Drug & supplement interaction

Alpha-lipoic Acid + Dactinomycin

Dactinomycin brand names: Cosmegen, Cosmegan.

Moderate Interaction
The bottom line Moderate

Alpha-lipoic Acid has a moderate interaction with Dactinomycin. Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.

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

Alpha-lipoic Acid and Dactinomycin

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

Moderate

ANTITUMOR ANTIBIOTICS

Why this applies to Dactinomycin

Dactinomycin falls under ANTITUMOR ANTIBIOTICS — the group Alpha-lipoic Acid interacts with.

Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of antitumor antibiotics.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of antitumor antibiotic drugs, which work by generating free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as alpha-lipoic acid have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using alpha-lipoic acid.
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 thinking behind this one. Dactinomycin is a chemotherapy drug that kills cancer cells partly by creating free radicals, a kind of cellular damage. Alpha-lipoic acid is an antioxidant, and antioxidants mop up free radicals. So on paper, taking ALA alongside dactinomycin could theoretically blunt how well the chemo works. To be fair, a few researchers argue the opposite, that antioxidants might actually help. Nobody really knows yet.

I want to be honest: this is a theory based on how the drugs work, not proven in studies. Still, with a cancer treatment this important, I wouldn't take chances. Please don't start alpha-lipoic acid (or any supplement) during this chemo without first running it by your oncologist.

References
  1. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  2. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  3. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. 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

Alpha-lipoic Acid Also Interacts With Other Medications

Alpha-lipoic Acid has 176 moderate, 86 minor known drug interactions in our database — the Dactinomycin 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 Alpha-lipoic Acid

Covers the 2,830 medications we’ve checked against Alpha-lipoic Acid. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Dactinomycin

This page covers Alpha-lipoic Acid only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dactinomycin page lists 6 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Rose Hip (moderate), Turmeric (moderate), Vitamin C (moderate) and Vitamin E (moderate).

By severity: 6 moderate.

From our pharmacist’s overview on the Dactinomycin page

“Every supplement flagged against dactinomycin (Cosmegen) tells the same story. This chemotherapy drug works partly by generating free radicals inside cancer cells, and each ingredient on this page is an antioxidant, vitamin C and vitamin E among them, plus turmeric and a couple of vitamin C rich botanicals.”

Reviewed by 2 · Jul 18, 2026

Open the Dactinomycin interaction page

One more smart check

Taking Alpha-lipoic Acid as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,223 real supplement products containing Alpha-lipoic Acid, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Alpha-lipoic Acid. Your product may carry other ingredients that interact with Dactinomycin too, on top of Alpha-lipoic Acid — 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 Alpha-lipoic Acid and Dactinomycin 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 Alpha-lipoic Acid
Top 5%

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

29 days ago today
Medication Dactinomycin
Top half

#800 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 Alpha-lipoic Acid

What is Alpha-lipoic Acid?

Alpha-lipoic Acid
  • Diabetic nerve pain (neuropathy)
  • Blood sugar support in diabetes
  • Antioxidant support
  • Liver health
  • Skin aging (topical and oral)

Alpha-lipoic acid (ALA) is an antioxidant made naturally by the body and found in small amounts in foods. It is most studied for diabetic nerve pain, where some evidence suggests it may help, but evidence for most other uses is limited. It is generally well tolerated, but talk to your pharmacist or doctor before using it, especially if you have diabetes or thyroid problems.

Read the full Alpha-lipoic Acid monograph & all interactions
Medication

About Dactinomycin

What Is Dactinomycin Used For?

Brand names: Cosmegen, Cosmegan

Dactinomycin is used to treat a range of cancers in both adults and children. These include Wilms tumor (a kidney cancer), rhabdomyosarcoma (a soft-tissue cancer), Ewing sarcoma (a bone and soft-tissue cancer), and metastatic nonseminomatous testicular cancer. For each of these, it is used as part of a multi-drug chemotherapy regimen.

It is also used in post-menarchal patients (those who have had their first period) with gestational trophoblastic neoplasia — a tumor that grows from pregnancy tissue — either alone or in combination with other drugs. In adults, it can be used as part of a regional perfusion procedure to treat locally recurrent or locoregional solid tumors.

See full Dactinomycin drug information
Keep checking

Other Drugs & Alpha-lipoic Acid

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

0Major
176Moderate
86Minor
2,567No known interaction
Moderate

176 interactions

Showing 60 of 176 moderate interactions — see all 176 on the Alpha-lipoic Acid page.

Minor

86 interactions

Showing 60 of 86 minor interactions — see all 86 on the Alpha-lipoic Acid page.

No interaction 2,567 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 Alpha-lipoic Acid and Dactinomycin Together: Common Questions

Can you take Alpha-lipoic Acid with Dactinomycin?
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 Alpha-lipoic Acid and Dactinomycin 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 Dactinomycin and Alpha-lipoic Acid?

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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.