Drug & supplement interaction

European Mistletoe + Duloxetine

Duloxetine brand names: Cymbalta, Drizalma Sprinkle, Irenka.

No Known Interaction
The bottom line No known interaction

We found no known interaction between European Mistletoe and Duloxetine 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

European Mistletoe and Duloxetine

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 Duloxetine and European Mistletoe 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.

European Mistletoe safety at a glance

European Mistletoe overall Use caution Raw mistletoe is toxic if swallowed; standardized products should only be used under medical supervision.
Pregnancy Likely Unsafe When used orally or subcutaneously. European mistletoe might have uterine stimulant and abortifacient activity. Read the full pregnancy detail
Breastfeeding Avoid Avoid while breastfeeding because safety has not been established.

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 Duloxetine and European Mistletoe? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Duloxetine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Duloxetine is filed under 8 classifications — including antidepressant drugs, cytochrome p450 2d6 (cyp2d6) inhibitors, serotonergic drugs. European Mistletoe has documented interactions with 2 drug classes — the most serious being antihypertensive drugs (moderate) and immunosuppressants (moderate) — and none of Duloxetine’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

European Mistletoe Does Interact With Other Medications

European Mistletoe has 293 moderate known drug interactions in our database — Duloxetine isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against European Mistletoe

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

What to actually watch for

No Interaction Found — But Data Suggests European Mistletoe and Duloxetine 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. 2 of them are worth acting on rather than waiting out — marked below.

  • Seizures Worth acting on Additional detail

    European Mistletoe

    “Orally, European mistletoe seems to be well tolerated when used in small amounts. However, a thorough evaluation of safety outcomes has not been conducted. Parenterally, European mistletoe may be safe when administered by a healthcare provider.”

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

    “Orally, European mistletoe may cause seizures, coma, and death (18). Subcutaneously, European mistletoe can cause headaches or fatigue or malaise. When injected into the tumor, European mistletoe can cause headaches. Intravenous infusion of aviscumine, a pure form of mistletoe lectin I produced by recombinant DNA techniques, can cause fatigue.”

    European Mistletoe · Natural Medicines adverse-effect record, reported in epilepsy.

    6 sources cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    2. 7044. Kaegi E. Unconventional therapies for cancer: 3. Iscador. Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. CMAJ 1998;158:1157-9.
    3. 7045. Grossarth-Matichek R, Kiene H, Baumgartner SM, Ziegler R. Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health
    4. 9769. Deliorman D, Calis I, Ergun F. A new acyclic monoterpene glucoside from Viscum album ssp. album. Fitoterapia 2001;72:101-5. PubMed
    5. 93261. Kienle GS, Grugel R, Kiene H. Safety of higher dosages of Viscum album L. in animals and humans--systematic review of immune changes and safety parameters. BMC Complement Altern Med. 2011 Aug 28;11:72. PubMed
    6. 93265. Steele ML, Axtner J, Happe A, Kröz M, Matthes H, Schad F. Adverse Drug Reactions and Expected Effects to Therapy with Subcutaneous Mistletoe Extracts (Viscum album L.) in Cancer Patients. Evid Based Complement Alternat Med. 2014;2014:724258.

    Duloxetine

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

  • Liver problems Worth acting on Additional detail

    European Mistletoe

    “Orally, European mistletoe has been associated with two cases of hepatotoxicity when used in combination with other herbal ingredients. In one case, in which a patient took a combination herbal product, it was deemed unlikely that European mistletoe was the causative agent. It was determined to be most likely due to another ingredient or product contamination.”

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

    4 sources cited
    1. 3932. Harvey J, Colin-Jones DG. Mistletoe hepatitis. Br Med J (Clin Res Ed) 1981;282:186-7.
    2. 88777. Kim HJ, Kim H, Ahn JH, Suk JH. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern Complement Med 2015;21(3):180-5. PubMed
    3. 16385. Schoffski P, Breidenbach I, Krauter J, et al. Weekly 24 h infusion of aviscumine (rViscumin): A phase I study in patients with solid tumours. Eur J Cancer 2005;41:1431-8.
    4. 93261. Kienle GS, Grugel R, Kiene H. Safety of higher dosages of Viscum album L. in animals and humans--systematic review of immune changes and safety parameters. BMC Complement Altern Med. 2011 Aug 28;11:72. PubMed

    Duloxetine

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

  • Stomach pain Additional detail

    European Mistletoe

    “Orally, European mistletoe may cause vomiting, diarrhea, and intestinal cramps (18). Intraperitoneal and intratumoral injection may cause nausea, vomiting, and abdominal pain. Subcutaneously, European mistletoe may cause flatulence, loose stools, diarrhea, nausea, and vomiting. Intravenously, aviscumine, a pure form of mistletoe lectin I produced by recombinant DNA techniques, may cause nausea and vomiting.”

