Drug & supplement interaction

Epistane + Asfotase Alfa

Asfotase Alfa brand name: Strensiq.

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 Epistane and Asfotase Alfa 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.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Epistane and Asfotase Alfa

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 Asfotase Alfa and Epistane 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.

Epistane safety at a glance

Epistane overall Avoid Epistane is a liver-toxic anabolic steroid, not a safe supplement, and is banned for sale as a dietary supplement.
Pregnancy Possibly Unsafe When used orally. Anabolic androgenic steroids, such as epistane, can disrupt the body's hormonal balance and cause various adverse effects including reduced fe... Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally. Anabolic androgenic steroids, such as epistane, can disrupt the body's hormonal balance and cause various adverse effects including reduced fe... 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 Asfotase Alfa and Epistane? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
Keep it in perspective

Epistane Does Interact With Other Medications

Epistane has 370 moderate known drug interactions in our database — Asfotase Alfa isn’t one of them. If you take anything else, check it against the full list below.

Moderate 370 No known interaction 2,460 (incl. Asfotase Alfa)
Taking anything else?

Check Another of Your Medications Against Epistane

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

What to actually watch for

No Interaction Found — But Data Suggests Epistane and Asfotase Alfa 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. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Epistane

    “Epistane is an anabolic androgenic steroid, and more specifically a 17-alpha-alkylated androgen. Therefore, there is concern that epistane has hepatotoxic effects. Also, epistane is structurally similar to epitiostanol, which was associated with hepatotoxicity in a case series of four patients.”

    Epistane · Natural Medicines adverse-effect record, reported in cholestasis.

    2 sources cited
    1. 91138. Rahnema CD, Crosnoe LE, Kim ED. Designer steroids - over-the-counter supplements and their androgenic component: review of an increasing problem. Andrology. 2015;3(2):150-5. PubMed
    2. 109606. Díaz FC, Sáez-González E, Benlloch S, et al. Albumin dialysis with MARS for the treatment of anabolic steroid-induced cholestasis. Ann Hepatol. 2016;15(6):939-943.

    Asfotase Alfa

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

  • Itching Additional detail

    Epistane

    Recorded for Epistane in the same Natural Medicines adverse-effect record shown under Liver problems above.

    Asfotase Alfa

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

Reported for Epistane but not commonly for Asfotase Alfa: yellowing of the skin or eyes.

Effects for Asfotase Alfa come from the ADVERSE REACTIONS section of its FDA label; effects for Epistane come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 9,959 voluntary FDA FAERS reports for Asfotase Alfa 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

Epistane in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Unsafe

When used orally. Anabolic androgenic steroids, such as epistane, can disrupt the body's hormonal balance and cause various adverse effects including reduced fertility, hair loss, acne, and behavioral changes. Anabolic androgenic steroid use has also been associated with hepatotoxicity and increased risk for heart disease. The US Food and Drug Administration and other regulatory agencies warn that dietary supplements containing anabolic steroids are dangerous. 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

One more smart check

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

We hold 32 real supplement products containing Epistane, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Epistane. Even though Epistane itself has no known interaction with Asfotase Alfa, 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 Epistane and Asfotase Alfa 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 Epistane
Steady interest

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

29 days ago today
Medication Asfotase Alfa
Top half

#1,405 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 Epistane reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Epistane and Asfotase Alfa 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 Epistane

What is Epistane?

  • Building muscle mass
  • Increasing strength
  • Cutting or losing body fat
  • Bodybuilding cycles

Epistane is a synthetic anabolic steroid (a methylated 'designer steroid'), not a true dietary supplement or herb, even though it has been sold as a 'prohormone.' It is liver-toxic, can disrupt your natural hormones, and is illegal to sell as a supplement in the US under the Designer Anabolic Steroid Control Act. We strongly recommend avoiding it and talking with a doctor or pharmacist.

Synthetic compound (not a plant) · Capsules, tablets (sold as a 'prohormone' or 'designer steroid' supplement)

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

Epistane: dosing

There is no established or recommended safe dose for Epistane, because it is an anabolic steroid that was never approved as a medicine or a legitimate supplement. They can discuss safer, legal ways to reach your fitness goals and check on your liver and hormone health.

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

Read the full Epistane monograph & all interactions
Medication

About Asfotase Alfa

What Is Asfotase Alfa Used For?

Brand name: Strensiq

Strensiq (asfotase alfa), given as a subcutaneous injection, is approved to treat perinatal/infantile-onset and juvenile-onset hypophosphatasia (HPP) — a rare genetic disorder in which the body lacks enough of an enzyme called TNSALP, leading to problems with bone mineralization, rickets, bone deformity, and muscle weakness.

HPP can present at birth or in childhood. Strensiq is the specific brand approved for these forms of the disease. Safety and effectiveness have been established in pediatric patients across both onset types.

Most-Reported Side Effects for Asfotase Alfa

From FAERS, the FDA’s public side-effect reporting system (9,959 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Injection site pain 1,327 reports
Fatigue 952 reports
Injection site erythema 869 reports
Injection site reaction 747 reports
Arthralgia 665 reports
See full Asfotase Alfa drug information
Keep checking

Other Drugs & Epistane

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

0Major
370Moderate
0Minor
2,459No known interaction
370 Moderate 2,459 No interaction
Moderate

370 interactions

Showing 60 of 370 moderate interactions — see all 370 on the Epistane page.

No interaction 2,459 drugs checked — show the list

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

Showing the 60 most looked-up of 2,459 medications checked with no known interaction — see the full Epistane list.

See the full Epistane interactions page
See every supplement checked against Asfotase Alfa, ranked by severity
Evidence & sources

Epistane References

The 3 references that drive our Epistane 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. Joseph JF, Parr MK. Synthetic androgens as designer supplements. Curr Neuropharmacol. 2015;13(1):89-100. PubMed
  2. Rahnema CD, Crosnoe LE, Kim ED. Designer steroids - over-the-counter supplements and their androgenic component: review of an increasing problem. Andrology. 2015;3(2):150-5. PubMed
  3. Díaz FC, Sáez-González E, Benlloch S, et al. Albumin dialysis with MARS for the treatment of anabolic steroid-induced cholestasis. Ann Hepatol. 2016;15(6):939-943.

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 Epistane and Asfotase Alfa Together: Common Questions

Is it safe to take Epistane with Asfotase Alfa?
We do not list a known interaction between Epistane and Asfotase Alfa. 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 Epistane and Asfotase Alfa 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.
Does Epistane interact with any other medications?
Yes. Epistane has 370 documented drug interactions in our database — Asfotase Alfa is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

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

Where next

Keep Exploring

Epistane monograph Uses, safety profile, and every drug interaction in one place Asfotase Alfa drug information The full plain-English guide to this medication Asfotase Alfa supplement interactions Every supplement checked against Asfotase Alfa, 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 3 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Asfotase Alfa and Epistane?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.