Drug & supplement interaction

Calabar Bean + Methylnaltrexone

Methylnaltrexone brand name: Relistor.

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 Calabar Bean and Methylnaltrexone 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 Methylnaltrexone states a food rule worth keeping to, and 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

Calabar Bean and Methylnaltrexone

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 Methylnaltrexone and Calabar Bean 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.

Calabar Bean safety at a glance

Calabar Bean overall Avoid The raw bean is poisonous and can cause severe, even fatal, poisoning.
Pregnancy Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Unsafe When used orally; avoid using. 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 Methylnaltrexone and Calabar Bean? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Methylnaltrexone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Methylnaltrexone is filed under a single classification — cytochrome p450 2d6 (cyp2d6) inhibitors. Calabar Bean has documented interactions with 1 drug class — the most serious being anticholinergic drugs (minor) — and none of Methylnaltrexone’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

Calabar Bean Does Interact With Other Medications

Calabar Bean has 195 minor known drug interactions in our database — Methylnaltrexone isn’t one of them. If you take anything else, check it against the full list below.

Minor 195 No known interaction 2,635 (incl. Methylnaltrexone)
Taking anything else?

Check Another of Your Medications Against Calabar Bean

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

What to actually watch for

No Interaction Found — But Data Suggests Calabar Bean and Methylnaltrexone May Share Several of the Same Side Effects

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 taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Sweating / Diarrhea / Vomiting Additional detail

    Calabar Bean

    “Orally, physostigmine, a constituent of calabar bean, can cause cholinergic crisis, including paralysis, coma, and death. Other symptoms of cholinergic crisis may include bradycardia, confusion, diarrhea, miosis, muscle weakness, salivation, sweating, and vomiting (15).”

    Calabar Bean · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

    Methylnaltrexone

    Listed in the ADVERSE REACTIONS section of the FDA label for Methylnaltrexone. Read the label on DailyMed ›

Reported for Calabar Bean but not commonly for Methylnaltrexone: muscle weakness, raised blood pressure, a fast or pounding heartbeat and a slow heartbeat.

Effects for Methylnaltrexone come from the ADVERSE REACTIONS section of its FDA label; effects for Calabar Bean come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Calabar Bean in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When used orally; 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

How to take them

Some Methylnaltrexone Products Have a Food Rule — Calabar Bean Should Not Break It

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

o In patients with chronic non-cancer pain and OIC, take RELISTOR tablets with water on an empty stomach at least 30 minutes before the first meal of the day.

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

Overlapping uses

What Methylnaltrexone Is Prescribed For, and What Calabar Bean Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Methylnaltrexone is a prescription medicine with approved uses on its FDA label. Calabar Bean is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Methylnaltrexone is prescribed for: Methylnaltrexone, sold as Relistor, treats opioid-induced constipation (OIC) — constipation caused by opioid pain medications. Both Relistor tablets and Relistor injection are approved for adults with chronic non-cancer pain, including those with pain related to a prior cancer or its treatment who do not need frequent opioid dose increases. Relistor injection is also approved for adults with advanced illness or active cancer pain who require increasing opioid doses as part of palliative care.

Calabar Bean has been studied for:

  • Constipation studied, not established Calabar Bean has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Calabar Bean for constipation

    Although there has been interest in using oral calabar bean for constipation, there is insufficient reliable information about the clinical effects of calabar bean for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Methylnaltrexone on your own; if you are taking Calabar Bean for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Methylnaltrexone

This page covers Calabar Bean only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methylnaltrexone page lists 3 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Fever Bark (moderate), Iboga (moderate) and Yohimbe (moderate).

By severity: 3 moderate.

From our pharmacist’s overview on the Methylnaltrexone page

“If you take methylnaltrexone (Relistor) for opioid-induced constipation, the supplement list to know is short: three ingredients, all rated moderate, none major. Yohimbe, fever bark, and iboga are all cleared by the same liver enzyme, CYP2D6, and methylnaltrexone can slow that enzyme, letting their active compounds build up in your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Methylnaltrexone interaction page

How much people look this up

Where Calabar Bean and Methylnaltrexone 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 Calabar Bean
Steady interest

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

29 days ago today
Medication Methylnaltrexone
Steady interest

#2,469 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 Calabar Bean reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Calabar Bean and Methylnaltrexone records this page draws on were last updated July 10, 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 Calabar Bean

What is Calabar Bean?

