Drug & supplement interaction

Alpha-lipoic Acid + Lomustine

Lomustine brand name: Ceenu.

Moderate Interaction
The bottom line Moderate

Alpha-lipoic Acid has a moderate interaction with Lomustine. Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.

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

Alpha-lipoic Acid and Lomustine

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

Moderate

ALKYLATING AGENTS

Why this applies to Lomustine

Lomustine falls under ALKYLATING AGENTS — the group Alpha-lipoic Acid interacts with.

Theoretically, the antioxidant effects of alpha-lipoic acid might alter the effectiveness of alkylating agents.
The use of antioxidants like alpha-lipoic acid during chemotherapy is controversial. There are concerns that antioxidants could reduce the activity of chemotherapy drugs that generate 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. 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 is the honest picture with alpha-lipoic acid (ALA) and lomustine (Ceenu). Lomustine is a chemo drug that kills cancer cells partly by creating oxidative damage inside them. ALA is an antioxidant, and the worry is that mopping up those free radicals could blunt how well the chemo works. Interestingly, other researchers think antioxidants might actually help, so this really cuts both ways.

I want to be clear that this is theoretical. It is based on how these compounds behave in the lab, not on solid human studies, so nobody can say for sure it happens or which direction it goes. Because cancer treatment is so high-stakes, please do not add ALA on your own. Run it by your oncologist or pharmacist first so your therapy stays on track.

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 Lomustine 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 Lomustine

This page covers Alpha-lipoic Acid only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lomustine page lists 25 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Acerola (moderate), Coenzyme Q10 (moderate), Coffee Charcoal (moderate) and European Mandrake (moderate).

By severity: 1 major · 14 moderate · 10 minor.

From our pharmacist’s overview on the Lomustine page

“One capsule of lomustine (Ceenu) often carries a whole chemotherapy cycle, so supplements that keep it from being absorbed, or that blunt its cancer-fighting action, deserve more respect here than with most drugs. The lone major-rated interaction, activated charcoal, can bind lomustine in the gut and sharply cut how much reaches the body.”

Reviewed by 2 · Jul 18, 2026

Open the Lomustine 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 Lomustine 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 Lomustine 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 Lomustine
Top 25%

#382 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 Lomustine

What Is Lomustine Used For?

Brand name: Ceenu

Lomustine capsules are used to treat primary and metastatic brain tumors, typically after surgery and/or radiation therapy. Both Gleostine and Lomustine branded capsules share these approved uses.

Lomustine capsules are also used as part of a combination chemotherapy regimen for Hodgkin's lymphoma (a cancer of the lymph system) in patients whose disease has continued to progress after initial chemotherapy.

See full Lomustine 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 Lomustine Together: Common Questions

Can you take Alpha-lipoic Acid with Lomustine?
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 Lomustine 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 Lomustine 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.