Drug & supplement interaction

Alchemilla + Roflumilast

Roflumilast brand names: Daliresp, Zoryve.

Minor Interaction
The bottom line Minor

Alchemilla has a minor interaction with Roflumilast. While no side effects have been reported from orally using Alchemilla, a clinical study titled "Treatment of Aphthous Stomatitis with Topical Alchemilla vulgaris in Glycerine," published in Clinical Drug Investigation (https://pubmed.ncbi.nlm.nih.gov/17163290/), found that local mouth irritation occ...

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Alchemilla and Roflumilast

Here is the interaction we found between these two, with the evidence behind it.

Minor

Topical Drugs

Why this applies to Roflumilast

Roflumilast falls under Topical Drugs — the group Alchemilla interacts with.

While no side effects have been reported from orally using Alchemilla, a clinical study titled "Treatment of Aphthous Stomatitis with Topical Alchemilla vulgaris in Glycerine," published in Clinical Drug Investigation (https://pubmed.ncbi.nlm.nih.gov/17163290/), found that local mouth irritation occurred after applying a commercial product containing 3% alchemilla extract and glycerol (Aphtarine, Laboratoires Biosphere). Aphtarine was non-irritating in 68.2% of cases within 2-3 days, in 18.8% of cases within 4-7 days, and in 13.6% of cases with moderate irritation. Theoretically, combining Alchemilla with other potentially irritating topical products could increase the risk of local irritation and discomfort. The drug in this drug interaction monograph is available in a topical dosage form. There is no interaction expected from the oral dosage form of the drug.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing to know: this is a skin-level concern, not a deep metabolism one. Roflumilast comes as both a pill (Daliresp) for COPD and a topical cream or foam (Zoryve). Alchemilla is loaded with tannins, which are naturally drying and astringent, and one small study found that applying it to delicate tissue caused some local irritation.

So if you're using the topical form of roflumilast and also putting Alchemilla on the same area of skin, you might notice a bit more redness, stinging, burning, or dryness where they overlap. It's considered minor and the evidence is weak. If you take the roflumilast pill, there's no expected interaction at all. When in doubt, check with your pharmacist before layering products on the same spot.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Alchemilla Also Interacts With Other Medications

Alchemilla has 197 minor known drug interactions in our database — the Roflumilast one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Alchemilla

Covers the 2,830 medications we’ve checked against Alchemilla. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Roflumilast

This page covers Alchemilla only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Roflumilast page lists 141 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 96 moderate · 42 minor.

From our pharmacist’s overview on the Roflumilast page

“Roflumilast (Daliresp for severe COPD, Zoryve as a cream for skin conditions) is cleared almost entirely by one liver enzyme, CYP3A4, which is why 121 of the 141 supplements on this page can push its level up or down, and why real caution is warranted here. Start with the three rated major: grapefruit blocks that enzyme and can raise r…”

Reviewed by 2 · Jul 18, 2026

Open the Roflumilast interaction page

One more smart check

Taking Alchemilla as Part of a Dietary Supplement Product? Check It for Interactions

We hold 19 real supplement products containing Alchemilla, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Alchemilla. Your product may carry other ingredients that interact with Roflumilast too, on top of Alchemilla — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Alchemilla and Roflumilast Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Alchemilla
Top half

#530 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Roflumilast
Top half

#930 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Alchemilla

What is Alchemilla?

Alchemilla
  • Menstrual and women's health complaints
  • Diarrhea and digestive upset
  • Wound healing (topical)
  • Skin moisturizing (topical)
  • Mild inflammation

Alchemilla (lady's mantle) is a European herb traditionally used for digestive complaints, women's health issues, and as an astringent for skin and wounds. Solid human research is very limited, so its benefits remain largely unproven, and it should be avoided in pregnancy and breastfeeding due to a lack of safety data.

Read the full Alchemilla monograph & all interactions
Medication

About Roflumilast

What Is Roflumilast Used For?

Brand names: Daliresp, Zoryve

Daliresp and roflumilast tablets are used to reduce the risk of COPD (chronic obstructive pulmonary disease) flare-ups in adults with severe COPD linked to chronic bronchitis who have had flare-ups in the past. They are not rescue inhalers and will not relieve a sudden breathing attack.

Zoryve cream is used topically to treat plaque psoriasis (adults and children 2+) and mild to moderate atopic dermatitis (eczema) in adults and children as young as 2. Zoryve topical foam is used to treat seborrheic dermatitis (adults and children 9+) and plaque psoriasis of the scalp and body (adults and children 12+).

See full Roflumilast drug information
Keep checking

Other Drugs & Alchemilla

Browse every other medication we’ve checked against Alchemilla — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
197Minor
2,632No known interaction
Minor

197 interactions

Showing 60 of 197 minor interactions — see all 197 on the Alchemilla page.

No interaction 2,632 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Alchemilla and Roflumilast Together: Common Questions

Can you take Alchemilla with Roflumilast?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Alchemilla and Roflumilast interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.