    European Mistletoe · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    2. 7106. Huber R, Barth H, Schmitt-Graff A, Klein R. Hypereosinophilia induced by high-dose intratumoral and peritumoral mistletoe application to a patient with pancreatic carcinoma. J Altern Complement Med 2000;6:305-10. PubMed
    3. 93264. Schad F, Atxner J, Buchwald D, Happe A, Popp S, Kröz M, Matthes H. Intratumoral Mistletoe (Viscum album L) Therapy in Patients With Unresectable Pancreas Carcinoma: A Retrospective Analysis. Integr Cancer Ther. 2014 Jul;13(4):332-40.
    4. 96495. Steele ML, Axtner J, Happe A, Kroz M, Matthes H, Schad F. Use and safety of intratumoral application of European mistletoe (Visum album L) preparations in oncology. Integr Cancer Ther. 2015 Mar;14(2):140-8.
    5. 93261. Kienle GS, Grugel R, Kiene H. Safety of higher dosages of Viscum album L. in animals and humans--systematic review of immune changes and safety parameters. BMC Complement Altern Med. 2011 Aug 28;11:72. PubMed
    6. 93265. Steele ML, Axtner J, Happe A, Kröz M, Matthes H, Schad F. Adverse Drug Reactions and Expected Effects to Therapy with Subcutaneous Mistletoe Extracts (Viscum album L.) in Cancer Patients. Evid Based Complement Alternat Med. 2014;2014:724258.

    Duloxetine

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

  • Tiredness / Headache Additional detail

    European Mistletoe

    Recorded for European Mistletoe in the same Natural Medicines adverse-effect record shown under Seizures above.

    Duloxetine

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

  • Diarrhea / Vomiting / Nausea Additional detail

    European Mistletoe

    Recorded for European Mistletoe in the same Natural Medicines adverse-effect record shown under Seizures above.

    Duloxetine

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

Reported for European Mistletoe but not commonly for Duloxetine: shortness of breath, an allergic reaction, low potassium and a severe allergic reaction.

Effects for Duloxetine come from the ADVERSE REACTIONS section of its FDA label; effects for European Mistletoe come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

European Mistletoe in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally or subcutaneously. European mistletoe might have uterine stimulant and abortifacient activity.

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 European Mistletoe or Duloxetine

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 Mistletoe or Duloxetine, 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 Duloxetine

This page covers European Mistletoe only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Duloxetine page lists 132 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Lithium (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 107 moderate · 20 minor.

Open the Duloxetine interaction page

One more smart check

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

We hold 91 real supplement products containing European Mistletoe, each one broken down to its full ingredient list — and combination products often carry several ingredients besides European Mistletoe. Even though European Mistletoe itself has no known interaction with Duloxetine, 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 European Mistletoe and Duloxetine 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 Mistletoe
Top half

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

29 days ago today
Medication Duloxetine
Top 5%

#47 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 Mistletoe reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The European Mistletoe and Duloxetine records this page draws on were last updated July 11, 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 Mistletoe

What is European Mistletoe?

European Mistletoe
  • Cancer supportive care
  • Immune support
  • High blood pressure
  • Anxiety and stress
  • Inflammation

European mistletoe is a parasitic plant most studied as an injectable extract used alongside conventional cancer care in some European countries, mainly to improve quality of life rather than to cure cancer. The plant is toxic if eaten, and oral or self-treatment can be dangerous, so it should only be used under medical supervision. Talk to your pharmacist or doctor before using any mistletoe product.

Viscum album · Santalaceae · Leaves, stems, and young twigs (whole aerial parts) · Injectable extracts (used in some countries), capsules, tinctures, teas, and standardized extracts

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

European Mistletoe: dosing

There is no single standard dose of European mistletoe for the general public. Injectable extracts used in clinical settings are dosed and adjusted by trained health professionals based on the specific product and the person's response.Because oral mistletoe products can be toxic and are not well studied, we cannot recommend a safe home dose. Never use mistletoe to self-treat a serious condition like cancer or high blood pressure.

