The short answer
Have goldenseal reviewed before taking it with entrectinib. A human study found a modest effect on a CYP3A probe drug, but this does not establish how much goldenseal changes entrectinib levels or whether it increases toxicity.
What this answer covers
Hydrastis canadensis preparations with oral entrectinib. Human CYP3A probe effects do not establish exact cancer-drug exposure or toxicity.
- Supplement or preparation
- Hydrastis canadensis
- Medication ingredient
- entrectinib
Check the exact treatment
This review concerns oral entrectinib in ROZLYTREK capsules or oral pellets for selected gene-fusion cancers. The medicine produces an active metabolite called M5. Follow the instructions for the prescribed formulation; a change in parent-drug levels does not automatically describe total active exposure.
What the goldenseal study actually measured
A clinical study found about a 1.43-fold increase in midazolam total exposure after a particular goldenseal preparation. Other probe drugs behaved differently. This is evidence that the tested product can affect drug handling, but it is not proof that it acts like a strong inhibitor or changes all medicines by the same amount.
The cancer-drug data involve different substances
An entrectinib study used strong drug inhibitors and inducers, not goldenseal. Entrectinib and its active M5 metabolite were measured separately. The large parent-drug change with itraconazole cannot be assigned to a weaker botanical preparation or assumed to represent the same change in total active exposure.
Avoid making your own dose adjustment
Show the pharmacist the goldenseal product, amount and recent use. The cancer team can decide whether to avoid it and how to monitor treatment. No validated goldenseal spacing interval or automatic cancer-drug dose change was established; do not use another inhibitor’s dose instructions on your own.
Evidence and practical considerations
Absorption & effectiveness
A possible metabolic interaction warrants review, while the original exact-pair exposure/toxicity assertion remains insufficiently demonstrated.
- Exact scope
- Hydrastis canadensis preparations with oral entrectinib. Human CYP3A probe effects do not establish exact cancer-drug exposure or toxicity. with RxNorm 2197862 IN entrectinib. Current exact oral product: ROZLYTREK oral entrectinib capsules and pellets. Salt/formulation named explicitly; no transfer to unrelated drugs or routes.
- Medication form and route
- Oral
What remains uncertain
- Exact combination unstudied in checked originals. Tested goldenseal produced weak CYP3A probe inhibition, not demonstrated equivalence to label-defined moderate/strong inhibitors; no exact toxicity outcome.
Factors that may matter: Exact oral formulation and supplement preparation; Drug exposure versus clinical outcomes; Dose, duration and other medicines; Individual monitoring plan.
Read the supporting source summaries
Source 1: Current original prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed the exact oral formulation.
Avoid moderate/strong CYP3A inducers/inhibitors; parent drug and M5 exposure must be distinguished.
How this applies: RxNorm 2197862 IN entrectinib. Current exact oral product: ROZLYTREK oral entrectinib capsules and pellets. Salt/formulation named explicitly; no transfer to unrelated drugs or routes.
Exact current oral product source, not a clinical trial of every supplement. Formulation, dose, population and mechanism remain explicit.
Source 2: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Healthy adults in a clinical probe-cocktail study.
Midazolam AUC increased 1.43-fold; effects differed across other probes, with little effect on rosuvastatin/furosemide and reduced metformin exposure.
How this applies: Exact reported preparation, population and endpoints; transfer to entrectinib explicitly limited.
Original body read; weak CYP3A effect in this tested preparation, not proof of strong/moderate inhibition, exact target drug exposure or toxicity.
Source 3: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Healthy subjects and patients in separate clinical studies.
CYP3A inhibitors/inducers affected entrectinib and active M5 differently; parent exposure cannot represent the active sum automatically.
How this applies: Exact reported preparation, population and endpoints; transfer to entrectinib explicitly limited.
Original body; drug probes, not any named botanical, and exact experimental dose/form retained.
Source 4: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
entrectinib is IN.
How this applies: Exact ingredient.
Not clinical evidence.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Sources checked and article drafted. |
Article revision: d2343220691d20ac
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.