The short answer
Not known. We found no study that tested giloy (guduchi, Tinospora cordifolia) with tacrolimus, cyclosporine, mycophenolate, azathioprine or steroids such as prednisolone. The concern is about the immune system. In an Indian case series, giloy was linked to autoimmune-like hepatitis, an immune attack on the liver, and may have brought out a hidden autoimmune liver disease.
Nobody has shown that giloy makes these medicines work less well. Its liver risk is documented, though: a study from 13 Indian centres described 43 people with giloy-linked liver injury, four of whom died. If you take an immunosuppressant or a steroid, tell your prescribing doctor before you start giloy.
Sold in India as Pangraf (tacrolimus), Panimun Bioral (cyclosporine), Mycept (mycophenolate), Azoran (azathioprine), Medrol (methylprednisolone) and Dexona (dexamethasone).
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Possible clash with immune-suppressing treatment[1] | Immune activation by giloy proposed, not shown | Could unsettle the condition being treated; loss of drug effect not measured | Theoretical by mechanism |
| Autoimmune-like hepatitis after giloy in six people; one worsened as steroid treatment was tapered[1] | May trigger or unmask autoimmune liver disease | Hepatitis; not shown to block steroids | Case report |
| Liver injury linked to giloy in 43 people across 13 Indian centres[2][3] | Immune-mediated injury suspected | Hepatitis, sometimes severe | Observational |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Case series, 2021 Case report
Six people developed liver injury after taking giloy as an immune booster during the 2020 pandemic, for a median of 90 days. Liver biopsies looked like autoimmune hepatitis, and four people may have had a hidden autoimmune liver disease that giloy brought out. Three were treated with steroids, and one of them worsened as the steroids were tapered. This does not show that giloy blocks steroids, and six cases cannot show how often injury happens.[1]
Study across 13 Indian centres, 2022 Observational
Doctors looked back at 43 people who developed liver injury after taking giloy between April 2020 and July 2021. Symptoms began a median of 46 days after starting it, and giloy was judged the probable cause in 67.4%. Four people died and two needed a liver transplant. People with known autoimmune hepatitis already on immunosuppressants were left out, so the study says nothing directly about giloy taken with these drugs.[2]
What your doctor may watch for
- Liver tests (enzymes and bilirubin), and any yellowing of the eyes or skin (jaundice).[3]
- Tacrolimus blood levels, which the tacrolimus label already asks doctors to monitor.[4]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I take an immunosuppressant or steroid (name and dose) for my condition, and I am taking, or planning to take, giloy (juice, tablets, powder or kadha, and how much). Giloy has been linked to autoimmune-like liver injury. Is it a concern for my condition, and should my liver tests or drug levels be checked?”
Withheld until review
Questions people ask
Does giloy stop steroids from working?
There is no evidence of that. In the case series, three people were given steroids to treat giloy-linked liver injury and one worsened as the steroids were reduced, which does not show that giloy blocks steroids.[1]
Related
Ashwagandha with steroids and transplant drugs
One kidney transplant patient on tacrolimus, mycophenolate and prednisone rejected and lost the kidney after taking ashwagandha.
InteractionNeem and transplant medicines (immunosuppressants)
In lab tests, neem blocked the liver enzymes that clear tacrolimus, which could raise its levels. We found no study of neem with transplant medicines.
InteractionMulethi (licorice) and steroid medicines like prednisolone
Glycyrrhizin from mulethi slowed the clearance of prednisolone in six men. A European regulator advises against licorice with corticosteroids.
InteractionGiloy and paracetamol (Dolo, Crocin)
Not tested together. Giloy is a known cause of liver injury, and the paracetamol label warns people with liver disease. The combined effect is unknown.
Sources
- Nagral A, Adhyaru K, Rudra OS, Gharat A, Bhandare S. Herbal immune booster-induced liver injury in the COVID-19 pandemic: a case series. J Clin Exp Hepatol. 2021;11:732-738. PMID 34230786.
- Kulkarni AV, Hanchanale P, Prakash V, Kalal C, Sharma M, Kumar K, Bishnu S, Kulkarni AV, Anand L, Patwa AK, Kumbar S, Kainth S, Philips CA; Liver Research Club India. Tinospora cordifolia (giloy)-induced liver injury during the COVID-19 pandemic: multicenter nationwide study from India. Hepatol Commun. 2022;6:1289-1300. PMID 35037744.
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Tinospora. Updated 27 June 2025.
- Tacrolimus capsules, US prescribing information (DailyMed).
Awaiting review by The Good Vaidya Medical Board. Prepared from the sources below and checked against each one.
Published 4 November 2026 · Last updated 4 November 2026
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