Drug & supplement interaction

Asian Water Plantain + Ifosfamide

Ifosfamide brand name: Ifex.

Minor Interaction
The bottom line Minor

Asian Water Plantain has a minor interaction with Ifosfamide. Studies on animals have shown that Asian water plantain extract, which contains triterpenoids, is generally safe at doses up to 1440 mg/kg orally daily and does not cause harm to the body.

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

Asian Water Plantain and Ifosfamide

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

Minor

Nephrotoxic Drugs

Why this applies to Ifosfamide

Ifosfamide falls under Nephrotoxic Drugs — the group Asian Water Plantain interacts with.

Studies on animals have shown that Asian water plantain extract, which contains triterpenoids, is generally safe at doses up to 1440 mg/kg orally daily and does not cause harm to the body. However, using a higher dose of the extract, at 33.3 grams/kg orally for 60 days, has been linked to kidney issues, as indicated by increased blood urea nitrogen levels, and enlargement of the liver and kidneys. Additionally, two components of Asian water plantain, alisol A and alisol B, when given in doses of 400 mg/kg daily and 500 mg/kg daily respectively for 6 months, have been found to increase the production of markers that suggest potential kidney damage from certain medications. While these findings suggest there is very little risk that Asian water plantain may interact with drugs that are harmful to the kidneys, caution is still advised if combined with known nephrotoxic drugs (source: pubmed.ncbi.nlm.nih.gov/28408883/)
Severity Minor Likelihood Unlikely Evidence A

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 thing to know about ifosfamide: it's already known to be tough on the kidneys. That's a well-recognized side effect of this chemo drug, which is why your oncology team watches your kidney function closely during treatment. Asian water plantain (Ze Xie) is traditionally used as a diuretic, and in some animal studies its triterpenoid compounds showed possible signs of kidney stress at very high doses.

The concern here is simply piling one kidney stressor on top of another. The evidence for this is weak and the actual risk is considered low, but with a drug like ifosfamide I wouldn't add this supplement on your own. Please run it by your oncologist or pharmacist first so your kidneys stay protected.

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

Asian Water Plantain Also Interacts With Other Medications

Asian Water Plantain has 354 minor known drug interactions in our database — the Ifosfamide 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 Asian Water Plantain

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

Everything else you take

See Every Supplement That Interacts With Ifosfamide

This page covers Asian Water Plantain only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ifosfamide page lists 149 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 102 moderate · 42 minor.

From our pharmacist’s overview on the Ifosfamide page

“Grapefruit is the first thing I would take off the table during ifosfamide (Ifex) treatment, and this list as a whole deserves careful attention rather than a quick skim. Ifosfamide is chemotherapy, and the body activates it through the CYP3A4 enzyme, so supplements that block or speed up that enzyme can shift how much active drug you…”

Reviewed by 2 · Jul 18, 2026

Open the Ifosfamide interaction page

How much people look this up

Where Asian Water Plantain and Ifosfamide 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 Asian Water Plantain
Steady interest

#1,150 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ifosfamide
Steady interest

#2,231 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 Asian Water Plantain

What is Asian Water Plantain?

Asian Water Plantain
  • Promoting urination (diuretic)
  • Fluid retention and swelling
  • Urinary discomfort
  • Cholesterol and heart health support
  • Kidney and bladder support

Asian water plantain (Ze Xie) is a rhizome long used in traditional Chinese medicine, mainly as a diuretic and for fluid retention. Modern evidence is mostly limited to laboratory and animal studies, so its benefits in people are not well proven, and quality human safety data are lacking. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Asian Water Plantain monograph & all interactions
Medication

About Ifosfamide Injection

What Is Ifosfamide Injection Used For?

Brand name: Ifex

Ifosfamide Injection (brands: Ifex, IFOSFAMIDE) is indicated for use in combination with certain other approved cancer medicines as third-line chemotherapy for germ cell testicular cancer. It is always given alongside mesna, a protective drug that helps prevent serious bladder bleeding.

See full Ifosfamide Injection drug information
Keep checking

Other Drugs & Asian Water Plantain

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

0Major
0Moderate
354Minor
2,475No known interaction
Minor

354 interactions

Showing 60 of 354 minor interactions — see all 354 on the Asian Water Plantain page.

No interaction 2,475 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 Asian Water Plantain and Ifosfamide Together: Common Questions

Can you take Asian Water Plantain with Ifosfamide?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Asian Water Plantain and Ifosfamide interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Ifosfamide and Asian Water Plantain?

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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.