Drug & supplement interaction

Chokeberry + Fentanyl

Fentanyl brand names: Sublimaze, Duragesic, Fentora, Lazanda, Abstral, and others.

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

Chokeberry has a moderate interaction with Fentanyl. Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.

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

Chokeberry and Fentanyl

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Fentanyl

Fentanyl falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Chokeberry interacts with.

Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that chokeberry inhibits CYP3A4. In humans, there is one case report of a drug interaction with trabectedin, a CYP3A4 substrate, which is hypothesized to have been caused by chokeberry inhibition of CYP3A4.
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 gist: your body relies on a liver enzyme called CYP3A4 to break down fentanyl. In lab studies, chokeberry has shown it might slow that enzyme down a bit. If that happened in real life, fentanyl could clear out of your system more slowly and build up, which means stronger opioid effects like heavy drowsiness, confusion, very slow or shallow breathing, and dangerously low alertness. With a powerful drug like fentanyl, even small shifts deserve respect.

That said, this is mostly theoretical. The evidence is thin (lab data plus a single case report with a different drug), and everyday chokeberry juice or jam is unlikely to matter much. Concentrated supplements are the bigger question mark. Please check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bräunlich M, Christensen H, Johannesen S, Slimestad R, Wangensteen H, Malterud KE, Barsett H. In vitro inhibition of cytochrome P450 3A4 by Aronia melanocarpa constituents. Planta Med. 2013 Jan;79(2):137-41. PubMed
  2. Strippoli S, Lorusso V, Albano A, Guida M. Herbal-drug interaction induced rhabdomyolysis in a liposarcoma patient receiving trabectedin. BMC Complement Altern Med. 2013 Jul 30;13:199. 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

Chokeberry Also Interacts With Other Medications

Chokeberry has 810 moderate known drug interactions in our database — the Fentanyl one above is one of them. If you take anything else, check it against the full list below.

Moderate 810 No known interaction 2,020 (incl. Fentanyl)
Taking anything else?

Check Another of Your Medications Against Chokeberry

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

From our Q&A

Questions About Chokeberry or Fentanyl

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

This page covers Chokeberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fentanyl page lists 226 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 176 moderate · 40 minor.

From our pharmacist’s overview on the Fentanyl page

“There is very little room for error with fentanyl (Duragesic, Sublimaze, Actiq, and other forms), a powerful opioid where a modest rise in blood level or an extra layer of sedation can become dangerous, so this interaction list deserves real respect. Most of the risk falls into two patterns.”

Reviewed by 2 · Jul 18, 2026

Open the Fentanyl interaction page

One more smart check

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

We hold 493 real supplement products containing Chokeberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chokeberry. Your product may carry other ingredients that interact with Fentanyl too, on top of Chokeberry — 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 Chokeberry and Fentanyl 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 Chokeberry
Top half

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

29 days ago today
Medication Fentanyl
Top half

#1,081 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 Chokeberry

What is Chokeberry?

Chokeberry
  • Antioxidant support
  • Heart and blood vessel health
  • Blood pressure support
  • Blood sugar support
  • Common cold symptoms
  • Anti-inflammatory support

Chokeberry (aronia) is a dark berry rich in antioxidants called polyphenols, and it's widely eaten as juice, jam, and supplements. Early research hints it may support heart health, blood pressure, and blood sugar, but the evidence is still limited and far from proven. It's generally well tolerated as a food, but talk to your pharmacist or doctor before using concentrated supplements.

Read the full Chokeberry monograph & all interactions
Medication

About Fentanyl

What Is Fentanyl Used For?

Brand names: Sublimaze, Duragesic, Fentora, Lazanda, Abstral, Subsys

Fentanyl is a strong opioid pain reliever. Which use applies depends on the product.

Fentanyl skin patches treat severe, persistent pain in people who are opioid-tolerant. Oral transmucosal fentanyl lozenges (OTFC) treat breakthrough cancer pain. Fentanyl Citrate Injection is given by trained staff during anesthesia, premedication and recovery after surgery.

See full Fentanyl drug information
Keep checking

Other Drugs & Chokeberry

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

0Major
810Moderate
0Minor
2,019No known interaction
810 Moderate 2,019 No interaction
Moderate

810 interactions

Showing 60 of 810 moderate interactions — see all 810 on the Chokeberry page.

No interaction 2,019 drugs checked — show the list

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

Showing the 60 most looked-up of 2,019 medications checked with no known interaction — see the full Chokeberry list.

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

Can you take Chokeberry with Fentanyl?
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 Chokeberry and Fentanyl 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 Fentanyl and Chokeberry?

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.