Drug & supplement interaction

Choline + Gemcitabine

Gemcitabine brand name: Gemzar.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Choline and Gemcitabine 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 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

Choline and Gemcitabine

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 Gemcitabine and Choline 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.

Choline safety at a glance

Choline overall Use caution Generally safe in food amounts, but high-dose supplements can cause side effects and have a daily upper limit.
Pregnancy Likely Safe When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pregnancy and... Read the full pregnancy detail
Breastfeeding Likely Safe When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pregnancy and... 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 Gemcitabine and Choline? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Gemcitabine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Gemcitabine is filed under 2 classifications — antineoplastics, hepatotoxic drugs. Choline has documented interactions with 1 drug class — the most serious being atropine (minor) — and none of Gemcitabine’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

Choline Does Interact With Other Medications

Choline has 16 minor known drug interactions in our database — Gemcitabine isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Choline

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

What to actually watch for

No Interaction Found — But Data Suggests Choline and Gemcitabine 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.

  • Nausea / Vomiting reported in 4.9% of FDA reports for Gemcitabine Additional detail

    Choline

    “Orally, large doses of choline can cause nausea, vomiting, salivation, and anorexia. Gastrointestinal discomfort has reportedly occurred with doses of 9 grams daily, while gastroenteritis has reportedly occurred with doses of 32 grams daily. Doses of lecithin 100 grams standardized to 3.5% choline have reportedly caused diarrhea and fecal incontinence.”

    Choline · Natural Medicines adverse-effect record, reported in anorexia.

    5 sources cited
    1. 42275. Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
    2. 91231. Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. PubMed
    3. 42291. Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318. PubMed
    4. 42310. Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
    5. 42312. Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5

    Gemcitabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Gemcitabine, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Choline but not commonly for Gemcitabine: stomach upset, loss of bladder control, low blood pressure and low mood.

Effects for Gemcitabine come from the ADVERSE REACTIONS section of its FDA label; effects for Choline come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 53,020 voluntary FDA FAERS reports for Gemcitabine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Choline in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When used orally and appropriately. Choline is safe when taken in doses below the tolerable upper intake level (UL), which is 3 grams daily during pregnancy and lactation in those up to 18 years of age and 3.5 grams daily for those 19 years and older. There is insufficient reliable information available about the safety of choline used in higher doses during pregnancy and lactation.

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

Overlapping uses

What Gemcitabine Is Prescribed For, and What Choline Has Been Studied For

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

Gemcitabine is prescribed for: Gemcitabine Injection (available as Avgemsi, Gemcitabine, and Infugem) is used to treat several types of cancer. It is given in combination with carboplatin for advanced ovarian cancer that has returned at least 6 months after platinum-based treatment, and in combination with paclitaxel as a first-line treatment for metastatic breast cancer after prior chemotherapy with an anthracycline (a specific class of chemo drug). It is also given in combination with cisplatin for non-small cell lung cancer (NSCLC) that cannot be removed surgically or has spread. For pancreatic cancer that is locally advanced or has spread, it is used as a single agent — including in patients who have already been treated with fluorouracil.

Choline has been studied for:

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

    Choline for breast cancer

    It is unclear if dietary intake of choline reduces the risk of breast cancer.

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

    Choline for cancer

    It is unclear if dietary choline intake reduces the risk for cancer.

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 Gemcitabine on your own; if you are taking Choline for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Choline or Gemcitabine

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

This page covers Choline only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Gemcitabine page lists 39 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Beer (major), Siberian Cocklebur (major), Wine (major), Ashwagandha (moderate) and Black Cohosh (moderate).

By severity: 3 major · 35 moderate · 1 minor.

Open the Gemcitabine interaction page

One more smart check

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

We hold 11,172 real supplement products containing Choline, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Choline. Even though Choline itself has no known interaction with Gemcitabine, 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 Choline and Gemcitabine 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 Choline
Top 5%

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

29 days ago today
Medication Gemcitabine
Steady interest

#2,568 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 Choline reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Choline and Gemcitabine 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 Choline

What is Choline?

Choline
  • Liver health and fatty liver
  • Brain and memory support
  • Prenatal nutrition and fetal development
  • General nutritional supplementation
  • Sports performance

Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help people who are deficient or who have higher needs (such as during pregnancy), but they are not proven cure-alls and very high doses can cause side effects. Check with your pharmacist or doctor before starting a supplement.

