Drug & supplement interaction

Aristolochia + Esketamine

Esketamine brand name: Spravato.

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 Aristolochia and Esketamine 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

Aristolochia and Esketamine

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 Esketamine and Aristolochia 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.

Aristolochia safety at a glance

Aristolochia overall Avoid Aristolochia contains aristolochic acid, which can cause kidney failure and cancer; it should not be used.
Pregnancy Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Unsafe When used orally; avoid using. Read the full breastfeeding detail

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 Esketamine and Aristolochia? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Esketamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Esketamine is filed under 2 classifications — tricyclic antidepressants (tcas), antidepressant drugs. Aristolochia has documented interactions with 1 drug class — the most serious being nephrotoxic drugs (moderate) — and none of Esketamine’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

Aristolochia Does Interact With Other Medications

Aristolochia has 355 moderate known drug interactions in our database — Esketamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 355 No known interaction 2,475 (incl. Esketamine)
Taking anything else?

Check Another of Your Medications Against Aristolochia

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

What to actually watch for

What Aristolochia Itself Has Been Linked To

This is not an interaction — nothing below involves Esketamine. It is the side-effect record for Aristolochia on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Aristolochia, this list is the first place to look. 2 entries are worth acting on rather than waiting out — marked below.

  • Kidney problems Worth acting on Additional detail

    “Orally, use of aristolochia can cause end-stage renal failure and urothelial carcinoma of the bladder. These adverse effects are well documented. A case of hepatotoxicity associated with aristolochia use has also been reported.”

    Aristolochia · Natural Medicines adverse-effect record, reported in kidney failure.

    5 sources cited
    1. 12782. Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Mutagenesis 2002;17:265-77. PubMed
    2. 32376. News Potpourri. Southern Medical Journal 2000;93(11):1129-1130.
    3. 94872. Shaohua Z, Ananda S, Ruxia Y, Liang R, Xiaorui C, Liang L. Fatal renal failure due to the Chinese herb "GuanMu Tong" (Aristolochia manshuriensis): autopsy findings and review of literature. Forensic Sci Int. 2010;199(1-3):e5-7. PubMed
    4. 100337. Tazi I, Nafil H, Mahmal L. Fatal renal failure due to self administration of Aristolochia Longa after treatment with chemotherapy. Arab J Nephrol Transplant. 2012 Jan;5(1):54; discussion 55.
    5. 32383. Centre for Reviews and Dissemination (CRD). Systematic review: hepatotoxic events associated with herbal medicinal products. 2004;

    “Orally, use of aristolochia can cause end-stage renal failure and urothelial carcinoma of the bladder. There have been more than 100 cases of nephropathy, referred to as "Chinese herb nephropathy", characterized by interstitial fibrosis and associated with tea believed to be adulterated with aristolochia. This was originally reported in Belgium with accidental substitution of aristolochia for another herb.”

    Aristolochia · Natural Medicines adverse-effect record, reported in peritoneal dialysis.

    6 sources cited
    1. 12782. Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Mutagenesis 2002;17:265-77. PubMed
    2. 564. van Ypersele de Strihou C, Vanherweghem JL. The tragic paradigm of Chinese herbs nephropathy. Nephrol Dial Transplant 1995;10:157-60. DOI
    3. 6073. Nortier JL, Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N Engl J Med 2000;342:1686-92.
    4. 12783. Cronin AJ, Maidment G, Cook T, et al Aristolochic acid as a causative factor in a case of Chinese herbal nephropathy. Nephrol Dial Transplant 2002;17:524-5. PubMed
    5. 12784. Chang CH, Wang YM, Yang AH, Chiang SS. Rapidly progressive interstitial renal fibrosis associated with Chinese herbal medications. Am J Nephrol 2001;21:441-8. PubMed
    6. 12785. Lord GM, Cook T, Arlt VM, et al. Urothelial malignant disease and Chinese herbal nephropathy. Lancet 2001;358:1515-6. PubMed
  • Liver problems Worth acting on Additional detail

    Recorded for Aristolochia in the same Natural Medicines adverse-effect record shown under Kidney problems above.

Everything above comes from the Natural Medicines adverse-effect record for Aristolochia — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Esketamine’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Esketamine column appears here.

Special populations

Aristolochia in Pregnancy & Breastfeeding

Pregnancy And Lactation 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 Esketamine

This page covers Aristolochia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esketamine page lists 11 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Scopolia (major), Cowhage (moderate), Dhea (moderate), Griffonia Simplicifolia (moderate) and Indian Snakeroot (moderate).

By severity: 1 major · 6 moderate · 4 minor.

From our pharmacist’s overview on the Esketamine page

“Esketamine (Spravato) is the nasal spray for depression that hasn't responded to standard treatment, and its supplement list deserves genuine respect. Scopolia carries the only major rating and is the entry to understand before any other; pairing it with the medication can raise the risk of anticholinergic effects, meaning dry mouth, b…”

Reviewed by 2 · Jul 18, 2026

Open the Esketamine interaction page

How much people look this up

Where Aristolochia and Esketamine 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 Aristolochia
Top half

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

29 days ago today
Medication Esketamine
Steady interest

#2,708 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 Aristolochia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Aristolochia and Esketamine 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 Aristolochia

What is Aristolochia?

Aristolochia
  • Promoting menstruation
  • Aphrodisiac
  • Immune stimulation
  • Snakebite remedies
  • Pain and inflammation

Aristolochia contains aristolochic acid, a potent toxin linked to severe kidney damage and cancer, and it is not safe to take. The FDA and other health authorities have warned against any product containing aristolochic acid. Despite its history in traditional medicine, no proven benefit outweighs these serious dangers.

