Drug & supplement interaction

Apple + Nelarabine

Nelarabine brand name: Atriance.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Apple and Nelarabine 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 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

Apple and Nelarabine

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 Nelarabine and Apple 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.

Apple safety at a glance

Apple overall Generally safe Apples as a food are safe for most people when eaten in normal amounts.
Pregnancy Generally safe Apples eaten as food are considered safe in pregnancy, but concentrated extracts are not well studied.
Breastfeeding Generally safe Apples as a food are considered safe while breastfeeding; supplements are not well studied.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nelarabine and Apple? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nelarabine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nelarabine is filed under 3 classifications — immunosuppressants, cns depressants, seizure threshold lowering drugs. Apple has documented interactions with 7 drug classes — the most serious being organic anion-transporting polypeptide substrates (oatp) (major), aliskiren (tekturna, rasilez) (moderate) and antidiabetes drugs (moderate) — and none of Nelarabine’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

Apple Does Interact With Other Medications

Apple has 47 major, 253 moderate known drug interactions in our database — Nelarabine isn’t one of them. If you take anything else, check it against the full list below.

Major 47 Moderate 253 No known interaction 2,530 (incl. Nelarabine)
Taking anything else?

Check Another of Your Medications Against Apple

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

What to actually watch for

No Interaction Found — But Data Suggests Apple and Nelarabine May Share a Side Effect

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.

  • Bloating or gas Additional detail

    Apple

    “Orally, apple products, including whole apples, apple puree, and apple juice, may cause bloating and flatulence in some people.”

    Apple · Natural Medicines adverse-effect record, reported in flatulence.

    1 source cited
    1. 104184. Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed

    Nelarabine

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

Reported for Apple but not commonly for Nelarabine: an allergic reaction and a severe allergic reaction.

Effects for Nelarabine come from the ADVERSE REACTIONS section of its FDA label; effects for Apple come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 956 voluntary FDA FAERS reports for Nelarabine 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.

Overlapping uses

What Nelarabine Is Prescribed For, and What Apple Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Nelarabine is a prescription medicine with approved uses on its FDA label. Apple is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Nelarabine is prescribed for: Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens. Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

Apple has been studied for:

  • Cancer studied, not established Apple has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Apple for cancer

    It is unclear if apple consumption is beneficial for preventing cancer.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Nelarabine on your own; if you are taking Apple for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Apple or Nelarabine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Apple or Nelarabine, 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 Nelarabine

This page covers Apple only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

One more smart check

Taking Apple as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,841 real supplement products containing Apple, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Apple. Even though Apple itself has no known interaction with Nelarabine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Apple and Nelarabine 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 Apple
Top 10%

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

29 days ago today
Medication Nelarabine
Steady interest

#1,841 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 Apple reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Apple and Nelarabine records this page draws on were last updated July 10, 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 Apple

What is Apple?

Apple
  • General nutrition and fiber intake
  • Heart and cholesterol health
  • Blood sugar and weight management
  • Digestive regularity
  • Antioxidant support

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may support heart and digestive health, most claims about concentrated apple supplements or extracts are not strongly proven, so enjoy apples as food and talk with your pharmacist before using high-dose products.

Malus domestica · Rosaceae · Fruit (with peel), and sometimes the peel, pectin (fiber), juice, and cider vinegar · Fresh fruit, juice, dried fruit, applesauce, apple cider vinegar, pectin supplements, polyphenol extracts

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

Apple: dosing

There is no official medicinal dose for apples because they are a food rather than a drug. As part of a healthy diet, eating one or more whole apples per day is a reasonable goal for most people.For apple supplements such as pectin, polyphenol extracts, or apple cider vinegar products, there is no established standardized dose.

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

Read the full Apple monograph & all interactions
Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

Most-Reported Side Effects for Nelarabine

From FAERS, the FDA’s public side-effect reporting system (956 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Febrile neutropenia 75 reports
Neuropathy peripheral 60 reports
Neurotoxicity 60 reports
Sepsis 56 reports
Muscular weakness 55 reports
See full Nelarabine Injection drug information
Keep checking

Other Drugs & Apple

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

47Major
253Moderate
0Minor
2,529No known interaction
47 Major 253 Moderate 2,529 No interaction
Major

47 interactions

Moderate

253 interactions

Showing 60 of 253 moderate interactions — see all 253 on the Apple page.

