Drug & supplement interaction

American Spikenard + Apalutamide

Apalutamide brand name: Erleada.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between American Spikenard and Apalutamide 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.

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Interaction report

American Spikenard and Apalutamide

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 Apalutamide and American Spikenard 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 Spikenard safety at a glance

American Spikenard overall Use caution Little is known about its safety from modern studies, so use cautiously and short-term.

Pregnancy Possibly Unsafe When used orally; avoid using. Read the full pregnancy detail

Breastfeeding Avoid Avoid while breastfeeding due to a lack of safety information.

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 Apalutamide and American Spikenard? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Apalutamide

Interactions in our licensed database are recorded against drug classes, not just single drug names. Apalutamide is filed under 6 classifications — including cytochrome p450 2c8 (cyp2c8) substrates, cytochrome p450 2c9 (cyp2c9) inducers, cytochrome p450 2c19 (cyp2c19) inducers. American Spikenard has documented interactions with 1 drug class — the most serious being diuretic drugs (minor) — and none of Apalutamide’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 Spikenard Does Interact With Other Medications

American Spikenard has 75 minor known drug interactions in our database — Apalutamide isn’t one of them. If you take anything else, check it against the full list below.

Minor 75 No known interaction 2,755 (incl. Apalutamide)

Taking anything else?

Check Another of Your Medications Against American Spikenard

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

What to actually watch for

What Apalutamide’s Own FDA Label Lists

This is not an interaction — none of it involves American Spikenard. These are the most notable effects listed in the ADVERSE REACTIONS section of Apalutamide’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 10 of them are worth acting on rather than waiting out — marked below.

A change in thyroid levels Worth acting on
A stroke or mini-stroke Worth acting on
Bone thinning Worth acting on
Trouble passing urine Worth acting on
High potassium Worth acting on
A heart attack Worth acting on
Heart failure Worth acting on
High blood sugar Worth acting on
A severe skin reaction Worth acting on
Seizures Worth acting on

Showing the 10 most notable of 30 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Apalutamide. Read the label on DailyMed › Where a percentage is shown, it is the share of 11,688 voluntary FDA FAERS reports for Apalutamide that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. American Spikenard’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no American Spikenard side to compare — that is a limit of the record, not a statement that American Spikenard has no side effects.

Special populations

American Spikenard in Pregnancy & Breastfeeding

Pregnancy Possibly 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

Everything else you take

See Every Supplement That Interacts With Apalutamide

This page covers American Spikenard only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Apalutamide page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 113 moderate · 39 minor.

From our pharmacist’s overview on the Apalutamide page

“Apalutamide (Erleada) treats prostate cancer, and it only works when its blood level stays where it should, so approach this list with genuine care. Three of the 155 ingredients on file are rated major: grapefruit can push apalutamide levels up, St.”

Reviewed by 2 · Jul 18, 2026

Open the Apalutamide interaction page

How much people look this up

Where American Spikenard and Apalutamide 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 Spikenard

Top half

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

29 days ago today

Medication Apalutamide

Steady interest

#1,940 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 Spikenard reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The American Spikenard and Apalutamide 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About American Spikenard

What is American Spikenard?

Cough and chest congestion
Common cold
Asthma symptoms
Promoting sweating
Skin and wound support (topical)

American spikenard is a traditional North American herb used mainly as an expectorant and to ease coughs and colds, but there is no reliable human research to confirm it works. If you choose to try it, use it short-term, follow the product label, and check with a pharmacist or doctor first—especially if you are pregnant, breastfeeding, or have a health condition.

Aralia racemosa · Araliaceae · Root and rhizome · Tea, tincture, dried root, capsules, syrup

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

American Spikenard: dosing

There is no established or standardized dose for American spikenard. Traditional preparations include teas made from the dried root, tinctures, and syrups, but reliable dosing guidelines based on research do not exist.If you choose to use it, follow the directions on the product label and do not exceed the recommended amount.

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

Read the full American Spikenard monograph & all interactions

Medication

About Apalutamide

What Is Apalutamide Used For?

Brand name: Erleada

Erleada (apalutamide) is used to treat two types of prostate cancer. The first is metastatic castration-sensitive prostate cancer (mCSPC) — prostate cancer that has spread to other parts of the body and still responds to hormone-lowering therapy. The second is non-metastatic castration-resistant prostate cancer (nmCRPC) — prostate cancer that has stopped responding to standard hormone therapy but has not yet spread to other organs.

Erleada is always used alongside a gonadotropin-releasing hormone (GnRH) analog — a medicine that lowers testosterone — or in patients who have already had surgery to remove the testicles.

Most-Reported Side Effects for Apalutamide

From FAERS, the FDA’s public side-effect reporting system (11,688 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Rash 1,285 reports

Fatigue 1,177 reports

Hot flush 884 reports

Asthenia 430 reports

Diarrhea 401 reports

See full Apalutamide drug information

Keep checking

Other Drugs & American Spikenard

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

0Major

0Moderate

75Minor

2,754No known interaction

75 Minor 2,754 No interaction

Minor

75 interactions

Showing 60 of 75 minor interactions — see all 75 on the American Spikenard page.

No interaction 2,754 drugs checked — show the list

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

Showing the 60 most looked-up of 2,754 medications checked with no known interaction — see the full American Spikenard list.

See the full American Spikenard interactions page

See every supplement checked against Apalutamide, ranked by severity

Evidence & sources

American Spikenard References

The 1 references that drive our American Spikenard 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.

McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

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 Spikenard and Apalutamide Together: Common Questions

Is it safe to take American Spikenard with Apalutamide?

We do not list a known interaction between American Spikenard and Apalutamide. 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.

How was the American Spikenard and Apalutamide combination checked?

Interactions in our licensed database are recorded against drug classes. Apalutamide is filed under 6 classifications, and American Spikenard has documented interactions with 1 drug class — none of Apalutamide'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 Spikenard interact with any other medications?

Yes. American Spikenard has 75 documented drug interactions in our database — Apalutamide 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 Apalutamide interact with any supplements?

Yes. Apalutamide has documented interactions with 155 supplements in our database — American Spikenard is not one of them. The Apalutamide 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 Spikenard monograph Uses, safety profile, and every drug interaction in one place Apalutamide drug information The full plain-English guide to this medication Apalutamide supplement interactions Every supplement checked against Apalutamide, 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 1 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Apalutamide and American Spikenard?

Our pharmacists answer your medication & supplement questions — free.

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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.