The short answer
Chaparral has caused serious liver-injury concerns independently of adagrasib. Avoid unsupervised use and discuss it with your cancer team; the exact added combination risk is unknown.
What this answer covers
Oral Larrea tridentata (chaparral) products with oral adagrasib. Product composition and dose in historical spontaneous reports are incompletely characterized.
- Supplement or preparation
- Larrea tridentata
- Medication ingredient
- adagrasib
Chaparral has serious liver-injury reports
An FDA-authored series reviewed 18 illness reports after chaparral ingestion and found liver-injury evidence in 13. Some involved cirrhosis or liver failure requiring transplantation. These reports show a substantial safety concern but cannot tell us how often it occurs among all users.
The combination itself has not been tested
The reports did not involve adagrasib. Krazati independently can cause liver injury and requires laboratory monitoring. It is reasonable to avoid adding an unnecessary liver-risk product, while recognizing that the exact increase in risk from taking both has not been established.
Bring the product to your cancer team
Tell the oncologist or oncology pharmacist if you use chaparral tea, capsules or an extract, including the daily amount and other ingredients. The historical reports do not establish a safe brand, dose or preparation during treatment. Discuss an alternative for the symptom you are trying to manage.
Keep liver checks and report symptoms
Krazati labeling calls for liver tests before treatment, monthly for the first three months and as clinically indicated. Report jaundice, dark urine or persistent upper-abdominal discomfort promptly. Do not rely on hours-apart dosing or adjust your cancer medicine yourself to accommodate the herb.
Evidence and practical considerations
Side effects & toxicity
The added liver-injury risk specifically from chaparral with adagrasib has not been measured.
- Exact scope
- Oral Larrea tridentata (chaparral) products with oral adagrasib. Product composition and dose in historical spontaneous reports are incompletely characterized. with Exact adagrasib RxCUI 2625882 IN, confirmed by current RxNorm properties. Oral Krazati tablets; the August 2026 U.S. label covers single-agent treatment of specified previously treated KRAS G12C-mutated NSCLC. Older cetuximab combination cohorts and regional label instructions are not interchangeable.
- Medication form and route
- Oral
What remains uncertain
- The original series predates adagrasib, lacks an exposed denominator and cannot establish combination incidence.
Factors that may matter: Exact preparation and dose; Treatment phase and duration; Liver function; Electrolyte results and GI symptoms; Other medicines.
Read the supporting source summaries
Source 1: Current U.S. prescribing information
bms.com · Source check Sep 10, 2026
Population: Adults with specified previously treated KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer.
Warns about GI toxicity, QT prolongation and hepatotoxicity. Monitor/correct electrolytes, particularly potassium and magnesium, and monitor liver tests. Strong CYP3A inducers lower exposure. Avoid strong CYP3A inhibitors until steady state, approximately eight days. High-fat meal did not meaningfully change exposure; tablets may be taken with or without food.
How this applies: Exact current U.S. guidance; newer than the retained March 2026 DailyMed version. Exact adagrasib RxCUI 2625882 IN, confirmed by current RxNorm properties. Oral Krazati tablets; the August 2026 U.S. label covers single-agent treatment of specified previously treated KRAS G12C-mutated NSCLC. Older cetuximab combination cohorts and regional label instructions are not interchangeable.
Not direct evidence of each botanical combination. Strong-inhibitor effects after a single dose differ from steady-state model predictions. Effects of adagrasib on other CYP substrates are a separate direction. No universal supplement prescription.
Source 2: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: FDA review of 18 reports associated with ingested chaparral submitted from 1992-1994.
Thirteen reports had evidence of hepatotoxicity; some involved cirrhosis or liver failure requiring transplant.
How this applies: Primary supplement-associated liver injury series, indirect for combined cancer treatment.
Abstract-only spontaneous reports, no exposed denominator, varied products and no adagrasib. Cannot establish exact product potency, causality in every case or a combination event rate.
Source 3: Authoritative medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Medication terminology.
Identifies adagrasib as IN.
How this applies: Exact identity confirmation.
Not clinical interaction evidence.
Research assessment: · Open full citations ↗
Side effects & toxicity
Chaparral’s serious oral liver-injury reports justify avoiding unsupervised use during adagrasib treatment.
- Exact scope
- Oral Larrea tridentata (chaparral) products with oral adagrasib. Product composition and dose in historical spontaneous reports are incompletely characterized. with Exact adagrasib RxCUI 2625882 IN, confirmed by current RxNorm properties. Oral Krazati tablets; the August 2026 U.S. label covers single-agent treatment of specified previously treated KRAS G12C-mutated NSCLC. Older cetuximab combination cohorts and regional label instructions are not interchangeable.
- Medication form and route
- Oral
What remains uncertain
- A clinical precaution based on separate hepatotoxicity evidence, not proof of a synergistic interaction or an exact safe dose.
Factors that may matter: Exact preparation and dose; Treatment phase and duration; Liver function; Electrolyte results and GI symptoms; Other medicines.
Read the supporting source summaries
Source 1: Current U.S. prescribing information
bms.com · Source check Sep 10, 2026
Population: Adults with specified previously treated KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer.
Warns about GI toxicity, QT prolongation and hepatotoxicity. Monitor/correct electrolytes, particularly potassium and magnesium, and monitor liver tests. Strong CYP3A inducers lower exposure. Avoid strong CYP3A inhibitors until steady state, approximately eight days. High-fat meal did not meaningfully change exposure; tablets may be taken with or without food.
How this applies: Exact current U.S. guidance; newer than the retained March 2026 DailyMed version. Exact adagrasib RxCUI 2625882 IN, confirmed by current RxNorm properties. Oral Krazati tablets; the August 2026 U.S. label covers single-agent treatment of specified previously treated KRAS G12C-mutated NSCLC. Older cetuximab combination cohorts and regional label instructions are not interchangeable.
Not direct evidence of each botanical combination. Strong-inhibitor effects after a single dose differ from steady-state model predictions. Effects of adagrasib on other CYP substrates are a separate direction. No universal supplement prescription.
Source 2: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: FDA review of 18 reports associated with ingested chaparral submitted from 1992-1994.
Thirteen reports had evidence of hepatotoxicity; some involved cirrhosis or liver failure requiring transplant.
How this applies: Primary supplement-associated liver injury series, indirect for combined cancer treatment.
Abstract-only spontaneous reports, no exposed denominator, varied products and no adagrasib. Cannot establish exact product potency, causality in every case or a combination event rate.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Sources checked and article drafted. | |
| Research summary published |
Article revision: 63951b476da37d99
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.