Drug & supplement interaction

American Mistletoe + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between American Mistletoe and Nintedanib Esylate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Nintedanib Esylate states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

American Mistletoe and Nintedanib Esylate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Nintedanib Esylate and American Mistletoe in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

American Mistletoe safety at a glance

American Mistletoe overall Avoid American mistletoe contains toxic compounds and is not recommended for medicinal use.
Pregnancy Likely Unsafe When used orally. American mistletoe is considered an abortifacient. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nintedanib Esylate and American Mistletoe? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nintedanib Esylate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nintedanib Esylate is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. American Mistletoe has documented interactions with 2 drug classes — the most serious being antihypertensive drugs (major) and vasodilators (major) — and none of Nintedanib Esylate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

American Mistletoe Does Interact With Other Medications

American Mistletoe has 190 major, known drug interactions in our database — Nintedanib Esylate isn’t one of them. If you take anything else, check it against the full list below.

Major 190 No known interaction 2,640 (incl. Nintedanib Esylate)
Taking anything else?

Check Another of Your Medications Against American Mistletoe

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

What to actually watch for

No Interaction Found — But Data Suggests American Mistletoe and Nintedanib Esylate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Raised blood pressure Worth acting on Additional detail

    American Mistletoe

    “Evidence on adverse effects related to American mistletoe is limited to retrospective case reviews from poison control centers. Most reports suggest that American mistletoe may be relatively well tolerated at lower doses.”

    American Mistletoe · Natural Medicines adverse-effect record, reported in cardiac arrest.

    “Orally, large doses of American mistletoe may cause bradycardia, hypertension, and cardiac arrest (6,19695).”

    American Mistletoe · Natural Medicines adverse-effect record, reported in cardiac arrest.

    2 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 19695. Moore HW. Mistletoe poisoning: a review of the available literature, and the report of a case of probable fatal poisoning. J S Carolina Med Assoc 1963;59(8):269-271.

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate. Read the label on DailyMed ›

  • Diarrhea / Vomiting / Nausea reported in 26.6% of FDA reports for Nintedanib Esylate Additional detail

    American Mistletoe

    “Orally, American mistletoe can cause acute gastroenteritis. Consuming large doses of American mistletoe may cause nausea, vomiting, and diarrhea. Diarrhea and vomiting from ingestion of American mistletoe can lead to dehydration, hypovolemic shock, and cardiovascular collapse (6).”

    American Mistletoe · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for American Mistletoe but not commonly for Nintedanib Esylate: hallucinations, a slow heartbeat, dehydration and confusion.

Effects for Nintedanib Esylate come from the ADVERSE REACTIONS section of its FDA label; effects for American Mistletoe come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 188 voluntary FDA FAERS reports for Nintedanib Esylate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

American Mistletoe in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. American mistletoe is considered an abortifacient.

Lactation Likely Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Nintedanib Esylate Products Have a Food Rule — American Mistletoe Should Not Break It

At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take American Mistletoe on an empty stomach out of habit, keep them separate — and take Nintedanib Esylate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Nintedanib Esylate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Recommended dosage: 150 mg taken orally twice daily approximately 12 hours apart taken with food.

From the Dosage and Administration section of the FDA label we read for Nintedanib Esylate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers American Mistletoe only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

How much people look this up

Where American Mistletoe and Nintedanib Esylate 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 American Mistletoe
Steady interest

#1,251 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,963 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every American Mistletoe reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The American Mistletoe and Nintedanib Esylate records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About American Mistletoe

What is American Mistletoe?

American Mistletoe
  • Traditional folk remedies
  • Digestive complaints
  • Decorative holiday plant

American mistletoe is a parasitic plant that is best known as a holiday decoration, not a proven medicine. It contains toxins that can harm the heart, gut, and blood vessels, and it has little reliable evidence to support any health use. We do not recommend taking it, and all parts should be kept away from children and pets.

Phoradendron leucarpum · Santalaceae · Leaves, stems, and berries · Rarely used as a supplement; historically as tea or dried plant. Most often seen as a holiday decoration.

An interaction check asks whether these two react with each other — it does not ask whether American Mistletoe is a good idea for someone in your situation. Here is what our American Mistletoe record says about it on its own.

American Mistletoe: dosing

There is no established safe or effective dose of American mistletoe. Because the plant is toxic and not recommended for medicinal use, no dosing guidance can be given.If you ever see a product containing mistletoe, do not take it without first speaking to a pharmacist or doctor. The safest approach is to avoid using American mistletoe internally altogether.

From our American Mistletoe monograph — the full record covers uses, side effects and every documented interaction.

Read the full American Mistletoe monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
Keep checking

Other Drugs & American Mistletoe

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

190Major
0Moderate
0Minor
2,639No known interaction
190 Major 2,639 No interaction
Major

190 interactions

Showing 60 of 190 major interactions — see all 190 on the American Mistletoe page.

No interaction 2,639 drugs checked — show the list

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

Showing the 60 most looked-up of 2,639 medications checked with no known interaction — see the full American Mistletoe list.

See the full American Mistletoe interactions page
See every supplement checked against Nintedanib Esylate, ranked by severity
Evidence & sources

American Mistletoe References

The 4 references that drive our American Mistletoe monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999. DOI
  4. Moore HW. Mistletoe poisoning: a review of the available literature, and the report of a case of probable fatal poisoning. J S Carolina Med Assoc 1963;59(8):269-271.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking American Mistletoe and Nintedanib Esylate Together: Common Questions

Is it safe to take American Mistletoe with Nintedanib Esylate?
We do not list a known interaction between American Mistletoe and Nintedanib Esylate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do American Mistletoe and Nintedanib Esylate have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take American Mistletoe and Nintedanib Esylate at the same time of day?
At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take American Mistletoe on an empty stomach out of habit, keep them separate and take Nintedanib Esylate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Nintedanib Esylate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the American Mistletoe and Nintedanib Esylate combination checked?
Interactions in our licensed database are recorded against drug classes. Nintedanib Esylate is filed under 5 classifications, and American Mistletoe has documented interactions with 2 drug classes — none of Nintedanib Esylate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does American Mistletoe interact with any other medications?
Yes. American Mistletoe has 190 documented drug interactions in our database — Nintedanib Esylate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Nintedanib Esylate interact with any supplements?
Yes. Nintedanib Esylate has documented interactions with 285 supplements in our database — American Mistletoe is not one of them. The Nintedanib Esylate interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

American Mistletoe monograph Uses, safety profile, and every drug interaction in one place Nintedanib drug information The full plain-English guide to this medication Nintedanib Esylate supplement interactions Every supplement checked against Nintedanib Esylate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nintedanib Esylate and American Mistletoe?

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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.