Drug & supplement interaction

Balneotherapy + Palifermin

Palifermin brand name: Kepivance.

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 Balneotherapy and Palifermin 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

Balneotherapy and Palifermin

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 Palifermin and Balneotherapy in our sources. This does not guarantee that the combination is completely free of risk — research on Balneotherapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Balneotherapy at all — not against Palifermin, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Balneotherapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. 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.

Balneotherapy safety at a glance

Balneotherapy overall Use caution Generally low-risk for healthy adults, but warm or hot water bathing isn't safe for everyone.
Pregnancy Possibly Unsafe When heated balneotherapy is used. Conditions that increase maternal core temperature above 39°C have been associated with increased risk of teratogenicity. Som... Read the full pregnancy detail
Breastfeeding Use caution Likely low-risk for ordinary warm baths, but limited data exist on therapeutic spa treatments.

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 Palifermin and Balneotherapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Balneotherapy and Palifermin May Share a Side Effect

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 having Balneotherapy while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • A higher chance of infection Worth acting on reported in 6.2% of FDA reports for Palifermin Additional detail

    Balneotherapy

    “Balneotherapy is well tolerated when used appropriately, short term. Adverse effects attributed to balneotherapy have rarely been reported in clinical trials. They may include changes in blood pressure, cardiac arrhythmia, mild redness and burning of the skin, increased risk of infections, weakness, and insomnia.”

    Balneotherapy · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 98387. Karagülle M, Kardes S, Disçi R, Karagülle MZ. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial. Int J Biometeorol. 2018;62(2):195-205. PubMed
    2. 98390. Kovács C, Bozsik Á, Pecze M, et al. Effects of sulfur bath on hip osteoarthritis: a randomized, controlled, single-blind, follow-up trial: a pilot study. Int J Biometeorol. 2016;60(11):1675-1680. PubMed
    3. 98393. Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther. 2014;16(4):R141. PubMed
    4. 103537. Gáti T, Tefner IK, Kovács L, Hodosi K, Bender T. The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study. Int J Biometeorol. 2018;62(5):897-905. PubMed
    5. 103540. Farina S, Gisondi P, Zanoni M, et al. Balneotherapy for atopic dermatitis in children at Comano spa in Trentino, Italy. J Dermatolog Treat. 2011;22(6):366-71. PubMed
    6. 103541. Dubois O, Salamon R, Germain C, et al. Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Complement Ther Med. 2010;18(1):1-7. PubMed

    “Respiratory tract, skin, and urinary tract infections possibly related to balneotherapy have been reported.”

    Balneotherapy · Natural Medicines adverse-effect record, reported in urinary tract infections (utis).

    2 sources cited
    1. 103537. Gáti T, Tefner IK, Kovács L, Hodosi K, Bender T. The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study. Int J Biometeorol. 2018;62(5):897-905. PubMed
    2. 103541. Dubois O, Salamon R, Germain C, et al. Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Complement Ther Med. 2010;18(1):1-7. PubMed

    Palifermin

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

Reported for Balneotherapy but not commonly for Palifermin: an irregular heartbeat, raised blood pressure, low blood pressure and trouble sleeping.

Effects for Palifermin come from the ADVERSE REACTIONS section of its FDA label; effects for Balneotherapy come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 388 voluntary FDA FAERS reports for Palifermin 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

Balneotherapy in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When heated balneotherapy is used. Conditions that increase maternal core temperature above 39°C have been associated with increased risk of teratogenicity. Some early research also found an association between maternal heat exposure in the form of a hot tub or sauna during the first trimester and increased risk of neural tube defects. While a more recent analysis of clinical research shows that it is safe for pregnant women to sit in hot baths at 40°C (104°F) or in saunas at 70°C (158°F) for up to 20 minutes, regardless of trimester, clinical practice guidelines by the American College of Obstetricians and Gynecologists still discourage pregnant women from using hot water baths during pregnancy due to possible risks. Until more is known, pregnant women should avoid hot balneotherapy baths and other treatments. There is insufficient reliable information available about the safety of balneotherapy heated to less than 39°C; avoid using.

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 Palifermin

This page covers Balneotherapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palifermin page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Palifermin page

“Palifermin (Kepivance) is given by IV to prevent the severe mouth sores that intensive chemotherapy can cause, most often in patients heading into a stem cell transplant, and I read its interaction list with genuine caution because of how fragile those patients already are. All 17 supplements on file act on absorption through the gut,…”

Reviewed by 2 · Jul 18, 2026

Open the Palifermin interaction page

How much people look this up

Where Balneotherapy and Palifermin 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 Balneotherapy
Steady interest

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

29 days ago today
Medication Palifermin
Steady interest

#2,024 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 Balneotherapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Balneotherapy and Palifermin 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 .
Treatment approach

About Balneotherapy

What is Balneotherapy?

