Drug & supplement interaction

Willow Bark + Cobicistat

Cobicistat brand name: Tybost.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Willow Bark and Cobicistat in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Cobicistat states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Willow Bark and Cobicistat

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Cobicistat and Willow Bark in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Willow Bark safety at a glance

Willow Bark overall Use caution Generally tolerated short-term by healthy adults, but it acts like aspirin and is not safe for everyone.
Pregnancy Avoid Avoid during pregnancy because its aspirin-like action may pose risks, especially later in pregnancy.
Breastfeeding Possibly Unsafe When used orally. Willow bark contains salicylates which are excreted in breast milk and have been linked to adverse effects in breast-fed infants. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Cobicistat and Willow Bark? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Cobicistat

Interactions in our licensed database are recorded against drug classes, not just single drug names. Cobicistat is filed under 2 classifications — cytochrome p450 3a4 (cyp3a4) inhibitors, oral drugs. Willow Bark has documented interactions with 5 drug classes — the most serious being acetazolamide (moderate), anticoagulant/antiplatelet drugs (moderate) and aspirin (moderate) — and none of Cobicistat’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Willow Bark Does Interact With Other Medications

Willow Bark has 127 moderate known drug interactions in our database — Cobicistat isn’t one of them. If you take anything else, check it against the full list below.

Moderate 127 No known interaction 2,703 (incl. Cobicistat)
Taking anything else?

Check Another of Your Medications Against Willow Bark

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

What to actually watch for

No Interaction Found — But Data Suggests Willow Bark and Cobicistat May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Kidney problems / An allergic reaction Worth acting on reported in 44.9% of FDA reports for Cobicistat Additional detail

    Willow Bark

    “Orally, willow bark seems to be well tolerated.

    Most Common Adverse Effects:

    Orally: Diarrhea, dyspepsia, heartburn, and vomiting. May cause itching and rash in sensitive individuals.

    Serious Adverse Effects (Rare):

    Orally: Gastrointestinal bleeding and renal impairment. May cause serious allergic reactions, including anaphylaxis, in people who are allergic to aspirin.”

    Willow Bark · Natural Medicines adverse-effect record, reported in diarrhea.

    Cobicistat

    Listed in the ADVERSE REACTIONS section of the FDA label for Cobicistat, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Itching / A skin rash Additional detail

    Willow Bark

    “Orally, willow bark may cause itching and rash in some people due to allergy.”

    Willow Bark · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).

    5 sources cited
    1. 6456. Chrubasik S, Eisenberg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med 2000;109:9-14. PubMed
    2. 12474. Schmid B, Ludtke R, Selbmann HK, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial. Phytother Res 2001;15:344-50. PubMed
    3. 12475. Biegert C, Wagner I, Ludtke R, et al. Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials. J Rheumatol 2004;31:2121-30.
    4. 12804. Chrubasik S, Kunzel O, Model A, et al. Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology (Oxford) 2001;40:1388-93. PubMed
    5. 86459. Chrubasik, S., Kunzel, O., Black, A., Conradt, C., and Kerschbaumer, F. Potential economic impact of using a proprietary willow bark extract in outpatient treatment of low back pain: an open non-randomized study. Phytomedicine 2001;8(4):241-251. PubMed

    Cobicistat

    Listed in the ADVERSE REACTIONS section of the FDA label for Cobicistat. Read the label on DailyMed ›

  • Diarrhea / Vomiting Additional detail

    Willow Bark

    “Orally, willow bark extract can cause gastrointestinal adverse effects, but these appear to be less frequent than those caused by NSAIDs. Examples include diarrhea, heartburn, vomiting, and dyspepsia. In a case report of a child, severe gastrointestinal bleeding occurred following use of a specific syrup (FreddoBaby), which contained ribwort plantain, licorice, willow bark, black elder, meadowsweet, and propolis.”

    Willow Bark · Natural Medicines adverse-effect record, reported in diarrhea.

    5 sources cited
    1. 12474. Schmid B, Ludtke R, Selbmann HK, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial. Phytother Res 2001;15:344-50. PubMed
    2. 12475. Biegert C, Wagner I, Ludtke R, et al. Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials. J Rheumatol 2004;31:2121-30.
    3. 12804. Chrubasik S, Kunzel O, Model A, et al. Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology (Oxford) 2001;40:1388-93. PubMed
    4. 86459. Chrubasik, S., Kunzel, O., Black, A., Conradt, C., and Kerschbaumer, F. Potential economic impact of using a proprietary willow bark extract in outpatient treatment of low back pain: an open non-randomized study. Phytomedicine 2001;8(4):241-251. PubMed
    5. 86477. <p>Moro PA, Flacco V, Cassetti F, Clementi V, Colombo ML, Chiesa GM, Menniti-Ippolito F, Raschetti R, Santuccio C. Hypovolemic shock due to severe gastrointestinal bleeding in a child taking an herbal syrup. Ann Ist Super Sanita. 2011;47(3):278-83.</p>

    Cobicistat

    Listed in the ADVERSE REACTIONS section of the FDA label for Cobicistat. Read the label on DailyMed ›

  • Headache Additional detail

    Willow Bark

    “Orally, willow bark may cause headache and dizziness. In a clinical trial evaluating a combination product containing willow bark, black cohosh, sarsaparilla, poplar bark, and guaiac wood (Reumalex), severe headaches occurred.”

