Medication interaction hub

What Supplements Interact with Sirolimus?

Sirolimus brand name: Rapamune. Every interaction below applies to the brands too.

188 Interactions 3 Major 149 Moderate 36 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 Sirolimus? 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 Sirolimus 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.

Sirolimus (Rapamune) is the anti-rejection medicine transplant patients depend on, and it is a narrow-therapeutic-index drug, meaning small shifts in its blood level can invite rejection on one side or toxicity on the other. That is why the 188 supplements on this page deserve genuine wariness, starting with the three rated major. Grapefruit and St. John's wort push sirolimus levels in opposite directions by acting on the same liver enzyme that clears it, and activated charcoal can soak up the drug in the gut before it ever reaches the blood.

Most of the 149 moderate entries do a gentler version of the same thing, nudging sirolimus levels up or down through that enzyme or the gut pumps that move it, while 53 are immune-stimulating herbs that could work against the drug's entire purpose. The 36 minor entries carry less weight, but with a margin this slim, I would run every supplement past the transplant team.

— , Clinical Pharmacist · July 18, 2026

Major 3 Moderate 149 Minor 36 No known interaction 1,264

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

Sirolimus: Top Interactions at a Glance

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

Showing the 12 highest-ranked of 188 interacting ingredients — plus 1,264 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

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

Major Likelihood Likely Grapefruit + Sirolimusi

Grapefruit juice can increase levels of drugs metabolized by CYP3A4.

Read the full interaction Major Likelihood Probable Activated Charcoal + Sirolimusi

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 + Sirolimusi

St.

Read the full interaction
The complete list

Every Supplement Checked Against Sirolimus

All 1,452 ingredients in our database, ranked by severity — 188 with a Sirolimus interaction on file and 1,264 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 Sirolimus?

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 Carob with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, carob might also impair the absorption of oral drugs.

Full Carob + Sirolimus answer

Can you take Agar with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Agar forms a thick gel, which may disrupt the absorption of nutrients and medications.

Full Agar + Sirolimus answer

Can you take Algin with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, algin can alter the absorption of oral drugs.

Full Algin + Sirolimus answer

Can you take Atractylodes with Sirolimus?

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

Full Atractylodes + Sirolimus answer

Can you take Bael with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro.

Full Bael + Sirolimus answer

Can you take Baikal Skullcap with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, Baikal skullcap might increase levels of drugs transported by P-glycoprotein.

Full Baikal Skullcap + Sirolimus answer

Can you take Black Psyllium with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Full Black Psyllium + Sirolimus answer

Can you take Blond Psyllium with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Full Blond Psyllium + Sirolimus answer

Can you take Breadfruit with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, breadfruit might inhibit cytochrome P450 3A4 (CYP3A4) and increase levels of drugs metabolized by these enzymes; until more i...

Full Breadfruit + Sirolimus answer

Can you take Cascara Sagrada with Sirolimus?

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 + Sirolimus answer

Can you take Fucus Vesiculosus with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.

Full Fucus Vesiculosus + Sirolimus answer

Can you take Hemp with Sirolimus?

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

Full Hemp + Sirolimus answer

Can you take Hibiscus Sabdariffa with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.

Full Hibiscus Sabdariffa + Sirolimus answer

Can you take Honey with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, honey might decrease levels of drugs metabolized by CYP3A4, but research is conflicting.

Full Honey + Sirolimus answer

Can you take Hops with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.

Full Hops + Sirolimus answer

Can you take Karaya Gum with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Co-administration of oral drugs with bulk forming laxatives such as karaya gum may decrease, increase, or have no effect on the absorption o...

Full Karaya Gum + Sirolimus answer

Can you take Lychee with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, lychee might reduce the effectiveness of immunosuppressant drugs.

Full Lychee + Sirolimus answer

Can you take Marshmallow with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, mucilage in marshmallow might impair absorption of oral drugs.

Full Marshmallow + Sirolimus answer

Can you take Passion Flower with Sirolimus?

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

Full Passion Flower + Sirolimus answer

Can you take Puravive with Sirolimus?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Puravive contains Panax ginseng.

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

Sirolimus 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 Sirolimus through this category.

Immunosuppressants 53 ingredients

Medications that damp down the immune system. Supplements that stimulate immunity can work against them.

53 of the supplement ingredients on this page reach Sirolimus through this category.

P-Glycoprotein Substrates 37 ingredients

A drug-transport group: these medications are moved in and out of cells by the P-glycoprotein pump. Supplements that affect the pump can change how much of the drug is absorbed or kept in the body.

37 of the supplement ingredients on this page reach Sirolimus 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 Sirolimus through this category.

Sirolimus (Rapamune) 5 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.

5 of the supplement ingredients on this page reach Sirolimus through this category.

About Sirolimus

Sirolimus is an immunosuppressant medication used to prevent the body from rejecting a kidney transplant.

Generic name: Sirolimus  ·  Brand name: Rapamune.

See the full Sirolimus drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Sirolimus

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 Sirolimus.

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Pharmacist Counseling Corner

Sirolimus & Supplements: Common Questions

What supplements interact with Sirolimus?
Our database currently documents 188 ingredients with a known Sirolimus interaction (3 major, 149 moderate, 36 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 188. The highest-ranked right now: Grapefruit, Activated Charcoal, St. John's Wort.
Which Sirolimus 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 Sirolimus?
Plenty of supplements coexist fine with Sirolimus; a shorter list does not. Rather than memorizing it, check the specific ingredients on your labels — the ranked list above covers every one we've checked, and multi-ingredient products can be checked label-by-label with our scanner. Try the label scanner or the interaction checker.
Do brands like Rapamune have the same supplement interactions as Sirolimus?
Yes — Rapamune all contain Sirolimus, 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 Sirolimus and my other medications?
This page covers Sirolimus against supplements and herbal ingredients. Checking Sirolimus 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 Sirolimus 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 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.