Medication interaction hub

What Supplements Interact with Apremilast?

Apremilast brand name: Otezla. Every interaction below applies to the brands too.

138 Interactions 3 Major 94 Moderate 41 Minor
Curated & coded by · Clinical Pharmacist · Updated September 23, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Apremilast? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Apremilast against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

St. John's wort is the first thing I would rule out for anyone taking apremilast (Otezla) for psoriasis, psoriatic arthritis, or Behçet's mouth sores. It speeds up the enzyme that clears the drug, and lower blood levels can mean the medicine quietly stops controlling skin or joints. It shares major status with grapefruit, which does the opposite and raises levels, and activated charcoal, which can keep a dose from absorbing at all. Three major-rated entries on a list of 138 is enough that I would check this page before starting any supplement, not after.

Most of the 94 moderate entries act on that same enzyme, CYP3A4, so levels can drift up (more nausea, diarrhea, headache) or down (less relief). A smaller set of 17 can interfere with absorbing any pill taken by mouth, so space those well apart from each dose. The 41 minor entries carry less weight, but the three majors are where to start.

— , Clinical Pharmacist · July 18, 2026

Major 3 Moderate 94 Minor 41 No known interaction 1,314

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Apremilast: Top Interactions at a Glance

The most significant Apremilast supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 138 interacting ingredients — plus 1,314 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Apremilast + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Likely Grapefruit + Apremilasti

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Probable Activated Charcoal + Apremilasti

Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the route of administration.

Read the full interaction Major Likelihood Probable St. John's Wort + Apremilasti

St.

Read the full interaction
The complete list

Every Supplement Checked Against Apremilast

All 1,452 ingredients in our database, ranked by severity — 138 with a Apremilast interaction on file and 1,314 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Apremilast?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Grape with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.

Full Grape + Apremilast answer

Can you take Guar Gum with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.

Full Guar Gum + Apremilast answer

Can you take Gum Arabic with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.

Full Gum Arabic + Apremilast answer

Can you take Higenamine with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, higenamine might increase the levels and clinical effects drugs metabolized by CYP3A4.

Full Higenamine + Apremilast answer

Can you take Horny Goat Weed with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.

Full Horny Goat Weed + Apremilast answer

Can you take Hu Zhang with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.

Full Hu Zhang + Apremilast answer

Can you take Indian Long Pepper with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Indian long pepper might increase the effects and adverse effects of CYP3A4 substrates.

Full Indian Long Pepper + Apremilast answer

Can you take Kratom with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Kratom might increase the levels and clinical effects of drugs metabolized by CYP3A4.

Full Kratom + Apremilast answer

Can you take Lemongrass with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, lemongrass might decrease the metabolism of CYP3A4 substrates.

Full Lemongrass + Apremilast answer

Can you take Lentinan with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Laboratory research suggests that lentinan might increase the activity of cytochrome P450 3A4 (CYP3A4).

Full Lentinan + Apremilast answer

Can you take Licorice with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.

Full Licorice + Apremilast answer

Can you take Lime with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4.

Full Lime + Apremilast answer

Can you take Methoxylated Flavones with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro evidence suggests that methoxylated flavones might inhibit cytochrome P450 3A4 (CYP3A4).

Full Methoxylated Flavones + Apremilast answer

Can you take Moringa with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, moringa might increase or decrease levels of CYP3A4 substrates.

Full Moringa + Apremilast answer

Can you take Neem with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, neem leaf extract might increase the levels and clinical effects of CYP3A4 substrates.

Full Neem + Apremilast answer

Can you take Oregon Grape with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Oregon grape might increase serum levels of drugs metabolized by CYP3A4.

Full Oregon Grape + Apremilast answer

Can you take Padang Cassia with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research shows that a methanol extract of Padang cassia inhibits cytochrome P450 3A4 (CYP3A4) activity.

Full Padang Cassia + Apremilast answer

Can you take Panax Ginseng with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.

Full Panax Ginseng + Apremilast answer

Can you take Peony with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, use of peony may increase the levels and clinical effects of drugs metabolized by CYP3A4.

Full Peony + Apremilast answer

Can you take Peppermint with Apremilast?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, peppermint might increase the levels of CYP3A4 substrates.

Full Peppermint + Apremilast answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Apremilast is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Apremilast, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Apremilast sits in 2 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Apremilast through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Apremilast through this category.

About Apremilast

Apremilast is an oral anti-inflammatory medicine used to treat active psoriatic arthritis, plaque psoriasis, and oral ulcers associated with Behçet's Disease in adults and certain children.

Generic name: Apremilast  ·  Brand name: Otezla.

See the full Apremilast drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Apremilast

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Apremilast.

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Pharmacist Counseling Corner

Apremilast & Supplements: Common Questions

What supplements interact with Apremilast?
More than you might expect — 138 in total, though they are far from equal: 3 are rated major, 94 moderate, and 41 minor. The ranked list on this page puts the ones that genuinely matter first, and every entry opens a full report on that exact pair. The highest-ranked right now: Grapefruit, Activated Charcoal, St. John's Wort.
Which Apremilast supplement interactions are the most serious?
The 3 major-rated combinations — led by Grapefruit, Activated Charcoal and St. John's Wort — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Apremilast?
Usually yes — most people on Apremilast can take most supplements. The catch is the exceptions, and they aren't always the exotic ones (St. John's Wort trips up more prescriptions than almost anything sold next to it). Look up each ingredient you actually take in the list above, and treat "no known interaction" as a green-ish light, not a guarantee. Try the label scanner or the interaction checker.
Do brands like Otezla have the same supplement interactions as Apremilast?
Yes — Otezla all contain Apremilast, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
What about Apremilast and my other medications?
This page covers Apremilast against supplements and herbal ingredients. Checking Apremilast against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Apremilast drug information.

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

Where next

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 23, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.