Drug & supplement interaction

European Chestnut + Pretomanid

Pretomanid brand name: Pretomanid.

No Known Interaction
The bottom line No known interaction

We found no known interaction between European Chestnut and Pretomanid 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 label for Pretomanid states a food rule worth keeping to.

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Interaction report

European Chestnut and Pretomanid

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 Pretomanid and European Chestnut 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.

Worth understanding: our licensed dataset holds no drug-interaction record for European Chestnut at all — not against Pretomanid, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

European Chestnut safety at a glance

European Chestnut overall Use caution The nut is a common food, but concentrated leaf or bark extracts have not been well studied for safety.
Pregnancy Avoid There is not enough safety information, so medicinal use during pregnancy is best avoided.
Breastfeeding Avoid Safety during breastfeeding is unknown, so medicinal use is best avoided.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Pretomanid and European Chestnut? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Pretomanid’s Own FDA Label Lists

This is not an interaction — none of it involves European Chestnut. These are the most notable effects listed in the ADVERSE REACTIONS section of Pretomanid’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 10 of them are worth acting on rather than waiting out — marked below.

  • Low magnesium Worth acting on
  • High potassium Worth acting on
  • An irregular heartbeat Worth acting on mentioned in 5.3% of FDA reports for Pretomanid
  • Low sodium Worth acting on
  • Anemia Worth acting on mentioned in 11.1% of FDA reports for Pretomanid
  • Low blood sugar Worth acting on
  • Low potassium Worth acting on
  • Pancreatitis Worth acting on
  • High blood sugar Worth acting on
  • Seizures Worth acting on

Showing the 10 most notable of 37 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Pretomanid. Read the label on DailyMed › Where a percentage is shown, it is the share of 647 voluntary FDA FAERS reports for Pretomanid that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. European Chestnut’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no European Chestnut side to compare — that is a limit of the record, not a statement that European Chestnut has no side effects.

How to take them

Some Pretomanid Products Have a Food Rule — European Chestnut Should Not Break It

At least one FDA label for a product containing Pretomanid says to take it with food. If you take European Chestnut on an empty stomach out of habit, keep them separate — and take Pretomanid with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Pretomanid products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Recommended Dosage Pretomanid Tablets must be administered in combination with bedaquiline and linezolid with food [see Clinical Pharmacology (12.3) ] .

From the Dosage and Administration section of the FDA label we read for Pretomanid — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Pretomanid

This page covers European Chestnut only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pretomanid page lists 143 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 10 major · 122 moderate · 11 minor.

From our pharmacist’s overview on the Pretomanid page

“Pretomanid is reserved for highly drug-resistant tuberculosis, and it can stress the liver and lengthen the heart's QT interval, so the supplements on this page deserve genuine care. Ten of the 143 ingredients on file carry a major rating, and nearly all of those either compound the liver risk (alcohol in beer or wine is the plainest e…”

Reviewed by 2 · Jul 18, 2026

Open the Pretomanid interaction page

How much people look this up

Where European Chestnut and Pretomanid 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 European Chestnut
Steady interest

#1,129 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pretomanid
Steady interest

#2,246 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 European Chestnut reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The European Chestnut and Pretomanid 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 European Chestnut

What is European Chestnut?

  • Coughs and respiratory irritation
  • Diarrhea and digestive upset
  • Sore throat
  • Wound and skin care
  • General antioxidant support

European Chestnut is a tree whose leaves and nuts have a long history of use for coughs, diarrhea, and skin care, mostly in traditional folk medicine. High-quality human studies are lacking, so its benefits remain unproven, and it should be used cautiously and discussed with a pharmacist or doctor.

Castanea sativa · Fagaceae · Leaves, nuts (seeds), bark, and flowers · Tea, liquid extract, capsules, honey, and topical preparations

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

European Chestnut: dosing

There is no standardized or well-established medicinal dose for European Chestnut. Products vary widely in strength and in which part of the plant they use.If you choose to use a chestnut product, follow the directions on the label and do not exceed the recommended amount.

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

Read the full European Chestnut monograph & all interactions
Medication

About Pretomanid

What Is Pretomanid Used For?

Brand name: Pretomanid

Pretomanid Tablet is used only as part of a three-drug regimen — together with bedaquiline and linezolid — to treat adults with pulmonary (lung) tuberculosis that is resistant to multiple antibiotics, including isoniazid, rifamycins, a fluoroquinolone, and a second-line injectable TB drug. It is also used for adults whose TB is resistant to isoniazid and rifampin and who cannot tolerate or are not responding to standard TB therapy.

Pretomanid Tablets are not for drug-sensitive TB, latent (inactive) TB infection, TB outside the lungs, or TB that responds to standard treatment. They should only be used in combination with bedaquiline and linezolid — safety and effectiveness with other drug combinations have not been established.

See full Pretomanid drug information
Keep checking

Other Drugs & European Chestnut

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

European Chestnut References

The 1 references that drive our European Chestnut 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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

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 European Chestnut and Pretomanid Together: Common Questions

Is it safe to take European Chestnut with Pretomanid?
We do not list a known interaction between European Chestnut and Pretomanid. 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.
Should I take European Chestnut and Pretomanid at the same time of day?
At least one FDA label for a product containing Pretomanid says to take it with food. If you take European Chestnut on an empty stomach out of habit, keep them separate and take Pretomanid with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Pretomanid products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Does Pretomanid interact with any supplements?
Yes. Pretomanid has documented interactions with 143 supplements in our database — European Chestnut is not one of them. The Pretomanid 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 Pretomanid and European Chestnut?

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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.