American Pawpaw - Cytoxan (Cyclophosphamide) Interaction
Herbal: American Pawpaw
Also Known As: Asimina triloba, Asimina, Asiminier, Banango, Custard Apple, Dog-Banana, Hoosier Banana, Indiana Banana, Kentucky Banana, Ozark Banana, Papaye American, Pawpaw, Paw, Poor Man's Banana
Drug: Cyclophosphamide
Brand names:
Cytoxan, Neosar
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 06, 2024
Interaction Details
Cyclophosphamide is classified as belonging to the following category: Antineoplastics
American pawpaw (Asimina triloba) contains Annonacin, a natural compound that has been investigated for its potential anticancer effects. Laboratory studies suggest that Annonacin may inhibit or prevent the growth and spread of tumors or malignant cells by disrupting mitochondrial function, leading to cell death (source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6672878/; https://www.nature.com/articles/s41419-018-0772-x). It is currently unknown how American pawpaw may interact, if at all, with prescription antineoplastic drugs. However, since both Annonacin and antineoplastic drugs can affect cell processes and metabolism, there is a theoretical risk of interactions that could affect treatment efficacy or increase the risk of side effects. Therefore, caution should be exercised when combining pawpaw with prescription antineoplastic drugs, and consulting with a healthcare professional is recommended before making changes to your medication regimen.
Interaction Rating
Likelihood of Occurrence
UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
American Pawpaw Overview
Asimina triloba, also known as pawpaw, is a deciduous tree native to North America. It is recognized for its large, tropical-like leaves and distinctive oblong fruits resembling a mix of mangoes and bananas. Typically found in moist, fertile soils in forest understories or along riverbanks, the pawpaw tree is of medicinal interest due to its potential anticancer properties attributed to its acetogenin content, including annonacin. Annonacin has shown cytotoxic effects against cancer cells, particularly in laboratory studies, by disrupting mitochondrial function, leading to cell death. Other mechanisms are likely involved as well. While promising, more research is needed to fully understand its mechanisms and therapeutic potential. Other constituents of American pawpaw include epigallocatechin, epicatechin, and p-coumaric acid.
Cyclophosphamide Overview
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Cyclophosphamide is used alone or in combination with other medications to treat Hodgkin's lymphoma (Hodgkin's disease) and non-Hodgkin's lymphoma (types of cancer that begin in a type of white blood cells that normally fights infection); cutaneous T-cell lymphoma (CTCL, a group of cancers of the immune system that first appear as skin rashes); multiple myeloma (a type of cancer of the bone marrow); and certain types of leukemia (cancer of the white blood cells), including chronic lymphocytic leukemia (CLL), chronic myelogenous leukemia (CML), acute myeloid leukemia (AML, ANLL), and acute lymphoblastic leukemia (ALL). It is also used to treat retinoblastoma (cancer in the eye), neuroblastoma (a cancer that begins in nerve cells and occurs mainly in children), ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed), and breast cancer. Cyclophosphamide is also used to treat nephrotic syndrome (a disease that is caused by damage to the kidneys) in children whose disease has not improved, has gotten worse, or has come back after taking other medications or in children who experienced intolerable side effects with other medications. Cyclophosphamide is in a class of medications called alkylating agents. When cyclophosphamide is used to treat cancer, it works by slowing or stopping the growth of cancer cells in your body. When cyclophosphamide is used to treat nephrotic syndrome, it works by suppressing your body's immune system.
American Pawpaw - More Interactions
American Pawpaw interacts with 25 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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