Calabar Bean
  • Source of physostigmine (a prescription drug ingredient)
  • Historically used in 'trial by ordeal' rituals
  • Traditional pain relief and anti-inflammatory uses
  • Historically used for eye conditions (glaucoma)
  • Historically used as a poison

Calabar bean is a highly poisonous West African seed that contains physostigmine, a powerful cholinesterase inhibitor. It is not a safe dietary supplement, and eating the bean can cause serious poisoning or death. Only the purified, regulated drug physostigmine has a legitimate medical use, and that must be prescribed and monitored by a doctor.

Physostigma venenosum · Fabaceae · Seeds (beans) · Not available as a safe consumer supplement; historically the seed and its extracts were used, and the alkaloid physostigmine is used in prescription medicines

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

Calabar Bean: dosing

There is no safe or established dose of Calabar bean for self-care, and it should not be taken as a supplement. The bean is poisonous, and the amount of physostigmine it contains can vary, making any home use extremely risky.The only proper medical use of this plant's active compound is the regulated prescription drug physostigmine, which a doctor doses precisely and monitors closely. Never attempt to use the bean yourself.

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

Read the full Calabar Bean monograph & all interactions
Medication

About Methylnaltrexone

What Is Methylnaltrexone Used For?

Brand name: Relistor

Methylnaltrexone, sold as Relistor, treats opioid-induced constipation (OIC) — constipation caused by opioid pain medications. Both Relistor tablets and Relistor injection are approved for adults with chronic non-cancer pain, including those with pain related to a prior cancer or its treatment who do not need frequent opioid dose increases.

Relistor injection is also approved for adults with advanced illness or active cancer pain who require increasing opioid doses as part of palliative care.

See full Methylnaltrexone drug information
Keep checking

Other Drugs & Calabar Bean

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

0Major
0Moderate
195Minor
2,634No known interaction
195 Minor 2,634 No interaction
Minor

195 interactions

Showing 60 of 195 minor interactions — see all 195 on the Calabar Bean page.

No interaction 2,634 drugs checked — show the list

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

Showing the 60 most looked-up of 2,634 medications checked with no known interaction — see the full Calabar Bean list.

See the full Calabar Bean interactions page
See every supplement checked against Methylnaltrexone, ranked by severity
Evidence & sources

Calabar Bean References

The 2 references that drive our Calabar Bean 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. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

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 Calabar Bean and Methylnaltrexone Together: Common Questions

Is it safe to take Calabar Bean with Methylnaltrexone?
We do not list a known interaction between Calabar Bean and Methylnaltrexone. 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 Calabar Bean and Methylnaltrexone have any of the same side effects?
Yes — our sources link each of them separately to 3 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.
Should I take Calabar Bean and Methylnaltrexone at the same time of day?
At least one FDA label for a product containing Methylnaltrexone 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 Methylnaltrexone on its own and move Calabar Bean 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.
Are Calabar Bean and Methylnaltrexone used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Calabar Bean in each. That is a conversation for your prescriber, especially if Methylnaltrexone is being adjusted to a target.
How was the Calabar Bean and Methylnaltrexone combination checked?
Interactions in our licensed database are recorded against drug classes. Methylnaltrexone is filed under 1 classification, and Calabar Bean has documented interactions with 1 drug class — none of Methylnaltrexone'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 Calabar Bean interact with any other medications?
Yes. Calabar Bean has 195 documented drug interactions in our database — Methylnaltrexone 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 Methylnaltrexone interact with any supplements?
Yes. Methylnaltrexone has documented interactions with 3 supplements in our database — Calabar Bean is not one of them. The Methylnaltrexone 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

Calabar Bean monograph Uses, safety profile, and every drug interaction in one place Methylnaltrexone drug information The full plain-English guide to this medication Methylnaltrexone supplement interactions Every supplement checked against Methylnaltrexone, 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 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Methylnaltrexone and Calabar Bean?

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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.