPOISOMERASE I INHIBITORS.

Turmeric has antioxidant effects. There is some concern that this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research shows that curcumin, a constituent of turmeric, inhibits camptothecin-induced apoptosis of breast cancer cells by up to 71%. However, other in vitro research shows that curcumin augments the cytotoxic effects of camptothecin. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agents. 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.
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 thinking on this one. Irinotecan (Onivyde) is part of a chemo family that partly works by creating free radicals and oxidative stress inside cancer cells to help kill them. Because curcumin in turmeric acts as an antioxidant, there's a theoretical worry that it could mop up some of those free radicals and blunt how well your chemo works.

But I want to be honest with you: this concern comes from lab and test-tube studies only, and the results actually go both ways. Some studies show curcumin weakening the chemo effect, while others show it boosting it, likely depending on the dose. We simply don't have solid human evidence yet. Cooking with turmeric as a spice is very unlikely to matter, but please don't start a concentrated turmeric or curcumin supplement during cancer treatment without first checking with your oncologist or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Irinotecan Hydrochloride one above is among them. If you take anything else, check it against the full list below.

Moderate 1,055 Minor 77 No known interaction 1,698 (incl. Irinotecan Hydrochloride)
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 Irinotecan Hydrochloride

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 Irinotecan Hydrochloride, 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 Irinotecan Hydrochloride

This page covers Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Irinotecan Hydrochloride page lists 135 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Apple (major), Grapefruit (major), St. John's Wort (major), Sweet Orange (major) and Acacia Rigidula (moderate).

By severity: 4 major · 100 moderate · 31 minor.

From our pharmacist’s overview on the Irinotecan Hydrochloride page

“Irinotecan hydrochloride is chemotherapy, most often used against colorectal cancer, so the 135 supplements and foods on this page call for genuine care rather than a shrug. Four entries rate major, and St.”

Reviewed by 2 · Jul 18, 2026

Open the Irinotecan Hydrochloride 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 Irinotecan Hydrochloride 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 Irinotecan 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 Turmeric
Top 5%

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

29 days ago today
Medication Irinotecan Hydrochloride
Steady interest

#1,418 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 Irinotecan Lipid Complex Injection

What Is Irinotecan Lipid Complex Injection Used For?

  • Irinotecan lipid complex is used in combination with other medications to treat pancreatic cancer that has spread to other parts of the body that has worsened after treatment with other chemotherapy medications. Irinotecan lipid complex is in a class of antineoplastic medications called topoisomerase I inhibitors. It works by stopping the growth of cancer cells.

See full Irinotecan Lipid Complex Injection 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
1,055 Moderate 77 Minor 1,697 No 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

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

Showing the 60 most looked-up of 1,697 medications checked with no known interaction — see the full Turmeric list.

See the full Turmeric interactions page
See every supplement checked against Irinotecan 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
Turmeric monograph › Uses, safety, and every drug interaction in one place Irinotecan Hydrochloride supplement interactions › Every supplement checked against Irinotecan Hydrochloride, ranked by severity Irinotecan Lipid Complex Injection 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 Turmeric and Irinotecan Hydrochloride Together: Common Questions

Can you take Turmeric with Irinotecan 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 3 interactions listed for Turmeric and Irinotecan Hydrochloride?
Irinotecan Hydrochloride 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 Irinotecan 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 Irinotecan Hydrochloride and 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.