Not applicable (an essential nutrient found in foods and made in the body) · Capsules, tablets, softgels, and powders; common forms include choline bitartrate, choline chloride, phosphatidylcholine, alpha-GPC, and CDP-choline (citicoline)

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

Choline: dosing

There is no single "treatment" dose of choline that works for everyone, and the right amount depends on your age, sex, life stage, and diet. Health authorities have set recommended adequate intake levels for daily choline as well as a daily upper limit, but these are general nutrition guides rather than doses for treating any condition.Supplements come in different strengths and forms, and the amount of actual choline varies by form.

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

Read the full Choline monograph & all interactions
Medication

About Gemcitabine Injection

What Is Gemcitabine Injection Used For?

Brand name: Gemzar

Gemcitabine Injection (available as Avgemsi, Gemcitabine, and Infugem) is used to treat several types of cancer. It is given in combination with carboplatin for advanced ovarian cancer that has returned at least 6 months after platinum-based treatment, and in combination with paclitaxel as a first-line treatment for metastatic breast cancer after prior chemotherapy with an anthracycline (a specific class of chemo drug).

It is also given in combination with cisplatin for non-small cell lung cancer (NSCLC) that cannot be removed surgically or has spread. For pancreatic cancer that is locally advanced or has spread, it is used as a single agent — including in patients who have already been treated with fluorouracil.

Most-Reported Side Effects for Gemcitabine

From FAERS, the FDA’s public side-effect reporting system (53,020 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Disease progression 4,850 reports
Thrombocytopenia 3,706 reports
Neutropenia 3,295 reports
Anemia 3,084 reports
Malignant neoplasm progression 2,912 reports
See full Gemcitabine Injection drug information
Keep checking

Other Drugs & Choline

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

0Major
0Moderate
16Minor
2,813No known interaction
Minor

16 interactions

No interaction 2,813 drugs checked — show the list
Evidence & sources

Choline References

The 14 references that drive our Choline 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. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
  2. Cho E, Willett WC, Colditz GA, et al. Dietary choline and betaine and the risk of distal colorectal adenoma in women. J Natl Cancer Inst 2007;99:1224-31. PubMed
  3. Schmidt, C., Abicht, A., Krampfl, K., Voss, W., Stucka, R., Mildner, G., Petrova, S., Schara, U., Mortier, W., Bufler, J., Huebner, A., and Lochmuller, H. Congenital myasthenic syndrome due to a novel missense mutation in the gene encoding choline acetyl
  4. Tamminga, C., Smith, R. C., Chang, S., Haraszti, J. S., and Davis, J. M. Depression associated with oral choline. Lancet 10-23-1976;2(7991):905. PubMed
  5. Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
  6. Growdon, J. H. and Gelenberg, A. J. Choline and lecithin administration to patients with tardive dyskinesia. Trans.Am.Neurol.Assoc. 1978;103:95-99.
  7. Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318. PubMed
  8. Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
  9. Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5
  10. Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. PubMed
  11. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res. 2013;33(11):897-904. PubMed
  12. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015;102(5): 1113-25.
  13. Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8. PubMed
  14. Food and Nutrition Board, Institute of Medicine. Choline. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington D.C.: National Academy Press; 1998:390-422.

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 Choline and Gemcitabine Together: Common Questions

Is it safe to take Choline with Gemcitabine?
We do not list a known interaction between Choline and Gemcitabine. 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 Choline and Gemcitabine have any of the same side effects?
Yes — our sources link each of them separately to 2 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.
Are Choline and Gemcitabine 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 Choline in each. That is a conversation for your prescriber, especially if Gemcitabine is being adjusted to a target.
How was the Choline and Gemcitabine combination checked?
Interactions in our licensed database are recorded against drug classes. Gemcitabine is filed under 2 classifications, and Choline has documented interactions with 1 drug class — none of Gemcitabine'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 Choline interact with any other medications?
Yes. Choline has 16 documented drug interactions in our database — Gemcitabine 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 Gemcitabine interact with any supplements?
Yes. Gemcitabine has documented interactions with 39 supplements in our database — Choline is not one of them. The Gemcitabine interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Gemcitabine and Choline?

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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.