Drug & supplement interaction

Diindolylmethane + Palifermin

Palifermin brand name: Kepivance.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Diindolylmethane 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

Diindolylmethane 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 Diindolylmethane 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.

Diindolylmethane safety at a glance

Diindolylmethane overall Use caution Generally well tolerated in short-term studies, but long-term safety is not well established.
Pregnancy Likely Safe When used orally in amounts commonly found in foods. The typical diet supplies 2-24 mg of diindolylmethane daily. There is insufficient reliable information ava... Read the full pregnancy detail
Breastfeeding Likely Safe When used orally in amounts commonly found in foods. The typical diet supplies 2-24 mg of diindolylmethane daily. There is insufficient reliable information ava... 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.

Pharmacist analysis

DIM does have some theoretical drug interactions to be aware of, but they are generally believed to be only mild to moderate in nature.

Potential drug interactions with DIM include drugs in the following classes:

  • Drugs that are metabolized by the liver enzyme CYP1A2: DIM may induce this enzyme, increasing the metabolism of certain drugs.
  • Diuretics: DIM may reduce sodium levels, and could have additive effects with diuretics that increase sodium loss.
  • Estrogen: DIM may have both estrogenic and anti-estrogen effects.

These are all detailed in individual interaction pages.

There is no known interaction between DIM and the drug in question, however.

Nevertheless, always be sure to tell your doctor about all the medications you are taking, supplements included.

—

Still wondering about combining Palifermin and Diindolylmethane? 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. Diindolylmethane has documented interactions with 3 drug classes — the most serious being diuretic drugs (moderate), estrogens (moderate) and cytochrome p450 1a2 (cyp1a2) substrates (minor) — 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

Diindolylmethane Does Interact With Other Medications

Diindolylmethane has 116 moderate, 153 minor known drug interactions in our database — Palifermin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 116 Minor 153 No known interaction 2,561 (incl. Palifermin)
Taking anything else?

Check Another of Your Medications Against Diindolylmethane

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

What to actually watch for

No Interaction Found — But Data Suggests Diindolylmethane and Palifermin 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.

  • Fever reported in 16.0% of FDA reports for Palifermin Additional detail

    Diindolylmethane

    “In one case report, a patient developed drug rash with eosinophilia and systemic symptoms (DRESS) after consuming a product containing diindolylmethane, vitamin E, and broccoli powder. The patient developed fever, activated lymphocytes, and swollen lymph nodes. An allergen patch test was positive for diindolylmethane.”

    Diindolylmethane · Natural Medicines adverse-effect record, reported in fever.

    1 source cited
    1. 93840. Le TM, Sanders CJ, van de Corput L, van Erpecum KJ, Röckmann H. Drug rash with eosinophilia and systemic symptoms caused by the dietary supplement diindolylmethane. J Allergy Clin Immunol Pract. 2016 Jan-Feb;4(1):175-6. PubMed

    Palifermin

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

  • A skin rash reported in 10.1% of FDA reports for Palifermin Additional detail

    Diindolylmethane

    “Orally, diindolylmethane is generally well tolerated.

    Most Common Adverse Effects:

    Orally: Diarrhea, gas, headache, nausea, rash, and vomiting.

    Serious Adverse Effects (Rare):

    Orally: Drug rash with eosinophilia and systemic symptoms (DRESS).”

    Diindolylmethane · Natural Medicines adverse-effect record, reported in cluster headache.

    Palifermin

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

Reported for Diindolylmethane but not commonly for Palifermin: blood clots, a stroke or mini-stroke, low sodium and vomiting.

Effects for Palifermin come from the ADVERSE REACTIONS section of its FDA label; effects for Diindolylmethane 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

Diindolylmethane in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When used orally in amounts commonly found in foods. The typical diet supplies 2-24 mg of diindolylmethane daily. There is insufficient reliable information available about the safety of diindolylmethane when used in amounts greater than those found in foods during pregnancy and lactation; 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

From our Q&A

Questions About Diindolylmethane or Palifermin

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

This page covers Diindolylmethane 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

One more smart check

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

We hold 933 real supplement products containing Diindolylmethane, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Diindolylmethane. Even though Diindolylmethane itself has no known interaction with Palifermin, 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 Diindolylmethane 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 Diindolylmethane
Top 25%

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

29 days ago today
Medication Palifermin
Steady interest

#2,284 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 Diindolylmethane reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Diindolylmethane and Palifermin 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 Diindolylmethane

What is Diindolylmethane?

Diindolylmethane
  • Estrogen/hormone balance
  • Acne and hormonal skin issues
  • Prostate health support
  • Cancer-risk reduction (unproven)
  • PMS and menopause symptoms
  • General 'detox' support

Diindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and cancer prevention. Although early lab studies look interesting, strong human evidence is lacking for most of these uses. Talk with your pharmacist or doctor before taking DIM, especially if you have a hormone-sensitive condition.