    Willow Bark · Natural Medicines adverse-effect record, reported in cluster headache.

    2 sources cited
    1. 12804. Chrubasik S, Kunzel O, Model A, et al. Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology (Oxford) 2001;40:1388-93. PubMed
    2. 35946. Mills SY, Jacoby RK, Chacksfield M, Willoughby M. Effect of a proprietary herbal medicine on the relief of chronic arthritic pain: a double-blind study. Br J Rheumatol 1996;35:874-8. PubMed

    Cobicistat

    Listed in the ADVERSE REACTIONS section of the FDA label for Cobicistat. Read the label on DailyMed ›

Reported for Willow Bark but not commonly for Cobicistat: bleeding in the gut, a severe allergic reaction, stomach upset and heartburn.

Effects for Cobicistat come from the ADVERSE REACTIONS section of its FDA label; effects for Willow Bark come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 20,779 voluntary FDA FAERS reports for Cobicistat that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Willow Bark in Pregnancy & Breastfeeding

Lactation Possibly Unsafe

When used orally. Willow bark contains salicylates which are excreted in breast milk and have been linked to adverse effects in breast-fed infants.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Cobicistat Products Have a Food Rule — Willow Bark Should Not Break It

At least one FDA label for a product containing Cobicistat says to take it with food. If you take Willow Bark on an empty stomach out of habit, keep them separate — and take Cobicistat with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Cobicistat products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION TYBOST must be coadministered with atazanavir or darunavir at the same time, with food, and in combination with other HIV-1 antiretroviral agents.

From the Dosage and Administration section of the FDA label we read for Cobicistat — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Cobicistat

This page covers Willow Bark only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cobicistat page lists 30 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), Cannabidiol (cbd) (moderate), Cannabinol (cbn) (moderate) and Cannabis (moderate).

By severity: 1 major · 19 moderate · 10 minor.

From our pharmacist’s overview on the Cobicistat page

“Activated charcoal is the one entry to understand first if you take cobicistat (Tybost). Charcoal soaks up drugs in the gut, and since cobicistat's entire job is boosting an HIV medicine to protective levels, blunting its absorption can put the whole regimen at risk.”

Reviewed by 2 · Jul 18, 2026

Open the Cobicistat interaction page

One more smart check

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

We hold 43 real supplement products containing Willow Bark, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Willow Bark. Even though Willow Bark itself has no known interaction with Cobicistat, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Willow Bark and Cobicistat 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 Willow Bark
Steady interest

#1,189 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cobicistat
Steady interest

#2,044 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Willow Bark reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Willow Bark and Cobicistat records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Willow Bark

What is Willow Bark?

  • Low back pain
  • Osteoarthritis joint pain
  • Headache
  • Fever
  • General aches and inflammation

Willow bark is a traditional plant remedy that contains salicin, a compound related to aspirin, and is most often used for pain and inflammation. Some evidence suggests it may modestly help low back pain and joint pain, but the research is limited and the right dose is not well standardized. Because it acts like aspirin, people with aspirin allergies, bleeding problems, or who are pregnant should be cautious and talk to a pharmacist or doctor first.

Salix alba · Salicaceae · Bark · Capsules, tablets, dried bark for tea, liquid extracts, standardized extracts

An interaction check asks whether these two react with each other — it does not ask whether Willow Bark is a good idea for someone in your situation. Here is what our Willow Bark record says about it on its own.

Willow Bark: dosing

There is no single official dose for willow bark. Products vary widely, and many are standardized to a certain amount of salicin, which is the part researchers usually measure.Because strength differs from brand to brand, the best approach is to follow the directions on the product label and not exceed them. They can help you decide whether willow bark is appropriate and how much is reasonable for you.

From our Willow Bark monograph — the full record covers uses, side effects and every documented interaction.

Read the full Willow Bark monograph & all interactions
Medication

About Cobicistat

What Is Cobicistat Used For?

Brand name: Tybost

Tybost (cobicistat) is not itself an HIV treatment — it works by slowing the breakdown of certain HIV medicines so they stay active in your body long enough to work. Specifically, Tybost is used to boost the HIV medicines atazanavir or darunavir (once-daily dosing) as part of a complete HIV-1 treatment regimen in adults and in children weighing at least 14 kg (about 31 lbs).

