Drug & supplement interaction

Arnica + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

Moderate Interaction
The bottom line Moderate

Arnica has a moderate interaction with Nintedanib Esylate. Theoretically, arnica might have additive effects with anticoagulant and antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Arnica and Nintedanib Esylate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Nintedanib Esylate

Nintedanib Esylate falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Arnica interacts with.

Theoretically, arnica might have additive effects with anticoagulant and antiplatelet drugs. Homeopathic arnica preparations are unlikely to have this interaction.
In vitro evidence shows that sesquiterpene lactones in arnica flowers can decrease platelet aggregation. However, this effect has not been reported in humans.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the connection worth knowing. Lab studies suggest arnica may make blood platelets a little less sticky, which can nudge you toward easier bleeding. Nintedanib (Ofev) already carries its own bleeding risk on its own, so stacking these two could, in theory, add up to more bruising, nosebleeds, or bleeding gums.

The good news: this is mostly theoretical, based only on test-tube work, and it hasn't actually been seen in people. Homeopathic arnica (the very diluted kind) and arnica used on intact skin are very unlikely to matter here. Still, since Ofev itself can affect bleeding, I'd run any oral or concentrated arnica past your pharmacist or doctor first before combining them.

References
  1. Schroder H, Losche W, Strobach H, et al. Helenalin and 11 alpha, 13-dihydrohelenalin, two constituents from Arnica montana L., inhibit human platelet function via thiol-dependent pathways. Thromb Res 1990;57:839-45.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Arnica Also Interacts With Other Medications

Arnica has 121 moderate known drug interactions in our database — the Nintedanib Esylate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Arnica

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

From our Q&A

Questions About Arnica or Nintedanib Esylate

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

This page covers Arnica 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

One more smart check

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

We hold 43 real supplement products containing Arnica, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Arnica. Your product may carry other ingredients that interact with Nintedanib Esylate too, on top of Arnica — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Arnica 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 Arnica
Top half

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

29 days ago today
Medication Nintedanib Esylate
Top half

#1,060 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.

Supplement

About Arnica

What is Arnica?

Arnica
  • Bruising
  • Muscle soreness
  • Joint pain (osteoarthritis)
  • Swelling after injury or surgery
  • Sprains and minor aches

Arnica is a daisy-family plant used mainly in topical and homeopathic products for bruising, muscle soreness, and pain. The evidence is mixed and mostly weak, and undiluted arnica taken by mouth can be toxic, so it should only be used on unbroken skin or in heavily diluted homeopathic forms. Talk to your pharmacist or doctor before using it.

Read the full Arnica 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 & Arnica

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

0Major
121Moderate
0Minor
2,708No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Arnica page.

No interaction 2,708 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Arnica and Nintedanib Esylate Together: Common Questions

Can you take Arnica with Nintedanib Esylate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Arnica and Nintedanib Esylate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Nintedanib Esylate and Arnica?

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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.