Drug & supplement interaction

Astragalus + Levoleucovorin

Levoleucovorin brand name: Khapzory.

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 Levoleucovorin 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

Astragalus and Levoleucovorin

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 Levoleucovorin 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 Levoleucovorin and Astragalus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
Keep it in perspective

Astragalus Does Interact With Other Medications

Astragalus has 208 moderate known drug interactions in our database — Levoleucovorin 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. Levoleucovorin)
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 Levoleucovorin 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

    Levoleucovorin

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

  • Nausea reported in 7.8% of FDA reports for Levoleucovorin 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.

    Levoleucovorin

    Listed in the ADVERSE REACTIONS section of the FDA label for Levoleucovorin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

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

Effects for Levoleucovorin come from the ADVERSE REACTIONS section of its FDA label; effects for Astragalus come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 3,706 voluntary FDA FAERS reports for Levoleucovorin 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.

Overlapping uses

What Levoleucovorin Is Prescribed For, and What Astragalus Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Levoleucovorin is a prescription medicine with approved uses on its FDA label. Astragalus is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Levoleucovorin is prescribed for: Levoleucovorin injection (brands: Fusilev, Khapzory) is used intravenously in three main situations. First, it is given as a "rescue" treatment after high-dose methotrexate chemotherapy in osteosarcoma (bone cancer) — helping to limit the toxic effects methotrexate can have on healthy cells. Second, it is used when methotrexate is not clearing the body fast enough, or when there has been an accidental overdose of methotrexate or similar drugs called folic acid antagonists. Third, levoleucovorin injection is used alongside the chemotherapy drug 5-fluorouracil (5-FU) for the palliative treatment of advanced metastatic colorectal cancer — meaning it helps make 5-FU work better, though the goal is disease control rather than cure.

Read the rest of what Levoleucovorin is prescribed for

It is not approved for pernicious anemia or megaloblastic anemias related to vitamin B12 deficiency.

Astragalus has been studied for:

  • Colorectal cancer studied, not established Astragalus has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Astragalus for colorectal cancer

    Oral or intravenous astragalus has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Levoleucovorin on your own; if you are taking Astragalus for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Astragalus or Levoleucovorin

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 Levoleucovorin, 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.

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 Levoleucovorin, 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 Levoleucovorin 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 Levoleucovorin
Steady interest

#2,285 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 Levoleucovorin 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 Levoleucovorin Injection

What Is Levoleucovorin Injection Used For?

Brand name: Khapzory

Levoleucovorin injection (brands: Fusilev, Khapzory) is used intravenously in three main situations. First, it is given as a "rescue" treatment after high-dose methotrexate chemotherapy in osteosarcoma (bone cancer) — helping to limit the toxic effects methotrexate can have on healthy cells. Second, it is used when methotrexate is not clearing the body fast enough, or when there has been an accidental overdose of methotrexate or similar drugs called folic acid antagonists.

Third, levoleucovorin injection is used alongside the chemotherapy drug 5-fluorouracil (5-FU) for the palliative treatment of advanced metastatic colorectal cancer — meaning it helps make 5-FU work better, though the goal is disease control rather than cure. It is not approved for pernicious anemia or megaloblastic anemias related to vitamin B12 deficiency.

Most-Reported Side Effects for Levoleucovorin

From FAERS, the FDA’s public side-effect reporting system (3,706 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 288 reports
Neutropenia 251 reports
Diarrhea 246 reports
Decreased appetite 187 reports
Vomiting 171 reports
See full Levoleucovorin Injection 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 Levoleucovorin, 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 Levoleucovorin Together: Common Questions

Is it safe to take Astragalus with Levoleucovorin?
We do not list a known interaction between Astragalus and Levoleucovorin. 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 Levoleucovorin 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.
Are Astragalus and Levoleucovorin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Astragalus in each. That is a conversation for your prescriber, especially if Levoleucovorin is being adjusted to a target.
Does Astragalus interact with any other medications?
Yes. Astragalus has 208 documented drug interactions in our database — Levoleucovorin 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

Where next

Keep Exploring

Astragalus monograph Uses, safety profile, and every drug interaction in one place Levoleucovorin Injection drug information The full plain-English guide to this medication Levoleucovorin supplement interactions Every supplement checked against Levoleucovorin, 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

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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.