Drug & supplement interaction

Valerian + Sorafenib

Sorafenib brand name: Nexavar.

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

Sorafenib falls into 2 drug categories that Valerian can interact with; the most serious is rated moderate. Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.

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

Valerian and Sorafenib

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

Why Are There 2 Interactions?

Valerian interacts with whole categories of medication. Sorafenib falls into 2 of those categories, so it can interact with Valerian in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

GLUCURONIDATED DRUGS

1 of 2

Why this applies to Sorafenib

Sorafenib falls under GLUCURONIDATED DRUGS — the group Valerian interacts with.

Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
In vitro research shows that methanolic valerian extract and valerenic acid might competitively inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1) and UGT2B7.
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 folks taking Nexavar (sorafenib) along with valerian. Your body partly clears sorafenib using enzymes called UGTs (specifically UGT1A1). Lab and test-tube studies hint that valerian, or one of its compounds called valerenic acid, might mildly slow down these UGT enzymes. If that happened in real life, sorafenib could clear a bit more slowly and build up, which might mean stronger side effects like hand-foot skin reactions, rash, diarrhea, fatigue, or high blood pressure.

I want to keep this in perspective, though. This is based only on laboratory work, not human studies, so the real-world risk is uncertain and likely small. Still, since sorafenib is a serious cancer drug, please run any valerian use by your oncologist or pharmacist first rather than starting it on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Alkharfy, K. M. and Frye, R. F. Effect of valerian, valerian/hops extracts, and valerenic acid on glucuronidation in vitro. Xenobiotica 2007;37(2):113-123.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Sorafenib also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Although some in vitro evidence suggests that valerian extract might inhibit or induce CYP3A4, clinical pharmacokinetic (PK) studies show that valerian does not have a clinically significant effect on the CYP3A4 enzyme. In one PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of midazolam, an accepted CYP3A4 probe-substrate. In another PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days modestly increases levels of alprazolam, a CYP3A4 substrate, suggesting mild inhibition of CYP3A4. However, this mild inhibition is unlikely to be clinically relevant.
Severity Minor Likelihood Possible Evidence B

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

Good question, and the short answer is reassuring. Your kidney, liver, or thyroid cancer medicine Sorafenib (Nexavar) is partly handled by a liver enzyme called CYP3A4. In a test tube, valerian looked like it might nudge that enzyme one way or the other, but in actual studies in people, valerian did not meaningfully change how the body clears CYP3A4 drugs. One study showed only a tiny increase in a similar medication, and that small change wasn't enough to matter clinically.

So for most people, valerian is unlikely to push your sorafenib levels up enough to worsen side effects like hand-foot skin reactions, diarrhea, fatigue, or high blood pressure. Still, because sorafenib is a serious cancer drug, please run any new supplement past your oncologist or pharmacist first so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
  2. Lefebvre T, Foster BC, Drouin CE, et al. In vitro activity of commercial valerian root extracts against human cytochrome P450 3A4. J Pharm Pharmaceut Sci 2004;7:265-73.
  3. Donovan JL, DeVane CL, Chavin KD, et al. Multiple night-time doses of valerian (Valeriana officinalis) had minimal effects on CYP3A4 activity and no effect on CYP2D6 activity in healthy volunteers. Drug Metab Dispos 2004;32:1333-6. PubMed
  4. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  5. Hellum BH, Hu Z, Nilsen OG. The induction of CYP1A2, CYP2D6 and CYP3A4 by six trade herbal products in cultured primary human hepatocytes. Basic Clin Pharmacol Toxicol. 2007 Jan;100:23-30. 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

Valerian Also Interacts With Other Medications

Valerian has 337 moderate, 564 minor known drug interactions in our database — the Sorafenib one above is among them. If you take anything else, check it against the full list below.

Moderate 337 Minor 564 No known interaction 1,929 (incl. Sorafenib)
Taking anything else?

Check Another of Your Medications Against Valerian

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

From our Q&A

Questions About Valerian or Sorafenib

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Valerian or Sorafenib, 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 Sorafenib

This page covers Valerian only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sorafenib page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 241 moderate · 39 minor.

From our pharmacist’s overview on the Sorafenib page

“If you're on sorafenib (Nexavar) for cancer, be genuinely careful here, and learn the five major-rated entries first. Most of the 285 ingredients listed either have blood-thinning effects that stack onto sorafenib's bleeding risk (more than 200 do) or affect CYP3A4, the liver enzyme that clears the drug, pushing its level too high or t…”

Reviewed by 2 · Jul 18, 2026

Open the Sorafenib interaction page

One more smart check

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

We hold 2,185 real supplement products containing Valerian, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Valerian. Your product may carry other ingredients that interact with Sorafenib too, on top of Valerian — 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 Valerian and Sorafenib 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 Valerian
Top 10%

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

29 days ago today
Medication Sorafenib
Steady interest

#2,541 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 Valerian

What is Valerian?

Valerian
  • Insomnia and poor sleep
  • Anxiety and stress
  • Restlessness
  • Muscle tension or cramps
  • Menstrual discomfort

Valerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some people sleep but does not work reliably for everyone. It is generally well tolerated for short-term use, but talk to your pharmacist or doctor before starting it.

Read the full Valerian monograph & all interactions
Medication

About Sorafenib

What Is Sorafenib Used For?

Brand name: Nexavar

Sorafenib tablets are approved to treat three types of cancer. The first is unresectable hepatocellular carcinoma (HCC) — liver cancer that cannot be removed with surgery. The second is advanced renal cell carcinoma (RCC) — kidney cancer that has spread or progressed. Both the brand Nexavar and generic sorafenib tablets are approved for these two uses.

The third use is for locally recurrent or metastatic, progressive differentiated thyroid carcinoma (DTC) — thyroid cancer that has spread or worsened and no longer responds to radioactive iodine treatment. Nexavar and sorafenib tablets are both approved for this use as well.

See full Sorafenib drug information
Keep checking

Other Drugs & Valerian

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

0Major
337Moderate
564Minor
1,928No known interaction
337 Moderate 564 Minor 1,928 No interaction
Moderate

337 interactions

Showing 60 of 337 moderate interactions — see all 337 on the Valerian page.

Minor

564 interactions

Showing 60 of 564 minor interactions — see all 564 on the Valerian page.

No interaction 1,928 drugs checked — show the list

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

Showing the 60 most looked-up of 1,928 medications checked with no known interaction — see the full Valerian list.

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

Can you take Valerian with Sorafenib?
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 Valerian and Sorafenib?
Sorafenib belongs to more than one drug category, and Valerian 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 Valerian and Sorafenib 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 Sorafenib and Valerian?

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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.