Drug & supplement interaction

Calendula + Nelarabine

Nelarabine brand name: Atriance.

Minor Interaction
The bottom line Minor

Calendula has a minor interaction with Nelarabine. Theoretically, calendula might have additive effects when used with CNS depressants, although this appears to be unlikely.

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

Calendula and Nelarabine

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

Minor

CNS DEPRESSANTS

Why this applies to Nelarabine

Nelarabine falls under CNS DEPRESSANTS — the group Calendula interacts with.

Theoretically, calendula might have additive effects when used with CNS depressants, although this appears to be unlikely.
Although some animal research has suggested that a saponoside constituent in calendula may have sedative effects, calendula has been used for over 30 years without reports of sedation in humans.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the honest picture for combining calendula with nelarabine. The interaction on file isn't about cancer treatment at all. It's a very mild, mostly theoretical concern that calendula might add to drowsiness when taken with medicines that calm the nervous system. Nelarabine itself can cause neurological side effects like sleepiness, dizziness, confusion, or tiredness, so the idea is that the two together could in theory make you a little more drowsy.

In real life, this is unlikely to amount to much. The evidence is only anecdotal, based on an animal study, and calendula has been used for decades without reports of sedation in people. Still, since nelarabine is a serious chemo drug, I'd run any supplement, even a skin cream or tea, past your oncology team first.

References
  1. Bojadjiev C. On the sedative and hypotensive effect of preparations from the plant Calendula officinalis. Nauch Trud Visshi Med Inst Sof 1964;43:15-20.
  2. Samochowiec L. Pharmacological study of saponosides from Aralia mandshurica Rupr. et Maxim and Calendula officinalis L. Herba Pol. 1983;29:151-155.
  3. Final Assessment report on Calendula officinalis L., flos. European Medicines Agency: Committee on Herbal Medicinal Products (HMPC). 2018. EMA/HMPC/603409/2017. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-cal

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

Calendula Also Interacts With Other Medications

Calendula has 247 minor known drug interactions in our database — the Nelarabine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Calendula

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

From our Q&A

Questions About Calendula or Nelarabine

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

This page covers Calendula only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

One more smart check

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

We hold 214 real supplement products containing Calendula, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Calendula. Your product may carry other ingredients that interact with Nelarabine too, on top of Calendula — 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 Calendula and Nelarabine 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 Calendula
Steady interest

#1,010 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nelarabine
Top 25%

#626 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 Calendula

What is Calendula?

Calendula
  • Minor wounds and skin healing
  • Skin inflammation and irritation
  • Diaper rash
  • Mouth and throat inflammation
  • Soothing dry or chapped skin

Calendula is a flowering plant whose petals are used mainly in skin creams, oils, and ointments to soothe minor irritation and support wound healing. Some early research is promising for skin and mouth uses, but the overall evidence is limited. It is generally well tolerated on the skin, but people allergic to ragweed, daisies, or marigolds should be cautious.

Read the full Calendula monograph & all interactions
Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

See full Nelarabine Injection drug information
Keep checking

Other Drugs & Calendula

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

0Major
0Moderate
247Minor
2,582No known interaction
Minor

247 interactions

Showing 60 of 247 minor interactions — see all 247 on the Calendula page.

No interaction 2,582 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Calendula and Nelarabine Together: Common Questions

Can you take Calendula with Nelarabine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Calendula and Nelarabine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Nelarabine and Calendula?

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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.