  • Osteoarthritis joint pain
  • Rheumatoid arthritis
  • Low back pain
  • Fibromyalgia
  • Psoriasis and skin conditions
  • Relaxation and stress relief

Balneotherapy is a traditional treatment that uses bathing in mineral-rich or thermal water, often combined with mud or other natural elements, mainly for joint and skin problems. Some studies suggest it may ease pain and stiffness in conditions like osteoarthritis, but the quality of evidence is limited and benefits may be short-term. It is generally considered low-risk for healthy adults, but people with heart problems, open wounds, or certain medical conditions should check with a doctor first.

Mineral water, thermal spring water, mud, and other natural bathing media · Mineral or thermal baths, mud packs, spa hydrotherapy, sulfur baths, Dead Sea bathing

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

Balneotherapy: dosing

There is no single standardized "dose" for balneotherapy. Treatment programs vary widely in water temperature, mineral content, length of each session, and number of sessions per week. Avoid very hot water and overly long sessions, and stop if you feel dizzy, overheated, or unwell.

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

Read the full Balneotherapy monograph & all interactions
Medication

About Palifermin

What Is Palifermin Used For?

Brand name: Kepivance

Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells).

Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Most-Reported Side Effects for Palifermin

From FAERS, the FDA’s public side-effect reporting system (388 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Mucosal inflammation 56 reports
Febrile neutropenia 39 reports
Rash 39 reports
Stomatitis 34 reports
Erythema 28 reports
See full Palifermin drug information
Keep checking

Other Drugs & Balneotherapy

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Balneotherapy list.

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

Balneotherapy References

The 31 references that drive our Balneotherapy 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. Sukenik S, Baradin R, Codish S, et al. Balneotherapy at the Dead Sea area for patients with psoriatic arthritis and concomitant fibromyalgia. Isr Med Assoc J 2001;3:147-50.
  2. Ardic F, Ozgen M, Aybek H, et al. Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int 2007;27:441-6. PubMed
  3. Altan L, Bingol U, Aslan M, Yurtkuran M. The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 2006;35:283-9. PubMed
  4. Pittler MH, Karagulle MZ, Karagulle M, Ernst E. Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials. Rheumatology (Oxford) 2006;45:880-4. PubMed
  5. Yurtkuran M, Ay A, Karakoc Y. Improvement of the clinical outcome in Ankylosing spondylitis by balneotherapy. Joint Bone Spine 2005;72:303-8. PubMed
  6. Tsoureli-Nikita E, Menchini G, Ghersetich I, Hercogova J. Alternative treatment of psoriasis with balneotherapy using Leopoldine spa water. J Eur Acad Dermatol Venereol 2002;16:260-2. PubMed
  7. Evicik D, Kizilay B, Gokcen E. The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 2002;22:56-9. PubMed
  8. Buskila D, Abu-Shakra M, Neumann L, et al. Balneotherapy for fibromyalgia at the Dead Sea. Rheumatol Int 2001;20:105-8. PubMed
  9. Ravanelli N, Casasola W, English T, Edwards KM, Jay O. Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. Br J Sports Med. 2018;0:1-8. PubMed
  10. Milunsky A, Ulcickas M, Rothman KJ, et al. Maternal heat exposure and neural tube defects. JAMA. 1992;268(7):882-5. DOI
  11. [No authors listed]. ACOG Committee Opinion No. 650: physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol 2015;126:e135-42. PubMed
  12. Bagdatli AO, Donmez A, Eröksüz R, Bahadir G, Turan M, Erdogan N. Does addition of 'mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study. Int J Biometeorol. 2015;59(12) PubMed
  13. Karagülle M, Kardes S, Disçi R, Karagülle MZ. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial. Int J Biometeorol. 2018;62(2):195-205. PubMed
  14. Karagülle M, Kardes S, Karagülle MZ. Long-term efficacy of spa therapy in patients with rheumatoid arthritis. Rheumatol Int. 2018;38(3):353-362. PubMed
  15. Koçyigit BF, Gür A, Altindag Ö, Akyol A, Gürsoy S. Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: A randomized, controlled clinical study. Agri. 2016;28(2):72-8. PubMed

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

Having Balneotherapy While Taking Palifermin: Common Questions

Is it safe to have Balneotherapy while taking Palifermin?
We do not list a known interaction between Balneotherapy and Palifermin. 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 Balneotherapy and Palifermin have any of the same side effects?
Yes — our sources link each of them separately to one 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 Palifermin interact with any supplements?
Yes. Palifermin has documented interactions with 17 supplements in our database — Balneotherapy is not one of them. The Palifermin 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

Balneotherapy monograph Uses, safety profile, and every drug interaction in one place Palifermin drug information The full plain-English guide to this medication Palifermin supplement interactions Every supplement checked against Palifermin, 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 31 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Palifermin and Balneotherapy?

Our pharmacists answer your medication & supplement questions — free.

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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.