Drug & supplement interaction

Coca + Palifermin

Palifermin brand name: Kepivance.

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 Coca and Palifermin 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

Coca and Palifermin

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 Palifermin and Coca 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.

Coca safety at a glance

Coca overall Avoid Coca leaf naturally contains cocaine and is a controlled substance in most countries; only cocaine-free extract is legal as a flavoring.
Pregnancy Unsafe When inhaled or used orally. Coca, and the constituent cocaine, are contraindicated due to abortifacient and teratogenic effects. Coca use is also associated wi... Read the full pregnancy detail
Breastfeeding Unsafe When inhaled or used orally. Coca and the constituent, cocaine, are contraindicated. Cocaine is excreted into human milk and intoxication can occur in infants c... 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 Palifermin and Coca? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Palifermin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Palifermin is filed under a single classification — oral drugs. Coca has documented interactions with 4 drug classes — the most serious being alcohol (ethanol) (major), nifedipine (procardia) (major) and antidiabetes drugs (moderate) — and none of Palifermin’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

Coca Does Interact With Other Medications

Coca has 2 major, 257 moderate known drug interactions in our database — Palifermin isn’t one of them. If you take anything else, check it against the full list below.

Major 2 Moderate 257 No known interaction 2,571 (incl. Palifermin)
Taking anything else?

Check Another of Your Medications Against Coca

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

What to actually watch for

No Interaction Found — But Data Suggests Coca and Palifermin May Share a Side Effect

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.

  • Swelling Additional detail

    Coca

    “Orally, the cocaine constituent of coca can cause serious adverse effects. Respiratory adverse effects include exacerbation of asthma, thermal airway injury, adult respiratory distress syndrome (ARDS), pneumothorax, pneumomediastinum, pulmonary thrombosis, bronchiolitis obliterans, pulmonary edema, pulmonary infiltrates, pulmonary vascular disease, and pulmonary hemorrhage (17).

    Intranasally, chronic cocaine abuse is…”

    Coca · Natural Medicines adverse-effect record, reported in acute respiratory distress syndrome (ards).

    2 sources cited
    1. 17. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
    2. 1258. Alexandrakis G, Tse DT, Rosa RH Jr, Johnson TE. Nasolacrimal duct obstruction and orbital cellulitis associated with chronic intranasal cocaine abuse. Arch Ophthalmol 1999;117:1617-22. PubMed

    Palifermin

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

Reported for Coca but not commonly for Palifermin: a heart attack, shortness of breath, severe muscle breakdown and anxiety or restlessness.

Effects for Palifermin come from the ADVERSE REACTIONS section of its FDA label; effects for Coca come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 388 voluntary FDA FAERS reports for Palifermin 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

Coca in Pregnancy & Breastfeeding

Pregnancy Unsafe

When inhaled or used orally. Coca, and the constituent cocaine, are contraindicated due to abortifacient and teratogenic effects. Coca use is also associated with a high incidence of sudden infant death syndrome (SIDS).

Lactation Unsafe

When inhaled or used orally. Coca and the constituent, cocaine, are contraindicated. Cocaine is excreted into human milk and intoxication can occur in infants consuming human milk after recent exposure to cocaine.

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

Everything else you take

See Every Supplement That Interacts With Palifermin

This page covers Coca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palifermin page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Palifermin page

“Palifermin (Kepivance) is given by IV to prevent the severe mouth sores that intensive chemotherapy can cause, most often in patients heading into a stem cell transplant, and I read its interaction list with genuine caution because of how fragile those patients already are. All 17 supplements on file act on absorption through the gut,…”

Reviewed by 2 · Jul 18, 2026

Open the Palifermin interaction page

How much people look this up

Where Coca and Palifermin 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 Coca
Steady interest

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

29 days ago today
Medication Palifermin
Steady interest

#2,477 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 Coca reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Coca and Palifermin records this page draws on were last updated July 11, 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 Coca

What is Coca?

Coca
  • Altitude sickness
  • Fatigue and low energy
  • Appetite and hunger suppression
  • Digestive upset
  • Flavoring agent in foods and drinks

Coca is a South American plant best known as the natural source of cocaine. While the leaves have a long history of traditional use for altitude sickness, fatigue, and hunger, the whole plant contains cocaine and other alkaloids that make it legally controlled and potentially dangerous in most countries. Only decocainized (cocaine-free) coca extract is used in foods, and there is little reliable evidence to recommend coca as a supplement.

Erythroxylum coca · Erythroxylaceae · Leaves (and decocainized extract) · Tea (mate de coca), chewed leaves, decocainized extract used as a flavoring

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

Coca: dosing

There is no established safe or standard dose of coca as a dietary supplement, and the cocaine-containing leaf is illegal in most countries. We do not recommend a dose.For products that use cocaine-free coca extract as a flavoring, follow the directions on the product label.