Aristolochia spp. · Aristolochiaceae · Root, stem, and aerial parts (in traditional remedies) · Dried herb, powders, capsules, teas, and traditional tinctures

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

Aristolochia: dosing

There is no safe or recommended dose of Aristolochia. Because it contains a toxic, cancer-causing compound, it should not be taken at all.If you come across a supplement, tea, or traditional remedy that lists Aristolochia (or related names like birthwort, Mu Tong, or Fang Ji) as an ingredient, do not use it.

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

Read the full Aristolochia monograph & all interactions
Medication

About Esketamine Nasal Spray

What Is Esketamine Nasal Spray Used For?

Brand name: Spravato

Spravato nasal spray is approved for two uses in adults. First, it treats treatment-resistant depression (TRD) — depression that has not responded to other antidepressants — either on its own or alongside an oral antidepressant. Second, it treats depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, always used together with an oral antidepressant in this case.

Important limits: Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behavior on its own. It is not a replacement for hospitalization if that is clinically needed, and it is not approved as an anesthetic.

Most-Reported Side Effects for Esketamine

From FAERS, the FDA’s public side-effect reporting system (17,728 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dissociation 3,733 reports
Sedation 2,706 reports
Suicidal ideation 1,351 reports
Nausea 957 reports
Depression 873 reports
See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & Aristolochia

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

0Major
355Moderate
0Minor
2,474No known interaction
355 Moderate 2,474 No interaction
Moderate

355 interactions

Showing 60 of 355 moderate interactions — see all 355 on the Aristolochia page.

No interaction 2,474 drugs checked — show the list

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

Showing the 60 most looked-up of 2,474 medications checked with no known interaction — see the full Aristolochia list.

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

Aristolochia References

The 27 references that drive our Aristolochia 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. van Ypersele de Strihou C, Vanherweghem JL. The tragic paradigm of Chinese herbs nephropathy. Nephrol Dial Transplant 1995;10:157-60. DOI
  2. Nortier JL, Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N Engl J Med 2000;342:1686-92.
  3. Lewis CJ, Alpert S. Letter to health care professionals -- FDA concerned about botanical products, including dietary supplements, containing aristolochic acid. Office of Nutritional Products, Labeling, Dietary Supplements. Center for Food Safety and Appli
  4. Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Mutagenesis 2002;17:265-77. PubMed
  5. Cronin AJ, Maidment G, Cook T, et al Aristolochic acid as a causative factor in a case of Chinese herbal nephropathy. Nephrol Dial Transplant 2002;17:524-5. PubMed
  6. Chang CH, Wang YM, Yang AH, Chiang SS. Rapidly progressive interstitial renal fibrosis associated with Chinese herbal medications. Am J Nephrol 2001;21:441-8. PubMed
  7. Lord GM, Cook T, Arlt VM, et al. Urothelial malignant disease and Chinese herbal nephropathy. Lancet 2001;358:1515-6. PubMed
  8. Lord GM, Tagore R, Cook T, et al. Nephropathy caused by Chinese herbs in the UK. Lancet 1999;354:481-2. PubMed
  9. Nortier JL, Vanherweghem JL. Renal interstitial fibrosis and urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). Toxicology 2002;181-182:577-80. PubMed
  10. Martinez M. C., Nortier J., Vereerstraeten P., Vanherweghem J. L. Progression rate of Chinese herb nephropathy: impact of Aristolochia fangchi ingested dose. Nephrol.Dial.Transplant. 2002;17(3):408-12. PubMed
  11. Nortier, J. [Renal interstitial fibrosis and urotelial carcinomas after ingestion of a Chinese herb (Aristolochia fangchi)]. Nephrologie 2002;23(1):37-38.
  12. Ioset, J. R., Raoelison, G. E., and Hostettmann, K. Detection of aristolochic acid in Chinese phytomedicines and dietary supplements used as slimming regimens. Food Chem Toxicol 2003;41(1):29-36. PubMed
  13. Yu Y., Zheng F. L., Li H. [Chinese herbs-induced renal failure with Fanconi syndrome: a report of 6 cases]. Zhonghua Nei Ke.Za Zhi. 2003;42:110-12.
  14. Schaneberg, B. T. and Khan, I. A. Analysis of products suspected of containing Aristolochia or Asarum species. J.Ethnopharmacol. 2004;94(2-3):245-249. PubMed
  15. Chan, T. Y., Tam, H. P., Lai, C. K., and Chan, A. Y. A multidisciplinary approach to the toxicologic problems associated with the use of herbal medicines. Ther Drug Monit. 2005;27(1):53-57. 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 Aristolochia and Esketamine Together: Common Questions

Is it safe to take Aristolochia with Esketamine?
We do not list a known interaction between Aristolochia and Esketamine. 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 Aristolochia and Esketamine combination checked?
Interactions in our licensed database are recorded against drug classes. Esketamine is filed under 2 classifications, and Aristolochia has documented interactions with 1 drug class — none of Esketamine'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 Aristolochia interact with any other medications?
Yes. Aristolochia has 355 documented drug interactions in our database — Esketamine 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 Esketamine interact with any supplements?
Yes. Esketamine has documented interactions with 11 supplements in our database — Aristolochia is not one of them. The Esketamine 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

Aristolochia monograph Uses, safety profile, and every drug interaction in one place Esketamine Nasal Spray drug information The full plain-English guide to this medication Esketamine supplement interactions Every supplement checked against Esketamine, 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 27 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and Aristolochia?

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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.