No interaction 2,529 drugs checked — show the list

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

Showing the 60 most looked-up of 2,529 medications checked with no known interaction — see the full Apple list.

See the full Apple interactions page
See every supplement checked against Nelarabine, ranked by severity
Evidence & sources

Apple References

The 16 references that drive our Apple 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. Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
  3. Rodriguez J, Crespo JF, Lopez-Rubio A, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183-189. PubMed
  4. Greenblatt DJ. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. J Clin Pharmacol 2009;49:1403-7. PubMed
  5. Bailey DG. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Br J Clin Pharmacol 2010;70:645-55. PubMed
  6. Kamath AV, Yao M, Zhang Y, Chong S. Effect of fruit juices on the oral bioavailability of fexofenadine in rats. J Pharm Sci 2005;94:233-9. PubMed
  7. Tapaninen T, Neuvonen PJ, Niemi M. Orange and apple juice greatly reduce the plasma concentrations of the OATP2B1 substrate aliskiren. Br J Clin Pharmacol 2011;71:718-26. PubMed
  8. Jeon H, Jang IJ, Lee S, et al. Apple juice greatly reduces systemic exposure to atenolol. Br J Clin Pharmacol 2012 May 11. doi: 10.1111/j.1365-2125.2012.04324.x. [Epub ahead of print]. PubMed
  9. Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed
  10. Asp, N. G., Agardh, C. D., Ahren, B., Dencker, I., Johansson, C. G., Lundquist, I., Nyman, M., Sartor, G., and Schersten, B. Dietary fibre in type II diabetes. Acta Med Scand Suppl 1981;656:47-50. PubMed
  11. Akamine Y, Miura M, Komori H, et al. Effects of one-time apple juice ingestion on the pharmacokinetics of fexofenadine enantiomers. Eur J Clin Pharmacol. 2014 Sep;70(9):1087-95. PubMed
  12. Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016 Aug;9(4):201-6. PubMed
  13. Tsiougkos N, Vovolis V. Repeated anaphylactic episodes to orange and apple. Eur Ann Allergy Clin Immunol. 2013 May;45(3):113-5.
  14. Rubido S, García-Caballero L, Abeleira MT, Limeres J, García M, Diz P. Effect of chewing an apple on dental plaque removal and on salivary bacterial viability. PLoS One. 2018;13(7):e0199812. PubMed
  15. Krishnasamy S, Lomer MCE, Marciani L, et al. Processing apples to puree or juice speeds gastric emptying and reduces postprandial intestinal volumes and satiety in healthy adults. J Nutr 2020;150(11):2890-9. PubMed

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 Apple and Nelarabine Together: Common Questions

Is it safe to take Apple with Nelarabine?
We do not list a known interaction between Apple and Nelarabine. 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 Apple and Nelarabine have any of the same side effects?
Yes — our sources link each of them separately to one 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.
Are Apple and Nelarabine used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Apple in each. That is a conversation for your prescriber, especially if Nelarabine is being adjusted to a target.
How was the Apple and Nelarabine combination checked?
Interactions in our licensed database are recorded against drug classes. Nelarabine is filed under 3 classifications, and Apple has documented interactions with 7 drug classes — none of Nelarabine'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 Apple interact with any other medications?
Yes. Apple has 300 documented drug interactions in our database — Nelarabine 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 Nelarabine interact with any supplements?
Yes. Nelarabine has documented interactions with 130 supplements in our database — Apple is not one of them. The Nelarabine 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

Apple monograph Uses, safety profile, and every drug interaction in one place Nelarabine Injection drug information The full plain-English guide to this medication Nelarabine supplement interactions Every supplement checked against Nelarabine, 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 16 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nelarabine and Apple?

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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.