Drug & supplement interaction

Black Alder + Pirfenidone

Pirfenidone brand name: Esbriet.

No Known Interaction
Medically reviewed by · Updated June 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Black Alder and Pirfenidone 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 Pirfenidone states a food rule worth keeping to.

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Interaction report

Black Alder and Pirfenidone

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 Pirfenidone and Black Alder 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.

Black Alder safety at a glance

Black Alder overall Use caution Limited safety data exist and it may cause nausea or stomach upset, so use cautiously and briefly.
Pregnancy Avoid There is not enough safety information, so it is best avoided during pregnancy.
Breastfeeding Avoid Safety while breastfeeding is unknown, so avoiding it is the safer choice.

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

Still wondering about combining Pirfenidone and Black Alder? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Pirfenidone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Pirfenidone is filed under 4 classifications — including cytochrome p450 1a2 (cyp1a2) substrates, cytochrome p450 1a2 (cyp1a2) substrates, photosensitizing drugs. Black Alder has documented interactions with 2 drug classes — the most serious being cisplatin (platinol-aq) (moderate) and doxorubicin (adriamycin, others) (moderate) — and none of Pirfenidone’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

Black Alder Does Interact With Other Medications

Black Alder has 2 moderate known drug interactions in our database — Pirfenidone isn’t one of them. If you take anything else, check it against the full list below.

Moderate 2 No known interaction 2,828 (incl. Pirfenidone)
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.

What to actually watch for

What Pirfenidone’s Own FDA Label Lists

This is not an interaction — none of it involves Black Alder. These are the most notable effects listed in the ADVERSE REACTIONS section of Pirfenidone’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 2 of them are worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on
  • A higher chance of infection Worth acting on
  • Weight loss mentioned in 5.5% of FDA reports for Pirfenidone
  • Heartburn
  • Sun sensitivity
  • Reduced appetite mentioned in 8.1% of FDA reports for Pirfenidone
  • Bloating or gas
  • Joint pain
  • Trouble sleeping
  • Tiredness mentioned in 9.5% of FDA reports for Pirfenidone

Showing the 10 most notable of 18 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Pirfenidone. Read the label on DailyMed › Where a percentage is shown, it is the share of 40,089 voluntary FDA FAERS reports for Pirfenidone that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Black Alder’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Black Alder side to compare — that is a limit of the record, not a statement that Black Alder has no side effects.

How to take them

Some Pirfenidone Products Have a Food Rule — Black Alder Should Not Break It

At least one FDA label for a product containing Pirfenidone says to take it with food. If you take Black Alder on an empty stomach out of habit, keep them separate — and take Pirfenidone 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 Pirfenidone 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 Take with food.

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

Everything else you take

See Every Supplement That Interacts With Pirfenidone

This page covers Black Alder only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pirfenidone page lists 115 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Alfalfa (moderate) and Angelica Archangelica (moderate).

By severity: 1 major · 80 moderate · 34 minor.

From our pharmacist’s overview on the Pirfenidone page

“Pirfenidone (Esbriet) slows the lung scarring of idiopathic pulmonary fibrosis, and when a drug is doing that kind of work, this is not a list to skim. Most of the 115 ingredients on file touch CYP1A2, the liver enzyme that clears pirfenidone, so they can push its blood level up (more nausea and liver strain) or drag it down and quietl…”

Reviewed by 2 · Jul 18, 2026

Open the Pirfenidone 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. Even though Black Alder itself has no known interaction with Pirfenidone, 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 Black Alder and Pirfenidone 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

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

29 days ago today
Medication Pirfenidone
Top half

#1,357 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 Black Alder reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Black Alder and Pirfenidone records this page draws on were last updated June 22, 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 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.

Alnus glutinosa · Betulaceae · Bark, leaves, and sometimes the catkins · Dried bark or leaf for tea, decoctions, tinctures, and gargles or mouth rinses

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

Black Alder: dosing

There is no established, standardized dose for Black Alder. Traditional use involved making a tea or decoction from the dried bark or leaves, or using a diluted preparation as a gargle or skin wash.If you choose to use a product, follow the directions on the label and do not exceed the recommended amount.

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

Read the full Black Alder monograph & all interactions
Medication

About Pirfenidone

What Is Pirfenidone Used For?

Brand name: Esbriet

Pirfenidone — available as capsules and tablets under the brand name Esbriet, as well as generic pirfenidone products — is indicated for the treatment of idiopathic pulmonary fibrosis (IPF), a chronic, progressive disease in which scar tissue builds up in the lungs and makes breathing increasingly difficult.

Esbriet capsules and tablets, pirfenidone capsules, and pirfenidone tablets are each specifically approved for IPF. No other uses are supported by the available product labels.

See full Pirfenidone 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
2Moderate
0Minor
2,827No known interaction
2 Moderate 2,827 No interaction
Moderate

2 interactions

No interaction 2,827 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 2,827 medications checked with no known interaction — see the full Black Alder list.

See the full Black Alder interactions page
See every supplement checked against Pirfenidone, ranked by severity
Evidence & sources

Black Alder References

The 1 references that drive our Black Alder 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. 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

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 Black Alder and Pirfenidone Together: Common Questions

Is it safe to take Black Alder with Pirfenidone?
We do not list a known interaction between Black Alder and Pirfenidone. 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 Black Alder and Pirfenidone at the same time of day?
At least one FDA label for a product containing Pirfenidone says to take it with food. If you take Black Alder on an empty stomach out of habit, keep them separate and take Pirfenidone with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Pirfenidone products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Black Alder and Pirfenidone combination checked?
Interactions in our licensed database are recorded against drug classes. Pirfenidone is filed under 4 classifications, and Black Alder has documented interactions with 2 drug classes — none of Pirfenidone'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 Black Alder interact with any other medications?
Yes. Black Alder has 2 documented drug interactions in our database — Pirfenidone 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 Pirfenidone interact with any supplements?
Yes. Pirfenidone has documented interactions with 115 supplements in our database — Black Alder is not one of them. The Pirfenidone 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

Black Alder monograph Uses, safety profile, and every drug interaction in one place Pirfenidone drug information The full plain-English guide to this medication Pirfenidone supplement interactions Every supplement checked against Pirfenidone, 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 1 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Pirfenidone and Black Alder?

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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.