Drug & supplement interaction

Black Seed + Omalizumab

Omalizumab brand name: Xolair.

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

Black Seed has a moderate interaction with Omalizumab. Theoretically, black seed might interfere with immunosuppressive therapy.

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

Black Seed and Omalizumab

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Omalizumab

Omalizumab falls under IMMUNOSUPPRESSANTS — the group Black Seed interacts with.

Theoretically, black seed might interfere with immunosuppressive therapy.
Animal and in vitro studies suggest that black seed might stimulate immune function. However, other animal studies suggest that black seed may suppress immune function.
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 honest picture with black seed and Xolair (omalizumab): this is a very early, theoretical concern, not something proven in people. Omalizumab works by quieting part of your immune system to control allergic asthma, nasal polyps, or stubborn hives. Black seed has been flagged because some lab and animal studies hint it might stimulate the immune system, which could in theory work against what omalizumab is trying to do, while other animal studies suggest the opposite. So the science genuinely points both directions.

Because we just don't have human data here, I wouldn't panic, but I also wouldn't add a concentrated black seed supplement without checking first. Food-amounts as a spice are unlikely to matter. Please run any black seed product past your pharmacist or doctor before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Islam, S. N., Begum, P., Ahsan, T., Huque, S., and Ahsan, M. Immunosuppressive and cytotoxic properties of Nigella sativa. Phytother.Res. 2004;18(5):395-398.
  2. Fararh, K. M., Atoji, Y., Shimizu, Y., Shiina, T., Nikami, H., and Takewaki, T. Mechanisms of the hypoglycaemic and immunopotentiating effects of Nigella sativa L. oil in streptozotocin-induced diabetic hamsters. Res Vet.Sci 2004;77(2):123-129. PubMed
  3. El Obeid, A., Al Harbi, S., Al Jomah, N., and Hassib, A. Herbal melanin modulates tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) production. Phytomedicine. 2006;13(5):324-333.
  4. Abbas, A. T., Abdel-Aziz, M. M., Zalata, K. R., and Tel, Abd Al-Galel. Effect of dexamethasone and Nigella sativa on peripheral blood eosinophil count, IgG1 and IgG2a, cytokine profiles and lung inflammation in murine model of allergic asthma. Egypt J Im
  5. Massadeh, A. M., Al Safi, S. A., Momani, I. F., Al Mahmoud, M., and Alkofahi, A. S. Analysis of cadmium and lead in mice organs: effect of Nigella sativa L. (Black Cumin) on the distribution and immunosuppressive effect of cadmium-lead mixture in mice. B 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 Seed Also Interacts With Other Medications

Black Seed has 911 moderate known drug interactions in our database — the Omalizumab one above is one of them. If you take anything else, check it against the full list below.

Moderate 911 No known interaction 1,919 (incl. Omalizumab)
Taking anything else?

Check Another of Your Medications Against Black Seed

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

From our Q&A

Questions About Black Seed or Omalizumab

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 Seed or Omalizumab, 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 Omalizumab

This page covers Black Seed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Omalizumab page lists 53 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate), Andrographis (moderate) and Ashwagandha (moderate).

By severity: 52 moderate · 1 minor.

From our pharmacist’s overview on the Omalizumab page

“None of the 53 supplements on file for omalizumab (Xolair) carries a major rating, so this is a list to read with steady attention rather than alarm. Xolair treats allergic asthma and chronic hives by calming part of the immune system, and every entry here pulls the other way: these are immune-stimulating products, echinacea and astrag…”

Reviewed by 2 · Jul 18, 2026

Open the Omalizumab interaction page

One more smart check

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

We hold 226 real supplement products containing Black Seed, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Seed. Your product may carry other ingredients that interact with Omalizumab too, on top of Black Seed — 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 Seed and Omalizumab 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 Seed
Top 25%

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

29 days ago today
Medication Omalizumab
Steady interest

#2,288 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 Seed

What is Black Seed?

Black Seed
  • Respiratory support (asthma, allergies, cough)
  • Digestive upset
  • Immune support
  • Blood sugar and cholesterol support
  • General inflammation

Black seed (Nigella sativa) is a traditional spice and remedy that has been studied for asthma, blood sugar, cholesterol, and blood pressure, with early research showing some promise but no firmly proven benefits. It is generally well tolerated in food amounts, but supplement-strength doses are less studied, so talk to your pharmacist or doctor before using it—especially if you are pregnant, breastfeeding, or take other medicines.

Read the full Black Seed monograph & all interactions
Medication

About Omalizumab Injection

What Is Omalizumab Injection Used For?

Brand name: Xolair

Xolair is used for several allergy-driven conditions. It treats moderate to severe persistent asthma in adults and children 6 and older whose symptoms aren't controlled by inhaled corticosteroids alone and who test positive for a perennial allergen (like dust mites or pet dander). It also treats chronic rhinosinusitis with nasal polyps (ongoing sinus inflammation with polyp growth) in adults 18 and older when nasal corticosteroids haven't worked well enough.

Xolair is approved to help reduce allergic reactions — including anaphylaxis (severe, life-threatening allergic reactions) — from accidental food exposures in adults and children as young as 1 year old with IgE-mediated food allergy. It is always used alongside food allergen avoidance, not as a substitute. Finally, Xolair treats chronic spontaneous urticaria (CSU — ongoing hives with no known cause) in adults and adolescents 12 and older who still have symptoms despite taking antihistamines. It is not for emergency treatment of allergic reactions and not for other forms of hives.

See full Omalizumab Injection drug information
Keep checking

Other Drugs & Black Seed

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

0Major
911Moderate
0Minor
1,918No known interaction
911 Moderate 1,918 No interaction
Moderate

911 interactions

Showing 60 of 911 moderate interactions — see all 911 on the Black Seed page.

No interaction 1,918 drugs checked — show the list

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

Showing the 60 most looked-up of 1,918 medications checked with no known interaction — see the full Black Seed list.

See the full Black Seed interactions page
See every supplement checked against Omalizumab, 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 Seed monograph › Uses, safety, and every drug interaction in one place Omalizumab supplement interactions › Every supplement checked against Omalizumab, ranked by severity Omalizumab Injection 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 Seed and Omalizumab Together: Common Questions

Can you take Black Seed with Omalizumab?
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 Seed and Omalizumab 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 Omalizumab and Black Seed?

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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.