Drug & supplement interaction

Asarabacca + Melphalan Flufenamide

Melphalan Flufenamide brand name: Pepaxto.

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 Asarabacca and Melphalan Flufenamide 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.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Asarabacca and Melphalan Flufenamide

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 Melphalan Flufenamide 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 Melphalan Flufenamide and Asarabacca? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Melphalan Flufenamide

Interactions in our licensed database are recorded against drug classes, not just single drug names. Melphalan Flufenamide is filed under a single classification — alkylating agents. Asarabacca has documented interactions with 1 drug class — the most serious being nephrotoxic drugs (major) — and none of Melphalan Flufenamide’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

Asarabacca Does Interact With Other Medications

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

Major 355 No known interaction 2,475 (incl. Melphalan Flufenamide)
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

What Asarabacca Itself Has Been Linked To

This is not an interaction — nothing below involves Melphalan Flufenamide. It is the side-effect record for Asarabacca on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Asarabacca, this list is the first place to look.

  • Diarrhea / Vomiting / Nausea Additional detail

    “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.

Everything above comes from the Natural Medicines adverse-effect record for Asarabacca — expand a row for the licensed statement it rests on. We haven’t matched Melphalan Flufenamide to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Melphalan Flufenamide.

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

Everything else you take

See Every Supplement That Interacts With Melphalan Flufenamide

This page covers Asarabacca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Melphalan Flufenamide page lists 7 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Alpha-lipoic Acid (moderate), Coenzyme Q10 (moderate), Rose Hip (moderate) and Turmeric (moderate).

By severity: 7 moderate.

From our pharmacist’s overview on the Melphalan Flufenamide page

“The single most important thing on this page is antioxidants. Melphalan flufenamide (Pepaxto) is a chemotherapy used for multiple myeloma, and part of how it kills cancer cells is by generating free radicals.”

Reviewed by 2 · Jul 18, 2026

Open the Melphalan Flufenamide interaction page

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 Melphalan Flufenamide, 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 Melphalan Flufenamide 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
Top half

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

29 days ago today
Medication Melphalan Flufenamide
Top 25%

#614 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 20, 2026. The Asarabacca and Melphalan Flufenamide 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 Melphalan Flufenamide Injection

What Is Melphalan Flufenamide Injection Used For?

Brand name: Pepaxto

  • Melphalan flufenamide injection is used along with dexamethasone to treat multiple myeloma (a type of cancer of the bone marrow) in adults whose disease has returned or has not improved after receiving at least four other chemotherapy medications. Melphalan flufenamide is in a class of medications called alkylating agents. It works by stopping or slowing the growth of cancer cells in your body.

See full Melphalan Flufenamide Injection 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
355 Major 2,474 No 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

We also checked Asarabacca 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 Asarabacca list.

See the full Asarabacca interactions page
See every supplement checked against Melphalan Flufenamide, ranked by severity
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 Melphalan Flufenamide Together: Common Questions

Is it safe to take Asarabacca with Melphalan Flufenamide?
We do not list a known interaction between Asarabacca and Melphalan Flufenamide. 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 Asarabacca and Melphalan Flufenamide combination checked?
Interactions in our licensed database are recorded against drug classes. Melphalan Flufenamide is filed under 1 classification, and Asarabacca has documented interactions with 1 drug class — none of Melphalan Flufenamide'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 Asarabacca interact with any other medications?
Yes. Asarabacca has 355 documented drug interactions in our database — Melphalan Flufenamide 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 Melphalan Flufenamide interact with any supplements?
Yes. Melphalan Flufenamide has documented interactions with 7 supplements in our database — Asarabacca is not one of them. The Melphalan Flufenamide 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

Asarabacca monograph Uses, safety profile, and every drug interaction in one place Melphalan Flufenamide Injection drug information The full plain-English guide to this medication Melphalan Flufenamide supplement interactions Every supplement checked against Melphalan Flufenamide, 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 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Melphalan Flufenamide and Asarabacca?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.