Drug & supplement interaction

Astragalus + Alpelisib

Alpelisib brand name: Piqray.

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 Astragalus and Alpelisib 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 Alpelisib 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

Astragalus and Alpelisib

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 Alpelisib and Astragalus 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.

Astragalus safety at a glance

Astragalus overall Use caution Generally well tolerated short-term in healthy adults, but quality human safety data is limited.
Pregnancy Avoid Not enough reliable safety data, so it is best avoided during pregnancy.
Breastfeeding Avoid Not enough reliable safety data, so it is best avoided while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Alpelisib and Astragalus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Alpelisib

Interactions in our licensed database are recorded against drug classes, not just single drug names. Alpelisib is filed under 3 classifications — cytochrome p450 2c9 (cyp2c9) inducers, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Astragalus has documented interactions with 4 drug classes — the most serious being antidiabetes drugs (moderate), cyclophosphamide (moderate) and immunosuppressants (moderate) — and none of Alpelisib’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

Astragalus Does Interact With Other Medications

Astragalus has 208 moderate known drug interactions in our database — Alpelisib isn’t one of them. If you take anything else, check it against the full list below.

Moderate 208 No known interaction 2,622 (incl. Alpelisib)
Taking anything else?

Check Another of Your Medications Against Astragalus

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

What to actually watch for

No Interaction Found — But Data Suggests Astragalus and Alpelisib 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.

  • Itching / A skin rash Additional detail

    Astragalus

    “Intravenously, astragalus may cause rash, eczema, and pruritus.”

    Astragalus · Natural Medicines adverse-effect record, reported in eczema.

    1 source cited
    1. 33034. Chen, H. W., Lin, I. H., Chen, Y. J., Chang, K. H., Wu, M. H., Su, W. H., Huang, G. C., and Lai, Y. L. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest PubMed

    Alpelisib

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

  • Nausea Additional detail

    Astragalus

    “Orally, astragalus has reportedly been associated with enterocolitis and nausea in one clinical trial. However, these effects may not have been caused by astragalus.”

    Astragalus · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 17355. Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;24:175-81.

    Alpelisib

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

Reported for Astragalus but not commonly for Alpelisib: muscle pain, heart failure, a fast or pounding heartbeat and sore throat.

Effects for Alpelisib come from the ADVERSE REACTIONS section of its FDA label; effects for Astragalus come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Alpelisib Products Have a Food Rule — Astragalus Should Not Break It

At least one FDA label for a product containing Alpelisib says to take it with food. If you take Astragalus on an empty stomach out of habit, keep them separate — and take Alpelisib 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 Alpelisib 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 Dose: Pediatric patients (2 to less than 18 years of age): 50 mg taken orally once daily with food.

From the Dosage and Administration section of the FDA label we read for Alpelisib — 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.

From our Q&A

Questions About Astragalus or Alpelisib

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

This page covers Astragalus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alpelisib page lists 139 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 96 moderate · 40 minor.

From our pharmacist’s overview on the Alpelisib page

“Alpelisib (Piqray) treats PIK3CA-mutated breast cancer, and a drug doing that job leaves little room for supplements that shift its blood level. Yet that is what most of this list does: 121 of the 139 ingredients on file can raise or lower alpelisib through CYP3A4, the liver enzyme that clears it.”

Reviewed by 2 · Jul 18, 2026

Open the Alpelisib interaction page

One more smart check

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

We hold 3,437 real supplement products containing Astragalus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Astragalus. Even though Astragalus itself has no known interaction with Alpelisib, 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 Astragalus and Alpelisib 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 Astragalus
Top 5%

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

29 days ago today
Medication Alpelisib
Steady interest

#1,891 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 Astragalus reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Astragalus and Alpelisib 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 Astragalus

What is Astragalus?

Astragalus
  • Immune support
  • Colds and flu
  • Upper respiratory infections
  • Fatigue and stress (adaptogen)
  • Heart health
  • General wellness in traditional medicine

Astragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong human evidence for most uses is still lacking. It is generally well tolerated by healthy adults for short-term use, but should be avoided during pregnancy and breastfeeding due to limited safety data.

Astragalus membranaceus · Fabaceae · Root · Capsules, tablets, dried root, tea, liquid extract (tincture), powder, and injectable forms used in some countries

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

Astragalus: dosing

There is no official, standardized dose of astragalus. The right amount can depend on the form (capsule, tea, extract), the part of the plant used, and how the product is prepared.Because doses vary widely between products and studies, the best advice is to follow the directions on the product label and not exceed them. A pharmacist can help you review a specific product and decide whether it is appropriate for you.If you start astragalus and notice any unwanted effects, stop and check with a healthcare professional. Avoid using it long-term without medical supervision, since long-term safety is not well established.

