Drug & supplement interaction

Turpentine Oil + Pirfenidone

Pirfenidone brand name: Esbriet.

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

Turpentine Oil has a minor interaction with Pirfenidone. There is some concern that turpentine oil can inhibit CYP1A2 enzyme activity by up to 90% via induction of inflammation and subsequent downregulation of CYP activity.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Turpentine Oil and Pirfenidone

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

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Pirfenidone

Pirfenidone falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Turpentine Oil interacts with.

There is some concern that turpentine oil can inhibit CYP1A2 enzyme activity by up to 90% via induction of inflammation and subsequent downregulation of CYP activity. However, animal research suggests that turpentine oil does not affect the metabolism of phenacetin, a CYP1A2 substrate, despite inducing inflammation.
Some medications metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, tizanidine (Zanaflex), zileuton (Zyflo), zolmitriptan (Zomig), and others.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for pirfenidone (Esbriet): your body relies on a liver enzyme called CYP1A2 to break it down and clear it out. The theory on file is that turpentine oil could slow that enzyme down. If that happened, pirfenidone could build up a bit more than expected, which might mean more of its usual side effects, things like nausea, upset stomach, tiredness, dizziness, or skin sensitivity to sunlight.

Now, the honest part: this concern comes only from lab and animal research, and one animal study actually showed no real change in how a CYP1A2 drug was processed. So this is rated minor and unlikely. Pirfenidone is not a prodrug, so the worry would be slightly stronger effects, not a stronger benefit. Still, please run any turpentine oil use past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Prasad VG, Vivek Ch, Anand Kumar P, Ravi Kumar P, Rao GS. Turpentine oil induced inflammation decreases absorption and increases distribution of phenacetin without altering its elimination process in rats. Eur J Drug Metab Pharmacokinet 2015;40(1):23-8. 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

Turpentine Oil Also Interacts With Other Medications

Turpentine Oil has 198 moderate, 177 minor known drug interactions in our database — the Pirfenidone one above is one of them. If you take anything else, check it against the full list below.

Moderate 198 Minor 177 No known interaction 2,455 (incl. Pirfenidone)
Taking anything else?

Check Another of Your Medications Against Turpentine Oil

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

Everything else you take

See Every Supplement That Interacts With Pirfenidone

This page covers Turpentine Oil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pirfenidone page lists 115 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Alfalfa (moderate) and Angelica Archangelica (moderate).

By severity: 1 major · 80 moderate · 34 minor.

From our pharmacist’s overview on the Pirfenidone page

“Pirfenidone (Esbriet) slows the lung scarring of idiopathic pulmonary fibrosis, and when a drug is doing that kind of work, this is not a list to skim. Most of the 115 ingredients on file touch CYP1A2, the liver enzyme that clears pirfenidone, so they can push its blood level up (more nausea and liver strain) or drag it down and quietl…”

Reviewed by 2 · Jul 18, 2026

Open the Pirfenidone interaction page

How much people look this up

Where Turpentine Oil and Pirfenidone 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 Turpentine Oil
Top half

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

29 days ago today
Medication Pirfenidone
Top half

#871 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 Turpentine Oil

What is Turpentine Oil?

Turpentine Oil
  • Muscle and joint aches (topical)
  • Cough and congestion (chest rubs)
  • Minor skin conditions
  • Antiseptic
  • Toothache (traditional)

Turpentine oil is a strong-smelling pine resin product used mostly in tiny amounts in topical rubs for muscle aches and congestion. It can be dangerous and even deadly if swallowed, and reliable evidence for health benefits is very limited. Never drink turpentine oil, and only use diluted, purified products on the skin with care.

Read the full Turpentine Oil monograph & all interactions
Medication

About Pirfenidone

What Is Pirfenidone Used For?

Brand name: Esbriet

Pirfenidone — available as capsules and tablets under the brand name Esbriet, as well as generic pirfenidone products — is indicated for the treatment of idiopathic pulmonary fibrosis (IPF), a chronic, progressive disease in which scar tissue builds up in the lungs and makes breathing increasingly difficult.

Esbriet capsules and tablets, pirfenidone capsules, and pirfenidone tablets are each specifically approved for IPF. No other uses are supported by the available product labels.

See full Pirfenidone drug information
Keep checking

Other Drugs & Turpentine Oil

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

0Major
198Moderate
177Minor
2,454No known interaction
198 Moderate 177 Minor 2,454 No interaction
Moderate

198 interactions

Showing 60 of 198 moderate interactions — see all 198 on the Turpentine Oil page.

Minor

177 interactions

Showing 60 of 177 minor interactions — see all 177 on the Turpentine Oil page.

No interaction 2,454 drugs checked — show the list

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

Showing the 60 most looked-up of 2,454 medications checked with no known interaction — see the full Turpentine Oil list.

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

Can you take Turpentine Oil with Pirfenidone?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Turpentine Oil and Pirfenidone interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Pirfenidone and Turpentine Oil?

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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.