Drug & supplement interaction

Bitter Almond + Ixazomib Citrate

Ixazomib Citrate brand name: Ninlaro.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Bitter Almond and Ixazomib Citrate 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 Ixazomib Citrate states a food rule worth keeping to.

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Interaction report

Bitter Almond and Ixazomib Citrate

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 Ixazomib Citrate and Bitter Almond 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.

Bitter Almond safety at a glance

Bitter Almond overall Avoid Bitter almond can release cyanide in the body and is considered unsafe to consume.

Pregnancy Avoid It may be poisonous and could harm the pregnancy; do not use.

Breastfeeding Likely Unsafe When used orally. There is insufficient reliable information available about the safety of bitter almond when used topically. Read the full breastfeeding detail

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 Ixazomib Citrate and Bitter Almond? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Ixazomib Citrate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ixazomib Citrate is filed under 3 classifications — hepatotoxic drugs, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Bitter Almond has documented interactions with 1 drug class — the most serious being cns depressants (moderate) — and none of Ixazomib Citrate’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

Bitter Almond Does Interact With Other Medications

Bitter Almond has 248 moderate known drug interactions in our database — Ixazomib Citrate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 248 No known interaction 2,582 (incl. Ixazomib Citrate)

Taking anything else?

Check Another of Your Medications Against Bitter Almond

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

What to actually watch for

What Bitter Almond Itself Has Been Linked To

This is not an interaction — nothing below involves Ixazomib Citrate. It is the side-effect record for Bitter Almond on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Bitter Almond, this list is the first place to look. 2 entries are worth acting on rather than waiting out — marked below.

A severe allergic reaction Worth acting on Additional detail

“Orally, bitter almond and its oil can be toxic due to its amygdalin content.

Most Common Adverse Effects:

Oral: Central nervous system depression with respiratory failure.

Serious Adverse Effects (Rare):

All routes of administration: Allergic reactions, including anaphylaxis.”

Bitter Almond · Natural Medicines adverse-effect record, reported in depression.
An allergic reaction Worth acting on Additional detail
“Tree nuts, which includes bitter almond, can cause allergic reactions in sensitive individuals. Due to the prevalence of this allergy in the general population, tree nuts are classified as a major food allergen in the United States.”

Bitter Almond · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).
1 source cited

105410. Food and Drug Administration. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA); Public Law 108-282, Title II. Accessed on May 19, 2021. Available at: https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-infor

Everything above comes from the Natural Medicines adverse-effect record for Bitter Almond — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Ixazomib Citrate’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Ixazomib Citrate column appears here.

Special populations

Bitter Almond in Pregnancy & Breastfeeding

Lactation Likely Unsafe

When used orally. There is insufficient reliable information available about the safety of bitter almond when used topically.

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

How to take them

Some Ixazomib Citrate Products Have a Food Rule — Bitter Almond Should Not Break It

At least one FDA label for a product containing Ixazomib Citrate says to take it on an empty stomach. Most supplements — Bitter Almond included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Ixazomib Citrate on its own and move Bitter Almond to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Ixazomib Citrate 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.

( 2.1 ) Dose should be taken at least one hour before or at least two hours after food.

From the Dosage and Administration section of the FDA label we read for Ixazomib Citrate — where that label names a specific product, the instruction is that product's. See the Ixazomib Citrate drug page ›

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.

Everything else you take

See Every Supplement That Interacts With Ixazomib Citrate

This page covers Bitter Almond only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ixazomib Citrate page lists 168 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 6 major · 124 moderate · 38 minor.

From our pharmacist’s overview on the Ixazomib Citrate page

“Anyone taking ixazomib citrate (Ninlaro) for multiple myeloma should give this list real weight, because a supplement that shifts this chemotherapy's blood level can shift how well it works against the cancer. Of the 168 ingredients on file, 121 act on CYP3A4, the enzyme that clears ixazomib.”

