Drug & supplement interaction

European Mandrake + Anastrozole

Anastrozole brand name: Arimidex.

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

European Mandrake has a moderate interaction with Anastrozole. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.

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

European Mandrake and Anastrozole

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

Moderate

ORAL DRUGS

Why this applies to Anastrozole

Anastrozole falls under ORAL DRUGS — the group European Mandrake interacts with.

Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First, the most important thing: European mandrake is genuinely poisonous and I'd urge you never to take it in any form. Beyond its own toxicity, here's the theoretical concern with your Arimidex (anastrozole). The tropane alkaloids in mandrake slow down how fast your gut moves things along. When food and pills sit in your digestive tract longer, your body may absorb more of a drug than usual.

So in theory, mandrake could nudge up how much anastrozole you take in, which might mean more of its typical effects like hot flashes, joint or bone aches, fatigue, or headache. To be honest, this is a theoretical idea based on how these chemicals behave, not something proven in real patients. Anastrozole works directly (it isn't a prodrug), so the direction is simply more drug exposure. Please skip the mandrake and check with your pharmacist or oncologist with any questions.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

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

European Mandrake Also Interacts With Other Medications

European Mandrake has 2,041 moderate known drug interactions in our database — the Anastrozole one above is one of them. If you take anything else, check it against the full list below.

Moderate 2,041 No known interaction 789 (incl. Anastrozole)
Taking anything else?

Check Another of Your Medications Against European Mandrake

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

From our Q&A

Questions About European Mandrake or Anastrozole

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

This page covers European Mandrake only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Anastrozole page lists 22 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), 7-methoxyflavone (moderate), Arimistane (moderate), Atractylodes (moderate) and Chrysin (moderate).

By severity: 1 major · 12 moderate · 9 minor.

From our pharmacist’s overview on the Anastrozole page

“Activated charcoal carries the one major rating on the anastrozole (Arimidex) list, because it can soak up the drug in the gut and cut how much your body absorbs. For a medicine that treats hormone-sensitive breast cancer by keeping estrogen suppressed, anything that lowers its level deserves real concern, and I would act on this list…”

Reviewed by 2 · Jul 18, 2026

Open the Anastrozole interaction page

How much people look this up

Where European Mandrake and Anastrozole 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 Mandrake
Top 25%

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

29 days ago today
Medication Anastrozole
Top 25%

#338 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 European Mandrake

What is European Mandrake?

European Mandrake
  • Insomnia (traditional)
  • Pain relief (historical)
  • Anxiety or depression (folk use)
  • Gout and aches (traditional)
  • Sedation or anesthesia (historical)

European mandrake is a highly toxic plant from the nightshade family that was used in ancient and medieval times as a sedative and pain reliever. It contains powerful poisons that can cause serious harm or death, and there is no proof it safely treats any condition. We strongly recommend you do not consume mandrake in any form.

Read the full European Mandrake monograph & all interactions
Medication

About Anastrozole

What Is Anastrozole Used For?

Brand name: Arimidex

Anastrozole (also sold as Arimidex) is used in postmenopausal women to treat hormone receptor-positive breast cancer at several stages. This includes early breast cancer after surgery (adjuvant therapy), locally advanced or metastatic breast cancer as a first treatment, and advanced breast cancer that has continued to grow after tamoxifen therapy.

For the second-line use in advanced breast cancer, women whose cancer did not respond to estrogen receptor (ER) testing or who did not respond to tamoxifen rarely benefited from anastrozole.

See full Anastrozole drug information
Keep checking

Other Drugs & European Mandrake

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

0Major
2,041Moderate
0Minor
788No known interaction
2,041 Moderate 788 No interaction
Moderate

2,041 interactions

Showing 60 of 2,041 moderate interactions — see all 2,041 on the European Mandrake page.

No interaction 788 drugs checked — show the list

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

Showing the 60 most looked-up of 788 medications checked with no known interaction — see the full European Mandrake list.

See the full European Mandrake interactions page
See every supplement checked against Anastrozole, 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
European Mandrake monograph › Uses, safety, and every drug interaction in one place Anastrozole supplement interactions › Every supplement checked against Anastrozole, ranked by severity Anastrozole 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 European Mandrake and Anastrozole Together: Common Questions

Can you take European Mandrake with Anastrozole?
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 European Mandrake and Anastrozole 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 Anastrozole and European Mandrake?

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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.