Medication interaction hub

What Supplements Interact with Telotristat Etiprate?

Telotristat Etiprate brand name: Xermelo. Every interaction below applies to the brands too.

36 Interactions 1 Major 26 Moderate 9 Minor
Curated & coded by · Clinical Pharmacist · Updated September 25, 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 Telotristat Etiprate? 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 Telotristat Etiprate 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.

Telotristat etiprate (Xermelo) works in the gut to calm the severe diarrhea of carcinoid syndrome, and the lone major-rated interaction among its 36 flagged supplements strikes at that point. Activated charcoal can soak up the drug before it reaches the bloodstream, and 17 of the entries, mostly bulking fibers and charcoal products, can block or slow its absorption. I'd treat this list with real care rather than a shrug. A pill that never gets absorbed never works.

The other 19 ingredients cut the opposite direction. Telotristat can rev up a liver enzyme called CYP3A4, which may weaken things like CBD and, more concerning, speed the conversion of pyrrolizidine alkaloids in herbs such as comfrey into liver-damaging byproducts. Alongside the single major rating sit 26 moderate and nine minor entries. Space fibers and charcoal well away from your dose, and check the herb list below carefully.

— , Clinical Pharmacist · July 18, 2026

Major 1 Moderate 26 Minor 9 No known interaction 1,416

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

Telotristat Etiprate: Top Interactions at a Glance

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

Showing the 12 highest-ranked of 36 interacting ingredients — plus 1,416 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

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

Major Likelihood Probable Activated Charcoal + Telotristat Etipratei

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 Telotristat Etiprate

All 1,452 ingredients in our database, ranked by severity — 36 with a Telotristat Etiprate interaction on file and 1,416 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 Telotristat Etiprate?

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 Comfrey with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Delta-9-tetrahydrocannabinol (thc) with Telotristat Etiprate?

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

Full Delta-9-tetrahydrocannabinol (thc) + Telotristat Etiprate answer

Can you take Dusty Miller with Telotristat Etiprate?

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 dusty miller.

Full Dusty Miller + Telotristat Etiprate answer

Can you take Evodia with Telotristat Etiprate?

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

Full Evodia + Telotristat Etiprate answer

Can you take Golden Ragwort with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Gravel Root with Telotristat Etiprate?

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 Gravel Root + Telotristat Etiprate answer

Can you take Groundsel with Telotristat Etiprate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking CYP3A4 inducers with groundsel might increase the risk of pyrrolizidine alkaloid toxicity, such as hepatotoxicity.

Full Groundsel + Telotristat Etiprate answer

Can you take Guar Gum with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Gum Arabic with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Hemp Agrimony with Telotristat Etiprate?

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

Full Hemp Agrimony + Telotristat Etiprate answer

Can you take Hound's Tongue with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Ostarine with Telotristat Etiprate?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use of ostarine with CYP3A4 inducers could decrease the clinical effects of ostarine.

Full Ostarine + Telotristat Etiprate answer

Can you take Slippery Elm with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Tansy Ragwort with Telotristat Etiprate?

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 tansy ragwort...

Full Tansy Ragwort + Telotristat Etiprate answer

Can you take Tragacanth with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Thyroid Extract with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Agar with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Algin with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Black Psyllium with Telotristat Etiprate?

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 + Telotristat Etiprate answer

Can you take Blond Psyllium with Telotristat Etiprate?

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

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

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 Telotristat Etiprate 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 Telotristat Etiprate through this category.

About Telotristat Etiprate

Telotristat is a tryptophan hydroxylase inhibitor used to treat carcinoid syndrome diarrhea in adults whose symptoms are not adequately controlled by somatostatin analog therapy.

Generic name: Telotristat Etiprate  ·  Brand name: Xermelo.

See the full Telotristat drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Telotristat Etiprate

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 Telotristat Etiprate.

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Products that contain Telotristat Etiprate-interacting ingredients

Real supplements from the NIH label database that contain the top interacting ingredients on this page — each one is worth a full label check before combining with Telotristat Etiprate.

Alkanet Root Powder by Bixa Botanical contains Alkanna
Pharmacist Counseling Corner

Telotristat Etiprate & Supplements: Common Questions

What supplements interact with Telotristat Etiprate?
More than you might expect — 36 in total, though they are far from equal: 1 are rated major, 26 moderate, and 9 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: Activated Charcoal, Coffee Charcoal, European Mandrake.
Which Telotristat Etiprate supplement interactions are the most serious?
Focus on the major group: Activated Charcoal. 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 Telotristat Etiprate?
Usually yes — most people on Telotristat Etiprate 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 Xermelo have the same supplement interactions as Telotristat Etiprate?
Yes — Xermelo all contain Telotristat Etiprate, 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 Telotristat Etiprate and my other medications?
This page covers Telotristat Etiprate against supplements and herbal ingredients. Checking Telotristat Etiprate 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 Telotristat 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 25, 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.