Drug & supplement interaction

Asarabacca + Asfotase Alfa

Asfotase Alfa brand name: Strensiq.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Asarabacca and Asfotase Alfa 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

Asarabacca and Asfotase Alfa

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 Asfotase Alfa and Asarabacca 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.

Asarabacca safety at a glance

Asarabacca overall Avoid It is in a plant family linked to toxic aristolochic acid, which can harm the kidneys and cause cancer.
Pregnancy Likely Unsafe When used orally. Asarabacca might act as a menstrual or uterine stimulant; contraindicated. Read the full pregnancy detail
Breastfeeding Avoid Safety has not been established and toxic compounds may pass to the baby, so avoid it.

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 Asfotase Alfa and Asarabacca? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
Keep it in perspective

Asarabacca Does Interact With Other Medications

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

Taking anything else?

Check Another of Your Medications Against Asarabacca

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

What to actually watch for

No Interaction Found — But Data Suggests Asarabacca and Asfotase Alfa 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.

  • Vomiting / Nausea Additional detail

    Asarabacca

    “Orally, asarabacca seems to be well tolerated when used appropriately (12). However, large doses may cause nausea and vomiting (12). Severe poisoning has also been reported. Symptoms of poisoning include burning of tongue, gastroenteritis, diarrhea, skin rashes, and partial paralysis (18). Also, asarabacca is commonly contaminated with aristolochic acid, which is nephrotoxic and carcinogenic.”

    Asarabacca · Natural Medicines adverse-effect record, reported in diarrhea.

    4 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 553. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
    3. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    4. 6118. 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

    “Orally, large doses of asarabacca may cause nausea and vomiting (12). Severe poisoning has also been reported. Symptoms of poisoning include burning of tongue, gastroenteritis, and diarrhea (18).”

    Asarabacca · Natural Medicines adverse-effect record, reported in diarrhea.

    3 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 553. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
    3. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

    Asfotase Alfa

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

Reported for Asarabacca but not commonly for Asfotase Alfa: diarrhea.

Effects for Asfotase Alfa come from the ADVERSE REACTIONS section of its FDA label; effects for Asarabacca come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 9,959 voluntary FDA FAERS reports for Asfotase Alfa 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

Asarabacca in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. Asarabacca might act as a menstrual or uterine stimulant; contraindicated.

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

One more smart check

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

We hold 2 real supplement products containing Asarabacca, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Asarabacca. Even though Asarabacca itself has no known interaction with Asfotase Alfa, 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 Asarabacca and Asfotase Alfa 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 Asarabacca
Steady interest

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

29 days ago today
Medication Asfotase Alfa
Top half

#1,104 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 Asarabacca reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Asarabacca and Asfotase Alfa 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 Asarabacca

What is Asarabacca?

Asarabacca
  • Sinus and nasal congestion
  • Coughs and bronchial complaints
  • Inducing sweating
  • Inducing vomiting (emetic)
  • Digestive upset

Asarabacca is a European woodland plant traditionally used to clear the nose, cause sweating, or trigger vomiting, but it is rarely used today. It belongs to a plant family that often contains aristolochic acid, a substance the FDA considers unsafe because it can cause serious kidney damage and cancer, so we do not recommend using it.

Asarum europaeum · Aristolochiaceae · Rhizome (root) and leaves · Dried herb, powder, tincture, traditional snuff

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

Asarabacca: dosing

There is no established safe or standardized dose for Asarabacca, and because of its toxicity, no dose can be recommended. Older herbal texts list traditional amounts for use as a snuff or emetic, but these do not account for the serious risks now understood.We advise not using this herb at all.

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

Read the full Asarabacca monograph & all interactions
Medication

About Asfotase Alfa

What Is Asfotase Alfa Used For?

Brand name: Strensiq

Strensiq (asfotase alfa), given as a subcutaneous injection, is approved to treat perinatal/infantile-onset and juvenile-onset hypophosphatasia (HPP) — a rare genetic disorder in which the body lacks enough of an enzyme called TNSALP, leading to problems with bone mineralization, rickets, bone deformity, and muscle weakness.

HPP can present at birth or in childhood. Strensiq is the specific brand approved for these forms of the disease. Safety and effectiveness have been established in pediatric patients across both onset types.

Most-Reported Side Effects for Asfotase Alfa

From FAERS, the FDA’s public side-effect reporting system (9,959 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Injection site pain 1,327 reports
Fatigue 952 reports
Injection site erythema 869 reports
Injection site reaction 747 reports
Arthralgia 665 reports
See full Asfotase Alfa drug information
Keep checking

Other Drugs & Asarabacca

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

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

355 interactions

Showing 60 of 355 major interactions — see all 355 on the Asarabacca page.

No interaction 2,474 drugs checked — show the list
Evidence & sources

Asarabacca References

The 4 references that drive our Asarabacca 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.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Jaspersen-Schib R, Theus L, Guirguis-Oeschger M, et al. [Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Center]. Schweiz Med Wochenschr 1996;126:1085-98.
  4. 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

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 Asarabacca and Asfotase Alfa Together: Common Questions

Is it safe to take Asarabacca with Asfotase Alfa?
We do not list a known interaction between Asarabacca and Asfotase Alfa. 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 Asarabacca and Asfotase Alfa 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.
Does Asarabacca interact with any other medications?
Yes. Asarabacca has 355 documented drug interactions in our database — Asfotase Alfa is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

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

Still Have a Question About Asfotase Alfa and Asarabacca?

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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.