Medication interaction hub

What Supplements Interact with Lefamulin Acetate?

Lefamulin Acetate brand name: Xenleta. Every interaction below applies to the brands too.

178 Interactions 8 Major 130 Moderate 40 Minor
Curated & coded by · Clinical Pharmacist · Updated October 1, 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 Lefamulin Acetate? 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 Lefamulin Acetate 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.

Before adding any supplement to lefamulin acetate (Xenleta), a short-course antibiotic for pneumonia, look hard at the eight major-rated entries among its 178 documented interactions. They cluster around two dangers: ingredients that change how much lefamulin reaches your blood, and ingredients that can stretch the heart's rhythm on top of this drug's own effect on it. Grapefruit can push levels up, while St. John's wort can pull them down enough to weaken the antibiotic.

Most of the 130 moderate entries are quieter. Many are probiotics, which any antibiotic can kill off, so space them well apart from your dose. Others slow or block absorption of the pill itself; activated charcoal is the major-rated example. The 40 minor entries echo these themes at lower strength. Since a pneumonia course lasts only days, pausing a questionable supplement until treatment ends costs you little and removes the doubt entirely.

— , Clinical Pharmacist · July 18, 2026

Major 8 Moderate 130 Minor 40 No known interaction 1,274

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

Lefamulin Acetate: Top Interactions at a Glance

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

Showing the 12 highest-ranked of 178 interacting ingredients — plus 1,274 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

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

Major Likelihood Likely Grapefruit + Lefamulin Acetatei

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Probable Activated Charcoal + Lefamulin Acetatei

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 Arsenic + Lefamulin Acetatei

Arsenic trioxide can prolong the QT interval.

Read the full interaction Major Likelihood Probable Cesium + Lefamulin Acetatei

Theoretically, taking cesium concomitantly with other drugs that prolong the QT interval may increase the risk of ventricular arrhythmias and death.

Read the full interaction Major Likelihood Probable Ephedra + Lefamulin Acetatei

Theoretically, ephedra might have an additive effect with drugs that prolong the QT interval.

Read the full interaction Major Likelihood Probable Sida Cordifolia + Lefamulin Acetatei

Theoretically, Sida cordifolia might increase the risk of additive QT interval prolongation when taken with QT interval-prolonging drugs.

Read the full interaction
The complete list

Every Supplement Checked Against Lefamulin Acetate

All 1,452 ingredients in our database, ranked by severity — 178 with a Lefamulin Acetate interaction on file and 1,274 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 Lefamulin Acetate?

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 Resveratrol with Lefamulin Acetate?

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

Full Resveratrol + Lefamulin Acetate answer

Can you take Rooibos with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking rooibos with CYP3A4 substrates may increase the effects of CYP3A4 substrates.

Full Rooibos + Lefamulin Acetate answer

Can you take Sage with Lefamulin Acetate?

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

Full Sage + Lefamulin Acetate answer

Can you take Schizonepeta with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, induces cytochrome P450 (CYP) 3A4.

Full Schizonepeta + Lefamulin Acetate answer

Can you take Slippery Elm with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.

Full Slippery Elm + Lefamulin Acetate answer

Can you take Sulforaphane with Lefamulin Acetate?

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

Full Sulforaphane + Lefamulin Acetate answer

Can you take Sweet Annie with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Sweet Annie may alter plasma levels and clinical effects of drugs metabolized by CYP3A4.

Full Sweet Annie + Lefamulin Acetate answer

Can you take Syrian Rue with Lefamulin Acetate?

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

Full Syrian Rue + Lefamulin Acetate answer

Can you take Terminalia with Lefamulin Acetate?

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

Full Terminalia + Lefamulin Acetate answer

Can you take Thunder God Vine with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of thunder god vine constituents.

Full Thunder God Vine + Lefamulin Acetate answer

Can you take Tragacanth with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, tragacanth might alter absorption of oral drugs.

Full Tragacanth + Lefamulin Acetate answer

Can you take Turmeric with Lefamulin Acetate?

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

Full Turmeric + Lefamulin Acetate answer

Can you take Uva Ursi with Lefamulin Acetate?

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

Full Uva Ursi + Lefamulin Acetate answer

Can you take Vitamin E with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.

Full Vitamin E + Lefamulin Acetate answer

Can you take White Pepper with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro evidence suggests that piperine, a constituent of white pepper, inhibits cytochrome P450 3A4 (CYP3A4).

Full White Pepper + Lefamulin Acetate answer

Can you take Wild Cherry with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research suggests that wild cherry can inhibit cytochrome P450 3A4 (CYP3A4) enzymes.

Full Wild Cherry + Lefamulin Acetate answer

Can you take Yohimbe with Lefamulin Acetate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.

Full Yohimbe + Lefamulin Acetate answer

Can you take Zedoary with Lefamulin Acetate?

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

Full Zedoary + Lefamulin Acetate answer

Can you take Thyroid Extract with Lefamulin Acetate?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Food and medications can interfere with thyroid hormone absorption.

Full Thyroid Extract + Lefamulin Acetate answer

Can you take Aegeline with Lefamulin Acetate?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Aegeline inhibits cytochrome P450 3A4 (CYP3A4) activity in vitro.

Full Aegeline + Lefamulin Acetate 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) Lefamulin Acetate is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Lefamulin Acetate, 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.

Lefamulin Acetate sits in 5 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 Lefamulin Acetate through this category.

Antibiotic Drugs 27 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.

27 of the supplement ingredients on this page reach Lefamulin Acetate 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 Lefamulin Acetate through this category.

Cytochrome P450 3A4 (Cyp3A4) Inhibitors 13 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.

13 of the supplement ingredients on this page reach Lefamulin Acetate through this category.

Qt Interval-Prolonging Drugs 13 ingredients

Medications that can affect the heart's electrical rhythm (the QT interval). Supplements with similar effects can add to that risk.

13 of the supplement ingredients on this page reach Lefamulin Acetate through this category.

About Lefamulin Acetate

Lefamulin is an antibacterial medicine used to treat community-acquired bacterial pneumonia (a lung infection caught outside of a hospital) in adults.

Generic name: Lefamulin Acetate  ·  Brand name: Xenleta.

See the full Lefamulin Injection drug information

Related: does Lefamulin Acetate deplete any nutrients?

Lefamulin Acetate has 7 reported nutrient associations in the research literature — see the Lefamulin Acetate nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Lefamulin Acetate

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 Lefamulin Acetate.

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Pharmacist Counseling Corner

Lefamulin Acetate & Supplements: Common Questions

What supplements interact with Lefamulin Acetate?
More than you might expect — 178 in total, though they are far from equal: 8 are rated major, 130 moderate, and 40 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, Arsenic.
Which Lefamulin Acetate supplement interactions are the most serious?
The 8 major-rated combinations — led by Grapefruit, Activated Charcoal, Arsenic, Cesium and Ephedra — 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 Lefamulin Acetate?
Usually yes — most people on Lefamulin Acetate 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 Xenleta have the same supplement interactions as Lefamulin Acetate?
Yes — Xenleta all contain Lefamulin Acetate, 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.
Does Lefamulin Acetate deplete any vitamins or nutrients?
It might — Lefamulin Acetate has 7 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Lefamulin Acetate nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Lefamulin Acetate and my other medications?
This page covers Lefamulin Acetate against supplements and herbal ingredients. Checking Lefamulin Acetate 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 Lefamulin Injection drug information.

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

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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 October 1, 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.