Herbal anti-inflammatory agents
ATC code: A07XA-CURCUMIN (Curcumin (Curcuma longa extract) – local code)
Brand names – supplements
Curcumin C3 Complex, Meriva (Indena), Theracurmin HP, Thorne Meriva 500-SF, Doctor's Best High Absorption Curcumin
Supplements are not tested in clinical trials and are not registered as medications.
Curcumin is the main active component of turmeric root (Curcuma longa). Inhibits the transcription factor NF-κB, pro-inflammatory cytokine synthesis (TNF-α, IL-1, IL-6), and COX-2 and lipoxygenase activity. In vitro, it demonstrates antioxidant, anti-inflammatory, and antifibrotic effects. The main clinical limitation is extremely low oral bioavailability of pure curcumin (less than 1%) due to poor absorption, rapid metabolism, and systemic elimination. Bioavailability is increased in formulations with piperine, phospholipids (Meriva), or nanoparticles.
Adjunct
The 2020 Cochrane review (7 RCTs, more than 380 patients) showed a moderate reduction in ulcerative colitis relapse rate with curcumin 1–3 g daily added to baseline therapy. The effect is confirmed in small RCTs and requires reproduction in large multicentre trials. Major societies (, ) do not include curcumin in UC management standards. Decisions are individualised with a gastroenterologist.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
The Foods 2021 systematic review (16 RCTs, more than 1,800 patients) showed moderate reductions in pain intensity and functional improvement in knee osteoarthritis patients on curcumin 500–1,500 mg daily for 8–12 weeks. Study quality is moderate, many manufacturer-funded, samples small. 2019 does not recommend curcumin for osteoarthritis. 2019 does not include curcumin in standards. Standard therapy: physical rehabilitation, paracetamol, NSAIDs, intra-articular injections when needed, and joint replacement.
Not recommended
Curcumin is a polyphenol from turmeric. In anti-aging and longevity communities, curcumin is sold to slow aging, extend life, and support cognitive function. Curcumin's bioavailability is very low (under 1% after oral intake), limiting real clinical activity; even with piperine or liposomal formulations, no significant anti-aging clinical effects have been shown. International anti-aging guidelines do not include curcumin. Curcumin is relatively safe but can cause GI disturbances, thin the blood (bleeding risk with anticoagulants), and trigger allergic reactions in susceptible people. If curcumin was recommended for longevity, consider seeking a second opinion.
Not recommended
Curcumin for cancer prevention in people without an established diagnosis is not mentioned in international guidelines. Laboratory antitumour data have not translated to clinical practice – large positive RCTs on cancer incidence or mortality are absent. In patients with active cancer on chemotherapy or targeted therapy, curcumin use should be discussed with the treating oncologist due to potential drug interactions.
Not recommended
Curcumin as monotherapy or adjunct in major depression is not mentioned in international psychiatric guidelines (, mental health). Small RCTs showed a weak effect on mild-to-moderate depression symptoms in combination with standard therapy – not reproduced in large RCTs. Standard depression therapy: psychotherapy and/or antidepressants, not curcumin.
1 pair found. Sorted from critical to minor.
Mechanism
Curcumin (Curcuma longa extract) theoretically weakly inhibits CYP2E1, which produces paracetamol's hepatotoxic metabolite NAPQI. For short paracetamol courses, hepatotoxicity risk may be slightly reduced. Clinical data are limited.
Symptoms
The combination usually causes no specific symptoms. Each drug's individual side effects remain.
Management
No dose adjustment needed. Dietary curcumin (curry, golden milk) does not clinically affect paracetamol metabolism. At supplement doses of curcumin (500–1000 mg/day), no clinically significant interaction has been documented. Paracetamol limit: up to 3 g/day.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Turmeric at culinary doses is safe. High-dose curcumin supplements in pregnancy are not recommended – there are theoretical data on uterine contractility stimulation and bleeding risk.
Turmeric at culinary doses is safe. High-dose curcumin supplements during breastfeeding are not recommended.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Curcumin (Curcuma longa extract) is evaluated for the following indications with varying evidence strength: Ulcerative colitis remission maintenance (evidence tier D), Knee osteoarthritis (evidence tier D), Cancer prevention (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Curcumin (Curcuma longa extract) (≥ 1 in 100): Nausea, epigastric discomfort, Diarrhoea at high doses, Yellow stool discoloration. See the Safety section for uncommon and serious reactions.
FDA category C. Turmeric at culinary doses is safe. High-dose curcumin supplements in pregnancy are not recommended – there are theoretical data on uterine contractility stimulation and bleeding risk.
Turmeric at culinary doses is safe. High-dose curcumin supplements during breastfeeding are not recommended.
Curcumin (Curcuma longa extract) is contraindicated in: Hypersensitivity to curcumin or turmeric; Pregnancy and breastfeeding; Active cholelithiasis; Acute cholangitis, biliary obstruction; Severe liver disease. Full list in the Safety section.
laboratory data on antitumour, anti-inflammatory, and neuroprotective effects do not translate to clinical practice. Pure curcumin bioavailability is less than 1%, and systemic concentrations at standard doses are insufficient to reproduce in vitro effects.
piperine increases curcumin bioavailability 20-fold, but is also a potent CYP3A4 and P-glycoprotein inhibitor. This creates a risk of drug interactions with many medicines (statins, immunosuppressants, antidepressants, warfarin). In polypharmacy, the curcumin+piperine combination requires caution.
the effect of dietary turmeric on joints is clinically minor. The curcuminoid dose in a standard cup of golden milk is 50–100 mg, 5–15 times less than RCT-tested doses. With osteoarthritis and pain, consult a clinician for standard therapy, not spices.