Drug & supplement interaction

Aristolochia + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

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 Aristolochia and Nintedanib Esylate 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 label for Nintedanib Esylate states a food rule worth keeping to, and 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

Aristolochia and Nintedanib Esylate

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

Why No Interaction Is Listed for Nintedanib Esylate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nintedanib Esylate is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Aristolochia has documented interactions with 1 drug class — the most serious being nephrotoxic drugs (moderate) — and none of Nintedanib Esylate’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 — Nintedanib Esylate 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. Nintedanib Esylate)
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

No Interaction Found — But Data Suggests Aristolochia and Nintedanib Esylate May Share Several of the Same Side Effects

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. 2 of them are worth acting on rather than waiting out — marked below.

  • Kidney problems Worth acting on Additional detail

    Aristolochia

    “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

    Nintedanib Esylate

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

  • Liver problems Worth acting on Additional detail

    Aristolochia

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

    Nintedanib Esylate

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

Effects for Nintedanib Esylate come from the ADVERSE REACTIONS section of its FDA label; effects for Aristolochia come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 188 voluntary FDA FAERS reports for Nintedanib Esylate 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.

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

How to take them

Some Nintedanib Esylate Products Have a Food Rule — Aristolochia Should Not Break It

At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Aristolochia on an empty stomach out of habit, keep them separate — and take Nintedanib Esylate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Nintedanib Esylate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Recommended dosage: 150 mg taken orally twice daily approximately 12 hours apart taken with food.

From the Dosage and Administration section of the FDA label we read for Nintedanib Esylate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Aristolochia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

How much people look this up

Where Aristolochia and Nintedanib Esylate 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

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

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,956 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 13, 2026. The Aristolochia and Nintedanib Esylate 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 Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib 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 Nintedanib Esylate, 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 Nintedanib Esylate Together: Common Questions

Is it safe to take Aristolochia with Nintedanib Esylate?
We do not list a known interaction between Aristolochia and Nintedanib Esylate. 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 Aristolochia and Nintedanib Esylate have any of the same side effects?
Yes — our sources link each of them separately to 2 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.
Should I take Aristolochia and Nintedanib Esylate at the same time of day?
At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Aristolochia on an empty stomach out of habit, keep them separate and take Nintedanib Esylate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Nintedanib Esylate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Aristolochia and Nintedanib Esylate combination checked?
Interactions in our licensed database are recorded against drug classes. Nintedanib Esylate is filed under 5 classifications, and Aristolochia has documented interactions with 1 drug class — none of Nintedanib Esylate'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 — Nintedanib Esylate 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 Nintedanib Esylate interact with any supplements?
Yes. Nintedanib Esylate has documented interactions with 285 supplements in our database — Aristolochia is not one of them. The Nintedanib Esylate 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 Nintedanib drug information The full plain-English guide to this medication Nintedanib Esylate supplement interactions Every supplement checked against Nintedanib Esylate, 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

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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.