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

Read the full European Mistletoe monograph & all interactions
Medication

About Duloxetine

What Is Duloxetine Used For?

Brand names: Cymbalta, Drizalma Sprinkle, Irenka

Duloxetine delayed-release capsules treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults. They also manage diabetic peripheral neuropathic pain (nerve pain from diabetes), fibromyalgia, and chronic musculoskeletal pain (such as chronic low back pain and pain from osteoarthritis) in adults.

GAD is also approved in pediatric patients 7 years and older for Cymbalta, Drizalma Sprinkle, and certain duloxetine delayed-release capsule products. Fibromyalgia is approved in patients 13 years and older for Cymbalta and some duloxetine delayed-release capsule products. Age-specific approvals vary by product — follow your prescriber's guidance on which product is right for your age group.

See full Duloxetine drug information
Keep checking

Other Drugs & European Mistletoe

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

0Major
293Moderate
0Minor
2,536No known interaction
Moderate

293 interactions

Showing 60 of 293 moderate interactions — see all 293 on the European Mistletoe page.

No interaction 2,536 drugs checked — show the list
Evidence & sources

European Mistletoe References

The 35 references that drive our European Mistletoe 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. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Harvey J, Colin-Jones DG. Mistletoe hepatitis. Br Med J (Clin Res Ed) 1981;282:186-7.
  5. Natl Cancer Inst. Mistletoe (PDQ). CancerNet. www.cancernet.nci.nih.gov/cam/mistletoe.htm#7 (Accessed 30 March 2001).
  6. Kaegi E. Unconventional therapies for cancer: 3. Iscador. Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. CMAJ 1998;158:1157-9.
  7. Grossarth-Matichek R, Kiene H, Baumgartner SM, Ziegler R. Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health
  8. Huber R, Barth H, Schmitt-Graff A, Klein R. Hypereosinophilia induced by high-dose intratumoral and peritumoral mistletoe application to a patient with pancreatic carcinoma. J Altern Complement Med 2000;6:305-10. PubMed
  9. Timoshenko AV, Cherenkevich SN, Gabius HJ. Viscum album agglutinin-induced aggregation of blood cells and the lectin effects on neutrophil function. Biomed Pharmacother 1995;49:153-8.. PubMed
  10. Bussing A, Regnery A, Schweizer K. Effects of Viscum album L. on cyclophosphamide-treated peripheral blood mononuclear cells in vitro: sister chromatid exchanges and activation/proliferation marker expression. Cancer Lett 1995;94:199-205.. PubMed
  11. Deliorman D, Calis I, Ergun F. A new acyclic monoterpene glucoside from Viscum album ssp. album. Fitoterapia 2001;72:101-5. PubMed
  12. Finall AI, McIntosh SA, Thompson WD. Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract. BMJ 2006;333:1293-4. PubMed
  13. Bauer C, Oppel T, Rueff F, Przybilla B. Anaphylaxis to viscotoxins of mistletoe (Viscum album) extracts. Ann Allergy Asthma Immunol 2005;94:86-9. PubMed
  14. Schoffski P, Breidenbach I, Krauter J, et al. Weekly 24 h infusion of aviscumine (rViscumin): A phase I study in patients with solid tumours. Eur J Cancer 2005;41:1431-8.
  15. Chernyshov VP, Omelchenko LI, Heusser P, and et al. Immunomodulatory actions of Viscum album (Iscador) in children with recurrent respiratory disease as a result of the Chernobyl nuclear accident. Complementary Therapies in Medicine 1997;5(3):141-146. DOI

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 Mistletoe and Duloxetine Together: Common Questions

Is it safe to take European Mistletoe with Duloxetine?
We do not list a known interaction between European Mistletoe and Duloxetine. 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 European Mistletoe and Duloxetine have any of the same side effects?
Yes — our sources link each of them separately to 8 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 European Mistletoe and Duloxetine combination checked?
Interactions in our licensed database are recorded against drug classes. Duloxetine is filed under 8 classifications, and European Mistletoe has documented interactions with 2 drug classes — none of Duloxetine'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 European Mistletoe interact with any other medications?
Yes. European Mistletoe has 293 documented drug interactions in our database — Duloxetine 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 Duloxetine interact with any supplements?
Yes. Duloxetine has documented interactions with 132 supplements in our database — European Mistletoe is not one of them. The Duloxetine 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 Duloxetine and European Mistletoe?

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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.