Drug & supplement interaction

Black Alder + Doxorubicin

Doxorubicin brand names: Doxil, Adriamycin, Rubex, Caelyx, Myocet.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Black Alder has a moderate interaction with Doxorubicin. Laboratory research shows that black alder bark extracts can antagonize the chemotherapeutic effects of doxorubicin.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Black Alder and Doxorubicin

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

Moderate

DOXORUBICIN (Adriamycin, others)

Laboratory research shows that black alder bark extracts can antagonize the chemotherapeutic effects of doxorubicin. This interaction has not been evaluated in humans. Until more is known, use this combination with caution.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing Black Alder and doxorubicin. Doxorubicin is a powerful chemotherapy drug that works by damaging cancer cell DNA. It is not a prodrug, so it doesn't need to be activated first. The worry here is the opposite problem: in laboratory and test-tube studies, black alder bark extracts seemed to blunt doxorubicin's cancer-fighting power. In plain terms, the supplement might make the chemo work less well, which is a big deal when the whole point is to fight cancer.

I'll be honest, this is only seen in lab dishes, not in people, so we truly don't know how much it matters in real life. Still, with something as important as cancer treatment, it's not worth the gamble. Please run any supplement past your oncologist or pharmacist before using it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Dinic J, Novakovic M, Podolski-Renic A, et al. Antioxidative activity of diarylheptanoids from the bark of black alder (Alnus glutinosa) and their interaction with anticancer drugs. Planta Med 2014;80(13):1088-96. doi: 10.1055/s-0034-1382993. Epub 2014 Au PubMed

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

Black Alder Also Interacts With Other Medications

Black Alder has 1 moderate known drug interaction in our database — the Doxorubicin one above is one of them. If you take anything else, check it against the full list below.

Moderate 1 No known interaction 2,829 (incl. Doxorubicin)
Taking anything else?

Check Another of Your Medications Against Black Alder

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

From our Q&A

Questions About Black Alder or Doxorubicin

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

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

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

By severity: 2 major · 110 moderate · 27 minor.

From our pharmacist’s overview on the Doxorubicin page

“Doxorubicin (Adriamycin, Doxil) is a chemotherapy drug, and with chemotherapy there is little room for a drug level that drifts up or down, so this list deserves genuine care. Of the 139 supplements and foods on file, only two carry a major rating, but they are common ones: grapefruit, which can raise levels of drugs processed the way…”

Reviewed by 2 · Jul 18, 2026

Open the Doxorubicin interaction page

One more smart check

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

We hold 21 real supplement products containing Black Alder, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Alder. Your product may carry other ingredients that interact with Doxorubicin too, on top of Black Alder — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Black Alder and Doxorubicin 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 Black Alder
Top half

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

29 days ago today
Medication Doxorubicin
Steady interest

#1,420 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 Black Alder

What is Black Alder?

Black Alder
  • Sore throat and mouth inflammation
  • Skin wounds and irritation (topical)
  • Fever and general aches (traditional)
  • Digestive complaints
  • Astringent for minor bleeding

Black Alder is a European tree whose bark and leaves have a long history in folk medicine, mainly as an astringent gargle or wound wash. There is very little modern human research to confirm any of these uses, and it can cause stomach upset, so it should be used cautiously and avoided during pregnancy and breastfeeding.

Read the full Black Alder monograph & all interactions
Medication

About Doxorubicin

What Is Doxorubicin Used For?

Brand names: Doxil, Adriamycin, Rubex, Caelyx, Myocet

Doxorubicin is used to treat a wide range of cancers. It is given as part of combination chemotherapy for women with breast cancer that has spread to the lymph nodes after surgery, and it is used for many other cancers — from blood cancers like leukemia and lymphoma to solid tumors like bone and soft tissue sarcomas.

It is considered a broad-spectrum cancer fighter, meaning it is active against many different tumor types. It is almost always given alongside other chemotherapy drugs rather than on its own.

See full Doxorubicin drug information
Keep checking

Other Drugs & Black Alder

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

0Major
1Moderate
0Minor
2,828No known interaction
1 Moderate 2,828 No interaction
Moderate

1 interaction

No interaction 2,828 drugs checked — show the list

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

Showing the 60 most looked-up of 2,828 medications checked with no known interaction — see the full Black Alder list.

See the full Black Alder interactions page
See every supplement checked against Doxorubicin, ranked by severity
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

Keep exploring
Black Alder monograph › Uses, safety, and every drug interaction in one place Doxorubicin supplement interactions › Every supplement checked against Doxorubicin, ranked by severity Doxorubicin drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Black Alder and Doxorubicin Together: Common Questions

Can you take Black Alder with Doxorubicin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Black Alder and Doxorubicin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Doxorubicin and Black Alder?

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.