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

Read the full Astragalus monograph & all interactions
Medication

About Alpelisib

What Is Alpelisib Used For?

Brand name: Piqray

Alpelisib is approved for two distinct uses, each tied to a specific brand. Piqray is used in combination with another drug called fulvestrant to treat adults with hormone receptor (HR)-positive, HER2-negative, advanced or metastatic breast cancer whose tumors carry a PIK3CA mutation — and only after the cancer has progressed on or after a hormone-based treatment. A companion diagnostic test is required before starting Piqray.

Vijoice is used to treat adults and children 2 years of age and older who have severe manifestations of PIK3CA-Related Overgrowth Spectrum (PROS) — a rare condition where PIK3CA gene mutations cause abnormal tissue, vascular, and bone overgrowth — and who need systemic (whole-body) therapy. Vijoice's approval for PROS was granted under the FDA's accelerated approval pathway based on response data, and continued approval may depend on confirmatory trials.

See full Alpelisib drug information
Keep checking

Other Drugs & Astragalus

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

0Major
208Moderate
0Minor
2,621No known interaction
208 Moderate 2,621 No interaction
Moderate

208 interactions

Showing 60 of 208 moderate interactions — see all 208 on the Astragalus page.

No interaction 2,621 drugs checked — show the list

We also checked Astragalus against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,621 medications checked with no known interaction — see the full Astragalus list.

See the full Astragalus interactions page
See every supplement checked against Alpelisib, ranked by severity
Evidence & sources

Astragalus References

The 13 references that drive our Astragalus 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. Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-25.
  2. Khoo KS, Ang PT. Extract of astragalus membranaceus and ligustrum lucidum does not prevent cyclophosphamide-induced myelosuppression. Singapore Med J 1995;36:387-90.
  3. Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;25:125-9.
  4. Sun Y, Hersh EM, Lee SL, et al. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod 1983;2:227-37..
  5. Ma J, Peng A, Lin S. Mechanisms of the therapeutic effect of astragalus membranaceus on sodium and water retention in experimental heart failure. Chin Med J (Engl) 1998;111:17-23.
  6. Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;24:175-81.
  7. Zhang, J. G., Yang, N., He, H., Wei, G. H., Gao, D. S., Wang, X. L., Wang, X. Z., and Song, G. Y. [Effect of Astragalus injection on plasma levels of apoptosis-related factors in aged patients with chronic heart failure.]. Chin J Integr.Med 2005;11(3):18 PubMed
  8. Chen, H. W., Lin, I. H., Chen, Y. J., Chang, K. H., Wu, M. H., Su, W. H., Huang, G. C., and Lai, Y. L. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest PubMed
  9. Tian H, Lu J, He H, et al.The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis. J Ethnopharmacol. 2016;191:206-215. doi: 10.1016/j.jep.2016.05.062. PubMed
  10. Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Integr Complement Med 2023. PubMed
  11. Chan KW, Kwong ASK, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine 2024;130:155457. PubMed
  12. Han X, Yu T, Chen X, Du Z, Yu M, Xiong J. Effect of Astragalus membranaceus on left ventricular remodeling in HFrEF: a systematic review and meta-analysis. Front Pharmacol 2024;15:1345797. PubMed
  13. Jing P, Hongzheng H, Zhenqi WU, Meijuan Z, Zuojing LI, Gang C. Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials. J Tradit Chin Med 2024;44(2):

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 Astragalus and Alpelisib Together: Common Questions

Is it safe to take Astragalus with Alpelisib?
We do not list a known interaction between Astragalus and Alpelisib. 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 Astragalus and Alpelisib have any of the same side effects?
Yes — our sources link each of them separately to 3 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 Astragalus and Alpelisib at the same time of day?
At least one FDA label for a product containing Alpelisib says to take it with food. If you take Astragalus on an empty stomach out of habit, keep them separate and take Alpelisib with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Alpelisib products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Astragalus and Alpelisib combination checked?
Interactions in our licensed database are recorded against drug classes. Alpelisib is filed under 3 classifications, and Astragalus has documented interactions with 4 drug classes — none of Alpelisib'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 Astragalus interact with any other medications?
Yes. Astragalus has 208 documented drug interactions in our database — Alpelisib 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 Alpelisib interact with any supplements?
Yes. Alpelisib has documented interactions with 139 supplements in our database — Astragalus is not one of them. The Alpelisib 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

Astragalus monograph Uses, safety profile, and every drug interaction in one place Alpelisib drug information The full plain-English guide to this medication Alpelisib supplement interactions Every supplement checked against Alpelisib, 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 13 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Alpelisib and Astragalus?

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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.