Drug & supplement interaction

Alfalfa + Fluorouracil

Fluorouracil brand names: Efudex, Tolak.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Alfalfa has a moderate interaction with Fluorouracil. Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.

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

Alfalfa and Fluorouracil

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

Moderate

PHOTOSENSITIZING DRUGS

Why this applies to Fluorouracil

Fluorouracil falls under PHOTOSENSITIZING DRUGS — the group Alfalfa interacts with.

Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.
Severity Moderate 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 gist: fluorouracil (you may know it as Efudex or Tolak cream, or the IV chemo version) can already make your skin more sensitive to sunlight, leading to easy sunburn, redness, and irritation. Alfalfa contains chlorophyll, and some animal studies hint it might add to that sun sensitivity. So the worry is that the two together could make your skin react more strongly to UV light.

I want to be honest with you, though: this is a theoretical concern based mostly on lab and animal data, not proven in people. It's not a major red flag. Still, since fluorouracil already calls for good sun protection, I'd skip concentrated alfalfa supplements and check with your oncologist or pharmacist first. Either way, wear sunscreen and cover up while you're on this treatment.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Puschner B, Chen X, Read D, Affolter VK. Alfalfa hay induced primary photosensitization in horses. Vet J. 2016 May;211:32-8. PubMed

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

Alfalfa Also Interacts With Other Medications

Alfalfa has 2 major, 580 moderate known drug interactions in our database — the Fluorouracil one above is one of them. If you take anything else, check it against the full list below.

Major 2 Moderate 580 No known interaction 2,248 (incl. Fluorouracil)
Taking anything else?

Check Another of Your Medications Against Alfalfa

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

From our Q&A

Questions About Alfalfa or Fluorouracil

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Alfalfa or Fluorouracil, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Fluorouracil

This page covers Alfalfa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fluorouracil page lists 26 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Angelica Archangelica (moderate), Arrach (moderate), Bergamot (moderate), Bishop's Weed (moderate) and Chenopodium Oil (moderate).

By severity: 23 moderate · 3 minor.

From our pharmacist’s overview on the Fluorouracil page

“If you are using fluorouracil cream (Efudex, Tolak) on sun-damaged skin, your skin is already primed to react to sunlight, and that is where most of its supplement interactions sit. Of the 26 ingredients on file, 20 can make skin more sun-sensitive on their own, chlorophyll, chlorella, and bergamot oil among them, so pairing one with t…”

Reviewed by 2 · Jul 18, 2026

Open the Fluorouracil interaction page

One more smart check

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

We hold 3,559 real supplement products containing Alfalfa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Alfalfa. Your product may carry other ingredients that interact with Fluorouracil too, on top of Alfalfa — 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 Alfalfa and Fluorouracil 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 Alfalfa
Top 10%

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

29 days ago today
Medication Fluorouracil
Steady interest

#2,199 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 Alfalfa

What is Alfalfa?

Alfalfa
  • High cholesterol
  • Digestive complaints
  • Menopausal symptoms
  • Arthritis and joint pain
  • General nutritional supplement

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoided by people with autoimmune diseases, those who are pregnant or breastfeeding, and anyone with a weakened immune system, and you should check with your pharmacist or doctor before trying it.

Read the full Alfalfa monograph & all interactions
Medication

About Fluorouracil Injection

What Is Fluorouracil Injection Used For?

Brand names: Efudex, Tolak

Fluorouracil Injection is used to treat four types of adenocarcinoma (a common form of cancer that begins in glandular cells): cancer of the colon and rectum, breast cancer, stomach (gastric) cancer, and pancreatic cancer.

It is nearly always given as part of a combination chemotherapy regimen alongside other cancer medicines, and the specific drugs paired with it depend on which cancer is being treated.

See full Fluorouracil Injection drug information
Keep checking

Other Drugs & Alfalfa

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

2Major
580Moderate
0Minor
2,247No known interaction
2 Major 580 Moderate 2,247 No interaction
Major

2 interactions

Moderate

580 interactions

Showing 60 of 580 moderate interactions — see all 580 on the Alfalfa page.

No interaction 2,247 drugs checked — show the list

We also checked Alfalfa against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,247 medications checked with no known interaction — see the full Alfalfa list.

See the full Alfalfa interactions page
See every supplement checked against Fluorouracil, ranked by severity
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

Keep exploring
Alfalfa monograph › Uses, safety, and every drug interaction in one place Fluorouracil supplement interactions › Every supplement checked against Fluorouracil, ranked by severity Fluorouracil Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Alfalfa and Fluorouracil Together: Common Questions

Can you take Alfalfa with Fluorouracil?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Alfalfa and Fluorouracil interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Fluorouracil and Alfalfa?

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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.