Drug & supplement interaction

American Spikenard + Fentanyl

Fentanyl brand names: Sublimaze, Duragesic, Fentora, Lazanda, Abstral, and others.

No Known Interaction
The bottom line No known interaction

We found no known interaction between American Spikenard and Fentanyl 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 Fentanyl

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 Fentanyl 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 Fentanyl and American Spikenard? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Fentanyl

Interactions in our licensed database are recorded against drug classes, not just single drug names. Fentanyl is filed under 10 classifications — including narcotic drugs, serotonergic drugs, serotonergic drugs. American Spikenard has documented interactions with 1 drug class — the most serious being diuretic drugs (minor) — and none of Fentanyl’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 — Fentanyl isn’t one of them. If you take anything else, check it against the full list below.

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 Fentanyl’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 Fentanyl’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.

  • Dependence or withdrawal symptoms Worth acting on mentioned in 5.6% of FDA reports for Fentanyl
  • Low magnesium Worth acting on
  • Serotonin syndrome Worth acting on
  • Hearing loss Worth acting on
  • A bowel blockage Worth acting on
  • Bone thinning Worth acting on
  • Pain or burning when passing urine Worth acting on
  • Muscle weakness Worth acting on
  • Memory problems Worth acting on
  • Dehydration Worth acting on

Showing the 10 most notable of 78 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 Fentanyl. Read the label on DailyMed › Where a percentage is shown, it is the share of 114,883 voluntary FDA FAERS reports for Fentanyl 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

From our Q&A

Questions About American Spikenard or Fentanyl

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers American Spikenard or Fentanyl, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Fentanyl

This page covers American Spikenard only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fentanyl page lists 226 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 176 moderate · 40 minor.

From our pharmacist’s overview on the Fentanyl page

“There is very little room for error with fentanyl (Duragesic, Sublimaze, Actiq, and other forms), a powerful opioid where a modest rise in blood level or an extra layer of sedation can become dangerous, so this interaction list deserves real respect. Most of the risk falls into two patterns.”

Reviewed by 2 · Jul 18, 2026

Open the Fentanyl interaction page

How much people look this up

Where American Spikenard and Fentanyl 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

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

29 days ago today
Medication Fentanyl
Steady interest

#1,661 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 Fentanyl 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 Spikenard

What is American Spikenard?

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 Fentanyl

What Is Fentanyl Used For?

Brand names: Sublimaze, Duragesic, Fentora, Lazanda, Abstral, Subsys

Fentanyl transdermal system is prescribed for severe, persistent pain that cannot be controlled with other pain medicines, including shorter-acting opioids. It is only for people who are already opioid-tolerant — meaning they've been taking a significant daily opioid dose for at least a week.

It is not for short-term pain, post-surgical pain, mild pain, or use on an as-needed basis. Because of serious risks including addiction, overdose, and death, it is reserved for situations where other treatment options have failed or are not appropriate.

Most-Reported Side Effects for Fentanyl

From FAERS, the FDA’s public side-effect reporting system (114,883 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Drug abuse 12,447 reports
Overdose 8,162 reports
Toxicity to various agents 7,374 reports
Drug dependence 6,445 reports
Nausea 5,689 reports
See full Fentanyl 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
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
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.

  1. 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 Fentanyl Together: Common Questions

Is it safe to take American Spikenard with Fentanyl?
We do not list a known interaction between American Spikenard and Fentanyl. 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 Fentanyl combination checked?
Interactions in our licensed database are recorded against drug classes. Fentanyl is filed under 10 classifications, and American Spikenard has documented interactions with 1 drug class — none of Fentanyl'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 — Fentanyl 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 Fentanyl interact with any supplements?
Yes. Fentanyl has documented interactions with 226 supplements in our database — American Spikenard is not one of them. The Fentanyl interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Fentanyl and American Spikenard?

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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.