Drug & supplement interaction

Epistane + Daunorubicin, Cytarabine

Daunorubicin, Cytarabine brand name: Vyxeos.

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

Epistane has a moderate interaction with Daunorubicin, Cytarabine. Theoretically, concomitant use might have additive adverse hepatotoxic effects.

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

Epistane and Daunorubicin, Cytarabine

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Daunorubicin, Cytarabine

Daunorubicin, Cytarabine falls under HEPATOTOXIC DRUGS — the group Epistane interacts with.

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
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 has been associated with hepatotixicity in a case series of four patients.
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 simple version. Vyxeos (the daunorubicin and cytarabine combo you get for leukemia) can already be tough on your liver. Epistane is a methylated anabolic steroid that is well known to stress the liver too. Put them together and the worry is that the liver strain piles up, so your liver enzymes could climb higher and you'd be at greater risk for liver injury, with signs like yellowing skin or eyes, dark urine, belly pain, or feeling unusually tired.

This particular concern is theoretical, based on how epistane behaves rather than reports of these two being used together, so I'm not trying to scare you. Still, epistane is liver-toxic and illegal to sell as a supplement, and you're already in serious cancer treatment. Please don't add it. Talk with your oncology team or pharmacist before taking anything new.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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. 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.

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

Epistane Also Interacts With Other Medications

Epistane has 369 moderate known drug interactions in our database — the Daunorubicin, Cytarabine one above is one of them. If you take anything else, check it against the full list below.

Moderate 369 No known interaction 2,461 (incl. Daunorubicin, Cytarabine)
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.

Everything else you take

See Every Supplement That Interacts With Daunorubicin, Cytarabine

This page covers Epistane only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Daunorubicin, Cytarabine page lists 50 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), Acerola (moderate) and Alpha-lipoic Acid (moderate).

By severity: 3 major · 47 moderate.

From our pharmacist’s overview on the Daunorubicin, Cytarabine page

“Vyxeos pairs daunorubicin and cytarabine to treat acute myeloid leukemia, and its supplement list is one to handle with genuine care. Most of it points at the liver: 38 of the 50 flagged ingredients can stress an organ already processing intensive chemotherapy, and the three rated major all belong to that group.”

Reviewed by 2 · Jul 18, 2026

Open the Daunorubicin, Cytarabine interaction page

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. Your product may carry other ingredients that interact with Daunorubicin, Cytarabine too, on top of Epistane — 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 Epistane and Daunorubicin, Cytarabine 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
Top half

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

29 days ago today
Medication Daunorubicin, Cytarabine
Top 5%

#98 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 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.

Read the full Epistane monograph & all interactions
Medication

About Daunorubicin and Cytarabine Lipid Complex Injection

What Is Daunorubicin and Cytarabine Lipid Complex Injection Used For?

Brand name: Vyxeos

  • Daunorubicin and cytarabine lipid complex is used to treat certain types of acute myeloid leukemia (AML; a type of cancer of the white blood cells) in adults and children 1 year of age and older. Daunorubicin is in a class of medications called anthracyclines. Cytarabine is in a class of medications called antimetabolites. Daunorubicin and cytarabine lipid complex slows or stops the growth of cancer cells in your body.

See full Daunorubicin and Cytarabine Lipid Complex Injection 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
369Moderate
0Minor
2,460No known interaction
369 Moderate 2,460 No interaction
Moderate

369 interactions

Showing 60 of 369 moderate interactions — see all 369 on the Epistane page.

No interaction 2,460 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 2,460 medications checked with no known interaction — see the full Epistane list.

See the full Epistane interactions page
See every supplement checked against Daunorubicin, Cytarabine, 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
Epistane monograph › Uses, safety, and every drug interaction in one place Daunorubicin, Cytarabine supplement interactions › Every supplement checked against Daunorubicin, Cytarabine, ranked by severity Daunorubicin and Cytarabine Lipid Complex Injection 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 Epistane and Daunorubicin, Cytarabine Together: Common Questions

Can you take Epistane with Daunorubicin, Cytarabine?
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 Epistane and Daunorubicin, Cytarabine 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 Daunorubicin, Cytarabine and Epistane?

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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.