Medical Oncologist
Medicines
Medicines, foods and supplements to avoid on sacituzumab govitecan
Some medicines change how the body breaks down the chemotherapy part of sacituzumab govitecan, and others add to its side effects. Live vaccines should be avoided, and herbal products need checking. This page explains the main groups to watch, common everyday questions, and why your team needs a full list of what you take.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- What should you avoid while on sacituzumab govitecan?
- The kinds of products to check
- Common products and the usual advice
- The vocabulary, in plain language
- The limits of what is known
- Food, drink and daily habits
- Seeing other doctors and pharmacies
- What people assume about interactions
- Common questions about interactions
The short answer
What should you avoid while on sacituzumab govitecan?
Sacituzumab govitecan releases a chemotherapy drug called SN-38 in the body. SN-38 is broken down mainly in the liver by an enzyme called UGT1A1. Anything that slows this enzyme can let SN-38 build up, making low white cell counts and loose motions more severe. Anything that speeds it up may lower the amount of active drug. For this reason the official label advises avoiding medicines that strongly block or boost UGT1A1 where possible. Examples your team may check for include atazanavir, used for HIV, and medicines that speed up liver enzymes, such as rifampicin for tuberculosis and some epilepsy medicines like phenytoin and carbamazepine. The herbal remedy St John's wort can also speed up drug breakdown. Beyond enzyme effects, some medicines add to the side effects: other drugs that lower blood counts, laxatives or stool softeners during loose motions, and medicines that can harm the kidneys when you are dehydrated. Live vaccines should be avoided because your immune system is weakened. There is no specific food known to interact with sacituzumab govitecan, but food safety matters when white cell counts are low, and alcohol can worsen dehydration and strain the liver. Herbal and ayurvedic products are a grey area, because they are rarely tested with cancer medicines. The safest rule is simple: tell your oncology team about everything you take, including tablets, tonics, powders and home remedies, before starting and whenever anything changes.
The liver enzyme matters
Medicines that block or boost UGT1A1 can change how much drug stays active.
Side effects can add up
Some medicines make low counts, loose motions or dehydration worse.
Always check first
Ask your team or pharmacist before starting any new medicine or supplement.
This page gives general information only. It is not a complete list of interactions.Main groups
The kinds of products to check
These are examples, not a full list. Your pharmacist can check your own medicines.
Enzyme blockers
Medicines that slow UGT1A1, such as atazanavir, can raise SN-38 levels and increase the risk of severe low counts and loose motions.
Enzyme boosters
Rifampicin, phenytoin, carbamazepine and St John's wort can speed up breakdown and may make the treatment less effective.
Never stop epilepsy medicine without advice.Medicines that add to side effects
Laxatives during loose motions, other medicines that lower blood counts, and regular painkillers such as ibuprofen when you are dehydrated.
Vaccines and remedies
Live vaccines should be avoided, and herbal products need checking.
Tell your team about
- Ayurvedic, homeopathic or Unani products
- Protein powders and tonics
- Medicines from other doctors
Examples
Common products and the usual advice
Product
Usual advice
Paracetamol
Often fine for pain, but do not use it to bring down a fever before calling your team
Loperamide
Used for late loose motions, exactly as your team instructs
Laxatives and stool softeners
Stop them if loose motions start, and ask before restarting
Vitamins and minerals
Usually only if a deficiency is found, after checking with your team
Herbal and ayurvedic products
Avoid unless your oncologist agrees, as effects are largely unknown
Words you will hear
The vocabulary, in plain language
- Drug interaction
- When one product changes how another medicine works or how strong its side effects are.
- SN-38
- The chemotherapy part of sacituzumab govitecan.
- UGT1A1
- A liver enzyme that breaks down SN-38 so it can leave the body.
- Enzyme inducer
- A product that speeds up the breakdown of other medicines.
- Enzyme inhibitor
- A product that slows the breakdown of other medicines.
- Live vaccine
- A vaccine containing a weakened germ, which is unsafe when immunity is low.
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Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
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Being straight with you
The limits of what is known
Formal interaction studies with sacituzumab govitecan are limited, so much of the advice is based on how SN-38 behaves and on experience with similar drugs.
Not every interaction is listed
A product missing from this page is not automatically safe.