A compound formed from indole-3-carbinol found in cruciferous vegetables (broccoli, cabbage, kale, Brussels sprouts) · Capsules, tablets, softgels (often combined with black pepper extract/BioPerine for absorption)

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

Diindolylmethane: dosing

There is no official, well-established dose for DIM. Supplement products vary widely in strength, and many add black pepper extract to improve absorption.The safest approach is to follow the directions on the product label and use the lowest amount that seems reasonable.

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

Read the full Diindolylmethane 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 & Diindolylmethane

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

0Major
116Moderate
153Minor
2,560No known interaction
116 Moderate 153 Minor 2,560 No interaction
Moderate

116 interactions

Showing 60 of 116 moderate interactions — see all 116 on the Diindolylmethane page.

Minor

153 interactions

Showing 60 of 153 minor interactions — see all 153 on the Diindolylmethane page.

No interaction 2,560 drugs checked — show the list

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

Showing the 60 most looked-up of 2,560 medications checked with no known interaction — see the full Diindolylmethane list.

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

Diindolylmethane References

The 14 references that drive our Diindolylmethane 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. Natl Inst Health, Natl Inst Environmental Health Sci. Indole-3-carbinol. Available at: http://ntp-server.niehs.nih.gov.
  2. Balk JL. Indole-3-carbinol for cancer prevention. Altern Med Alert 2000; 3:105-7.
  3. Riby JE, Chang GHF, Firestone GL, Bjeldanes LF. Ligand-independent activation of estrogen receptor function by 3,3'-diindolylmethane in human breast cancer cells. Biochem Pharmacol 2000;60:167-77. PubMed
  4. Lake BG, Tredger JM, Renwick AB, et al. 3'3-diindolylmethane induces CYP1A2 in cultured precision-cut human liver slices. Xenobiotica 1998;28:803-11. PubMed
  5. Dalessandri, K. M., Firestone, G. L., Fitch, M. D., Bradlow, H. L., and Bjeldanes, L. F. Pilot study: effect of 3,3'-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Canc PubMed
  6. Reed, G. A., Arneson, D. W., Putnam, W. C., Smith, H. J., Gray, J. C., Sullivan, D. K., Mayo, M. S., Crowell, J. A., and Hurwitz, A. Single-dose and multiple-dose administration of indole-3-carbinol to women: pharmacokinetics based on 3,3'-diindolylmetha
  7. Reed, G. A., Sunega, J. M., Sullivan, D. K., Gray, J. C., Mayo, M. S., Crowell, J. A., and Hurwitz, A. Single-dose pharmacokinetics and tolerability of absorption-enhanced 3,3'-diindolylmethane in healthy subjects. Cancer Epidemiol.Biomarkers Prev. 2008; PubMed
  8. Del Priore G., Gudipudi, D. K., Montemarano, N., Restivo, A. M., Malanowska-Stega, J., and Arslan, A. A. Oral diindolylmethane (DIM): pilot evaluation of a nonsurgical treatment for cervical dysplasia. Gynecol.Oncol. 2010;116(3):464-467. PubMed
  9. Heath, E. I., Heilbrun, L. K., Li, J., Vaishampayan, U., Harper, F., Pemberton, P., and Sarkar, F. H. A phase I dose-escalation study of oral BR-DIM (BioResponse 3,3'- Diindolylmethane) in castrate-resistant, non-metastatic prostate cancer. Am.J.Transl.R
  10. Jellinck, P. H., Forkert, P. G., Riddick, D. S., Okey, A. B., Michnovicz, J. J., and Bradlow, H. L. Ah receptor binding properties of indole carbinols and induction of hepatic estradiol hydroxylation. Biochem.Pharmacol. 3-9-1993;45(5):1129-1136. PubMed
  11. Bui PV, Moualla M, Upson DJ. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis. Case Rep Med. 2016;2016:7527098. PubMed
  12. Castañon A, Tristram A, Mesher D, Powell N, Beer H, Ashman S, Rieck G, Fielder H, Fiander A, Sasieni P. Effect of diindolylmethane supplementation on low-grade cervical cytological abnormalities: double-blind, randomised, controlled trial. Br J Cancer. 20 PubMed
  13. Le TM, Sanders CJ, van de Corput L, van Erpecum KJ, Röckmann H. Drug rash with eosinophilia and systemic symptoms caused by the dietary supplement diindolylmethane. J Allergy Clin Immunol Pract. 2016 Jan-Feb;4(1):175-6. PubMed
  14. Pence ST, Mehta K, Crum-Bailey J. The Serious Side of Supplements: An Ischemic Stroke in a Healthy 38-year-old Female. Mil Med 2022. 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 Diindolylmethane and Palifermin Together: Common Questions

Is it safe to take Diindolylmethane with Palifermin?
We do not list a known interaction between Diindolylmethane 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 Diindolylmethane and Palifermin 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.
How was the Diindolylmethane and Palifermin combination checked?
Interactions in our licensed database are recorded against drug classes. Palifermin is filed under 1 classification, and Diindolylmethane has documented interactions with 3 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 Diindolylmethane interact with any other medications?
Yes. Diindolylmethane has 269 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 — Diindolylmethane 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

Diindolylmethane 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 14 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Palifermin and Diindolylmethane?

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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.