Reviewed by 2 · Jul 18, 2026

Open the Ixazomib Citrate interaction page

One more smart check

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

We hold 2 real supplement products containing Bitter Almond, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bitter Almond. Even though Bitter Almond itself has no known interaction with Ixazomib Citrate, 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 Bitter Almond and Ixazomib Citrate 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 Bitter Almond

Top half

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

29 days ago today

Medication Ixazomib Citrate

Top 25%

#359 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 Bitter Almond reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Bitter Almond and Ixazomib Citrate 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Bitter Almond

What is Bitter Almond?

Cough suppressant
Muscle spasms (antispasmodic)
Itching and skin conditions
Flavoring agent
Sedative or 'narcotic' effects

Bitter almond is a variety of almond that contains amygdalin, a compound the body converts into cyanide, making it potentially poisonous. Because of this serious toxicity risk, bitter almond should not be eaten or used internally, and there is no reliable proof it treats any health condition. If you want almond's nutrition, choose ordinary sweet almonds instead.

Prunus dulcis var. amara · Rosaceae · Seeds (kernels) and the essential oil pressed from them · Essential oil, distilled water, flavoring extract

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

Bitter Almond: dosing

There is no safe, established dose of bitter almond or untreated bitter almond oil for taking by mouth, because of the cyanide poisoning risk.If you have a product that lists bitter almond as a flavoring, it should be cyanide-free and used only as directed on the label. Never try to dose raw bitter almonds or untreated oil yourself.

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

Read the full Bitter Almond monograph & all interactions

Medication

About Ixazomib

What Is Ixazomib Used For?

Brand name: Ninlaro

Ninlaro (ixazomib) is used to treat multiple myeloma — a cancer of plasma cells in the bone marrow. It is not used alone; it is always taken together with two other medicines, lenalidomide and dexamethasone. This combination is for adults who have already received at least one prior treatment for their myeloma.

Ninlaro is not recommended for use as maintenance therapy or in newly diagnosed multiple myeloma patients on a lenalidomide and dexamethasone regimen outside of controlled clinical trials.

See full Ixazomib drug information

Keep checking

Other Drugs & Bitter Almond

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

0Major

248Moderate

0Minor

2,581No known interaction

248 Moderate 2,581 No interaction

Moderate

248 interactions

Showing 60 of 248 moderate interactions — see all 248 on the Bitter Almond page.

No interaction 2,581 drugs checked — show the list

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

Showing the 60 most looked-up of 2,581 medications checked with no known interaction — see the full Bitter Almond list.

See the full Bitter Almond interactions page

See every supplement checked against Ixazomib Citrate, ranked by severity

Evidence & sources

Bitter Almond References

The 3 references that drive our Bitter Almond 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.

Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Food and Drug Administration. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA); Public Law 108-282, Title II. Accessed on May 19, 2021. Available at: https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-infor

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 Bitter Almond and Ixazomib Citrate Together: Common Questions

Is it safe to take Bitter Almond with Ixazomib Citrate?

We do not list a known interaction between Bitter Almond and Ixazomib Citrate. 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.

Should I take Bitter Almond and Ixazomib Citrate at the same time of day?

At least one FDA label for a product containing Ixazomib Citrate says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Ixazomib Citrate on its own and move Bitter Almond to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.

How was the Bitter Almond and Ixazomib Citrate combination checked?

Interactions in our licensed database are recorded against drug classes. Ixazomib Citrate is filed under 3 classifications, and Bitter Almond has documented interactions with 1 drug class — none of Ixazomib Citrate'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 Bitter Almond interact with any other medications?

Yes. Bitter Almond has 248 documented drug interactions in our database — Ixazomib Citrate 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 Ixazomib Citrate interact with any supplements?

Yes. Ixazomib Citrate has documented interactions with 168 supplements in our database — Bitter Almond is not one of them. The Ixazomib Citrate 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

Bitter Almond monograph Uses, safety profile, and every drug interaction in one place Ixazomib drug information The full plain-English guide to this medication Ixazomib Citrate supplement interactions Every supplement checked against Ixazomib Citrate, 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 3 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ixazomib Citrate and Bitter Almond?

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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.