Medication interaction hub

What Supplements Interact with Mitapivat?

Mitapivat brand name: Pyrukynd. Every interaction below applies to the brands too.

154 Interactions 3 Major 111 Moderate 40 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 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 Mitapivat? 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 Mitapivat 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

154 supplements and herbal ingredients have interactions with Mitapivat on file in the HelloPharmacist interaction database — 3 rated major, 111 moderate, and 40 minor. The most serious involve Grapefruit, Activated Charcoal and St. John's Wort.

Our assessment: with 3 major-rated interactions on the list, this one deserves real attention — know the major entries before combining anything with Mitapivat.

Major 3 Moderate 111 Minor 40 No known interaction 1,298

Ranked by severity below. Every entry links to the full pharmacist-reviewed report for that exact combination — what can happen, how likely it is, and what to do about it.

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 ↓

Most Viewed Ingredient Interactions

Mitapivat: Top Interactions at a Glance

The Mitapivat supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 154 interacting ingredients — plus 1,298 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Mitapivat Combinations Today

The Mitapivat + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Minor Likelihood Possible Cascara Sagrada + Mitapivati

Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.

Read the full interaction Moderate Likelihood Possible Golden Ragwort + Mitapivati

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in golden ragwort.

Read the full interaction Moderate Likelihood Possible Alpine Ragwort + Mitapivati

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in alpine ragwort.

Read the full interaction Moderate Likelihood Possible Hound's Tongue + Mitapivati

Theoretically, CYP3A4 inducers can increase the toxicity of the pyrrolizidine alkaloid (PA) constituents of hound's tongue.

Read the full interaction Major Likelihood Likely Grapefruit + Mitapivati

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Probable Activated Charcoal + Mitapivati

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

Read the full interaction
The complete list

Every Supplement Checked Against Mitapivat

All 1,452 ingredients in our database, ranked by severity — 154 with a Mitapivat interaction on file and 1,298 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 Mitapivat?

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 Cascara Sagrada with Mitapivat?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.

Full Cascara Sagrada + Mitapivat answer

Can you take Golden Ragwort with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in golden ragwor...

Full Golden Ragwort + Mitapivat answer

Can you take Alpine Ragwort with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid (PA) constituents in alpine ragwor...

Full Alpine Ragwort + Mitapivat answer

Can you take Hound's Tongue with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, CYP3A4 inducers can increase the toxicity of the pyrrolizidine alkaloid (PA) constituents of hound's tongue.

Full Hound's Tongue + Mitapivat answer

Can you take Bog Labrador Tea with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research shows that aqueous and ethanolic extracts of Bog Labrador tea leaves can increase the concentration of cytochrome P450 3A4...

Full Bog Labrador Tea + Mitapivat answer

Can you take Boneset with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Boneset belongs to the genus Eupatorium, and many species of this genus contain hepatotoxic pyrrolizidine alkaloids (PAs).

Full Boneset + Mitapivat answer

Can you take Borage with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.

Full Borage + Mitapivat answer

Can you take Boswellia Serrata with Mitapivat?

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

Full Boswellia Serrata + Mitapivat answer

Can you take Bulbine Natalensis with Mitapivat?

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

Full Bulbine Natalensis + Mitapivat answer

Can you take Butterbur with Mitapivat?

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

Full Butterbur + Mitapivat answer

Can you take Calamus with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effec...

Full Calamus + Mitapivat answer

Can you take Cannabis with Mitapivat?

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

Full Cannabis + Mitapivat answer

Can you take Cat's Claw with Mitapivat?

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

Full Cat's Claw + Mitapivat answer

Can you take Ceylon Leadwort with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Full Ceylon Leadwort + Mitapivat answer

Can you take Chanca Piedra with Mitapivat?

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

Full Chanca Piedra + Mitapivat answer

Can you take Chokeberry with Mitapivat?

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

Full Chokeberry + Mitapivat answer

Can you take Clove with Mitapivat?

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

Full Clove + Mitapivat answer

Can you take Coleus with Mitapivat?

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

Full Coleus + Mitapivat answer

Can you take Coltsfoot with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Hepatotoxic pyrrolizidine alkaloids (PA) are substrates of cytochrome P450 3A4 (CYP3A4).

Full Coltsfoot + Mitapivat answer

Can you take Comfrey with Mitapivat?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid constituents in comfrey.

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

Mitapivat 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 Mitapivat through this category.

Cytochrome P450 3A4 (Cyp3A4) Inducers 19 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.

19 of the supplement ingredients on this page reach Mitapivat 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 Mitapivat through this category.

Cytochrome P450 2C9 (Cyp2C9) Inducers 3 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.

3 of the supplement ingredients on this page reach Mitapivat through this category.

Cytochrome P450 2C19 (Cyp2C19) Inducers 2 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.

2 of the supplement ingredients on this page reach Mitapivat through this category.

About Mitapivat

Mitapivat is a pyruvate kinase activator used to treat hemolytic anemia in adults with pyruvate kinase (PK) deficiency (Pyrukynd) and anemia in adults with alpha- or beta-thalassemia (Aqvesme).

Generic name: Mitapivat  ·  Brand name: Pyrukynd.

See the full Mitapivat drug information
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Take a Supplement Product? Check the Whole Bottle Against Mitapivat

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 Mitapivat.

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Pharmacist Counseling Corner

Mitapivat & Supplements: Common Questions

What supplements interact with Mitapivat?
More than you might expect — 154 in total, though they are far from equal: 3 are rated major, 111 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, St. John's Wort.
Which Mitapivat supplement interactions are the most serious?
Focus on the major group: Grapefruit, Activated Charcoal and St. John's Wort. A major rating means the combination can be clinically significant, not that harm is guaranteed — but it's exactly the kind of thing to run past your pharmacist before your next dose, not after. Jump to the ranked list.
Can I take vitamins or supplements while on Mitapivat?
Usually yes — most people on Mitapivat 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 Pyrukynd have the same supplement interactions as Mitapivat?
Yes — Pyrukynd all contain Mitapivat, 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 Mitapivat and my other medications?
This page covers Mitapivat against supplements and herbal ingredients. Checking Mitapivat 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 Mitapivat 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 22, 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.