Tybost is not interchangeable with ritonavir (another booster) for all HIV medicines. It is not recommended with darunavir twice-daily, fosamprenavir, saquinavir, or tipranavir.

Most-Reported Side Effects for Cobicistat

From FAERS, the FDA’s public side-effect reporting system (20,779 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Bone density decreased 8,112 reports
Chronic kidney disease 4,754 reports
Renal injury 4,577 reports
Tooth loss 4,186 reports
Bone loss 4,107 reports
See full Cobicistat drug information
Keep checking

Other Drugs & Willow Bark

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

0Major
127Moderate
0Minor
2,702No known interaction
127 Moderate 2,702 No interaction
Moderate

127 interactions

Showing 60 of 127 moderate interactions — see all 127 on the Willow Bark page.

No interaction 2,702 drugs checked — show the list

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

Showing the 60 most looked-up of 2,702 medications checked with no known interaction — see the full Willow Bark list.

See the full Willow Bark interactions page
See every supplement checked against Cobicistat, ranked by severity
Evidence & sources

Willow Bark References

The 12 references that drive our Willow Bark monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Chrubasik S, Eisenberg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med 2000;109:9-14. PubMed
  2. Schmid B, Ludtke R, Selbmann HK, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial. Phytother Res 2001;15:344-50. PubMed
  3. Biegert C, Wagner I, Ludtke R, et al. Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials. J Rheumatol 2004;31:2121-30.
  4. Unsworth J, d'Assis-Fonseca A, Beswick DT, Blake DR. Serum salicylate levels in a breast fed infant. Ann Rheum Dis 1987;46:638-9. PubMed
  5. Clark JH, Wilson WG. A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Clin Pediatr (Phila) 1981;20:53-4. PubMed
  6. Chrubasik S, Kunzel O, Model A, et al. Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology (Oxford) 2001;40:1388-93. PubMed
  7. Schmid B, Kotter I, Heide L. Pharmacokinetics of salicin after oral administration of a standardised willow bark extract. Eur J Clin Pharmacol. 2001;57:387-91. PubMed
  8. Krivoy N, Pavlotzky E, Chrubasik S, et al. Effect of salicis cortex extract on human platelet aggregation. Planta Med 2001;67:209-12. PubMed
  9. Mills SY, Jacoby RK, Chacksfield M, Willoughby M. Effect of a proprietary herbal medicine on the relief of chronic arthritic pain: a double-blind study. Br J Rheumatol 1996;35:874-8. PubMed
  10. Chrubasik, S., Kunzel, O., Black, A., Conradt, C., and Kerschbaumer, F. Potential economic impact of using a proprietary willow bark extract in outpatient treatment of low back pain: an open non-randomized study. Phytomedicine 2001;8(4):241-251. PubMed
  11. <p>Moro PA, Flacco V, Cassetti F, Clementi V, Colombo ML, Chiesa GM, Menniti-Ippolito F, Raschetti R, Santuccio C. Hypovolemic shock due to severe gastrointestinal bleeding in a child taking an herbal syrup. Ann Ist Super Sanita. 2011;47(3):278-83.</p>
  12. Sweeney, K. R., Chapron, D. J., Brandt, J. L., Gomolin, I. H., Feig, P. U., and Kramer, P. A. Toxic interaction between acetazolamide and salicylate: case reports and a pharmacokinetic explanation. Clin Pharmacol Ther 1986;40(5):518-524.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Willow Bark and Cobicistat Together: Common Questions

Is it safe to take Willow Bark with Cobicistat?
We do not list a known interaction between Willow Bark and Cobicistat. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Willow Bark and Cobicistat have any of the same side effects?
Yes — our sources link each of them separately to 7 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Willow Bark and Cobicistat at the same time of day?
At least one FDA label for a product containing Cobicistat says to take it with food. If you take Willow Bark on an empty stomach out of habit, keep them separate and take Cobicistat with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Cobicistat products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Willow Bark and Cobicistat combination checked?
Interactions in our licensed database are recorded against drug classes. Cobicistat is filed under 2 classifications, and Willow Bark has documented interactions with 5 drug classes — none of Cobicistat's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Willow Bark interact with any other medications?
Yes. Willow Bark has 127 documented drug interactions in our database — Cobicistat is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Cobicistat interact with any supplements?
Yes. Cobicistat has documented interactions with 30 supplements in our database — Willow Bark is not one of them. The Cobicistat interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Willow Bark monograph Uses, safety profile, and every drug interaction in one place Cobicistat drug information The full plain-English guide to this medication Cobicistat supplement interactions Every supplement checked against Cobicistat, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 12 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Cobicistat and Willow Bark?

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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.