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

Read the full Coca monograph & all interactions
Medication

About Palifermin

What Is Palifermin Used For?

Brand name: Kepivance

Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells).

Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Most-Reported Side Effects for Palifermin

From FAERS, the FDA’s public side-effect reporting system (388 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Mucosal inflammation 56 reports
Febrile neutropenia 39 reports
Rash 39 reports
Stomatitis 34 reports
Erythema 28 reports
See full Palifermin drug information
Keep checking

Other Drugs & Coca

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

2Major
257Moderate
0Minor
2,570No known interaction
2 Major 257 Moderate 2,570 No interaction
Major

2 interactions

Moderate

257 interactions

Showing 60 of 257 moderate interactions — see all 257 on the Coca page.

No interaction 2,570 drugs checked — show the list

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

Showing the 60 most looked-up of 2,570 medications checked with no known interaction — see the full Coca list.

See the full Coca interactions page
See every supplement checked against Palifermin, ranked by severity
Evidence & sources

Coca References

The 15 references that drive our Coca 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. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Alexandrakis G, Tse DT, Rosa RH Jr, Johnson TE. Nasolacrimal duct obstruction and orbital cellulitis associated with chronic intranasal cocaine abuse. Arch Ophthalmol 1999;117:1617-22. PubMed
  4. McEvoy AW, Kitchen ND, Thomas DG. Intracerebral haemorrhage in young adults: the emerging importance of drug misuse. BMJ 2000;320:1322-4.
  5. Potter SM, Zelazo PR, Stack DM, Papageorgiou AN. Adverse effects of fetal cocaine exposure on neonatal auditory information processing. Pediatrics 2000;105:E40.. PubMed
  6. Bolla KI, Funderburk FR, Cadet JL. Differential effects of cocaine and cocaine alcohol on neurocognitive performance. Neurology 2000;54:2285-92. PubMed
  7. Heesch CM, Wilhelm CR, Ristich J, et al. Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans. Heart 2000;83:688-95. PubMed
  8. Favier R, Caceres E, Guillon L, et al. Coca chewing for exercise: hormonal and metabolic responses of nonhabitual chewers. J Appl Physiol 1996;81:1901-7.. PubMed
  9. Favier R, Caceres E, Sempore B, et al. Fluid regulatory hormone response to exercise after coca-induced body fluid shifts. J Appl Physiol 1997;83:376-82.. PubMed
  10. Buck AA, Sasaki TT, Hewitt JJ, Macrae AA. Coca chewing and health. An epidemiologic study among residents of a Peruvian village. Am J Epidemiol 1968;88:159-77.. PubMed
  11. Roldan CA, Aliabadi D, Crawford MH. Prevalence of heart disease in asymptomatic chronic cocaine users. Cardiology 2001;95:25-30.. PubMed
  12. Galarza Guzman M, Penaloza Imana R, Echalar Afcha L, et al. Effects of coca chewing on glucose tolerance test. Medicina (B Aires) 1997;57(3):261-4.
  13. Spielvogel H, Rodriguez A, Sempore B, et al. Body fluid homeostasis and cardiovascular adjustments during submaximal exercise: influence of chewing coca leaves. Eur J Appl Physiol Occup Physiol 1997;75(5):400-6. PubMed
  14. Spielvogel, H., Caceres, E., Koubi, H., Sempore, B., Sauvain, M., and Favier, R. Effects of coca chewing on metabolic and hormonal changes during graded incremental exercise to maximum. J.Appl.Physiol 1996;80(2):643-649. PubMed
  15. Favier, R., Caceres, E., Koubi, H., Sempore, B., Sauvain, M., and Spielvogel, H. Effects of coca chewing on hormonal and metabolic responses during prolonged submaximal exercise. J.Appl.Physiol 1996;80(2):650-655. PubMed

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 Coca and Palifermin Together: Common Questions

Is it safe to take Coca with Palifermin?
We do not list a known interaction between Coca and Palifermin. 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 Coca and Palifermin have any of the same side effects?
Yes — our sources link each of them separately to one 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.
How was the Coca and Palifermin combination checked?
Interactions in our licensed database are recorded against drug classes. Palifermin is filed under 1 classification, and Coca has documented interactions with 4 drug classes — none of Palifermin'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 Coca interact with any other medications?
Yes. Coca has 259 documented drug interactions in our database — Palifermin 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 Palifermin interact with any supplements?
Yes. Palifermin has documented interactions with 17 supplements in our database — Coca is not one of them. The Palifermin 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

Coca monograph Uses, safety profile, and every drug interaction in one place Palifermin drug information The full plain-English guide to this medication Palifermin supplement interactions Every supplement checked against Palifermin, 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 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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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.