Herbal products are unpredictable
Strength and contents vary between brands and batches, which makes effects hard to judge.
Sometimes a needed medicine is continued
If a medicine is important for another condition, your team may keep it and monitor you more closely.
What this page cannot tell you
It cannot check your own medicine list. A pharmacist or your oncologist should do that.
Food and drink
Food, drink and daily habits
No particular food is known to change how sacituzumab govitecan works, but some everyday choices still matter during treatment.
Food safety
When counts are low, eat freshly cooked hot food, drink boiled or filtered water, and avoid street food, raw sprouts, undercooked eggs and unpasteurised milk or paneer.
Alcohol
Alcohol can worsen dehydration, upset the stomach and add strain to the liver. Many people find it best avoided, especially around infusion days.
Spicy and oily food
These do not interact with the drug, but they can make loose motions worse.
Smoking and chewing tobacco
Tobacco raises infection risk and slows healing. Stopping helps, and support is available.
Other care
Seeing other doctors and pharmacies
Interactions often happen when different doctors prescribe without knowing the full picture.
Carry a medicines list
Keep an up-to-date list, including doses, and show it to every doctor, dentist and pharmacist.
Say you are on chemotherapy
Tell your family doctor, dentist or local chemist that you receive sacituzumab govitecan before they prescribe antibiotics, antifungals, epilepsy medicines or anything for tuberculosis or HIV.
Use one pharmacy where possible
A regular pharmacist is more likely to spot a clash between medicines.
Commonly believed
What people assume about interactions
Natural remedies cannot interfere with cancer medicines.
Some herbs change how the liver handles drugs, and many are untested.
Immunity boosters help during treatment.
None is proven to raise white cells, and some may interact.
Over-the-counter medicines are always safe.
Laxatives, painkillers and cold remedies can still cause problems.
I should stop all my regular medicines.
Never stop prescribed medicines without advice. Your team will check them.
Questions we are asked
Common questions about interactions
Can I take paracetamol?
Paracetamol is generally used for aches and pains during treatment, at the dose your doctor recommends. The important exception is fever: do not take it to lower a temperature before contacting your team, because it can hide an infection that needs urgent treatment when your white cell count may be low.
Is it safe to take antibiotics?
Most antibiotics can be used when needed, and they are essential if you develop an infection. A few, such as rifampicin, may change how the drug is broken down. Make sure whoever prescribes knows you are on sacituzumab govitecan, and tell your oncology team about any new antibiotic.
Can I drink tea or coffee?
Tea and coffee are not known to interact with the drug. However, strong or large amounts can worsen loose motions and dehydration. If you are having loose motions, weaker drinks and more water or oral rehydration solution are usually a better choice.
What about turmeric, giloy or ashwagandha?
Small amounts of turmeric used in everyday cooking are not a concern. Concentrated capsules, extracts and herbal tonics are different, because their effects on the liver and on cancer medicines are largely unknown. Some herbal products have also been linked to liver problems. Please ask your oncologist before taking them.
Can I have vaccines?
Live vaccines should be avoided during treatment. Inactivated vaccines, such as the flu injection, are often recommended, though timing matters because your response may be weaker. Household members may be advised on vaccines too. Ask your team before any vaccination.
I take medicine for epilepsy. Is that a problem?
Some epilepsy medicines, such as phenytoin and carbamazepine, can speed up drug breakdown. Do not stop or change them yourself, as that could trigger seizures. Your oncologist and neurologist may discuss whether another epilepsy medicine is suitable during treatment.
Can I take my diabetes and blood pressure tablets?
Usually yes. However, loose motions, vomiting and poor appetite can affect blood sugar and blood pressure, and some tablets may need adjusting while you are unwell or dehydrated. Ask your team for a sick-day plan for these medicines.
Does it interact with anti-sickness medicines?
The anti-sickness medicines given before and after the drip are chosen to be used with this treatment. If you are prescribed extra ones by another doctor, or buy remedies for acidity or sickness, check with your team to avoid doubling up or unwanted effects.
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Sources
- European Medicines Agency — Trodelvy product information
- Macmillan Cancer Support — Sacituzumab govitecan (Trodelvy)
- National Cancer Institute — Complementary and alternative medicine
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.