Drug & supplement interaction

American Spikenard + Tofacitinib

Tofacitinib brand names: Xeljanz, Xeljanz XR.

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 Spikenard and Tofacitinib 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 Tofacitinib

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

Why No Interaction Is Listed for Tofacitinib

Interactions in our licensed database are recorded against drug classes, not just single drug names. Tofacitinib is filed under 4 classifications — including cytochrome p450 2c19 (cyp2c19) substrates, immunosuppressants, cytochrome p450 3a4 (cyp3a4) substrates. American Spikenard has documented interactions with 1 drug class — the most serious being diuretic drugs (minor) — and none of Tofacitinib’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 — Tofacitinib 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. Tofacitinib)
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 Tofacitinib’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 Tofacitinib’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. 6 of them are worth acting on rather than waiting out — marked below.

  • Low blood sugar Worth acting on
  • Blood clots Worth acting on
  • A low white blood cell count Worth acting on
  • Liver problems Worth acting on
  • A higher chance of infection Worth acting on
  • An allergic reaction Worth acting on
  • Joint pain mentioned in 29.0% of FDA reports for Tofacitinib
  • Headache mentioned in 7.3% of FDA reports for Tofacitinib
  • Diarrhea
  • A skin rash

From the ADVERSE REACTIONS section of the FDA label for Tofacitinib. Read the label on DailyMed › Where a percentage is shown, it is the share of 185,980 voluntary FDA FAERS reports for Tofacitinib 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 Tofacitinib

This page covers American Spikenard only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tofacitinib page lists 184 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 Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 143 moderate · 38 minor.

From our pharmacist’s overview on the Tofacitinib page

“Supplements deserve genuine care alongside tofacitinib (Xeljanz, Xeljanz XR), a medicine that deliberately dials down the immune system to control conditions like rheumatoid arthritis and ulcerative colitis. Most of the interactions on this page run through the liver enzymes that clear the drug, meaning an herb can push its blood level…”

Reviewed by 2 · Jul 18, 2026

Open the Tofacitinib interaction page

How much people look this up

Where American Spikenard and Tofacitinib 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 Tofacitinib
Steady interest

#1,622 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 Tofacitinib 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 Tofacitinib

What Is Tofacitinib Used For?

Brand names: Xeljanz, Xeljanz XR

  • Tofacitinib is used alone or with other medications to treat rheumatoid arthritis (condition in which the body attacks its own joints causing pain, swelling, and loss of function) in adults who are unable to take or did not respond to one or more tumor necrosis factor (TNF) inhibitor medication(s). It is also used to treat psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin) in adults who are unable to take or did not respond to or tolerate one or more TNF inhibitor medication(s). Tofacitinib is used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) in adults who are unable to take or who did not respond to one or more TNF inhibitor medication(s). It is also used to treat polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years and older who are unable to take or who did not respond to one or more TNF inhibitor medication(s). Tofacitinib is in a class of medications called Janus kinase (JAK) inhibitors. It works by decreasing the activity of the immune system.

See full Tofacitinib 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 Tofacitinib, 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.

  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 Tofacitinib Together: Common Questions

Is it safe to take American Spikenard with Tofacitinib?
We do not list a known interaction between American Spikenard and Tofacitinib. 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 Tofacitinib combination checked?
Interactions in our licensed database are recorded against drug classes. Tofacitinib is filed under 4 classifications, and American Spikenard has documented interactions with 1 drug class — none of Tofacitinib'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 — Tofacitinib 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 Tofacitinib interact with any supplements?
Yes. Tofacitinib has documented interactions with 184 supplements in our database — American Spikenard is not one of them. The Tofacitinib 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 Tofacitinib drug information The full plain-English guide to this medication Tofacitinib supplement interactions Every supplement checked against Tofacitinib, 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 Tofacitinib 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.