Drug & supplement interaction

European Mistletoe + Trifarotene

Trifarotene brand name: Aklief.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between European Mistletoe and Trifarotene 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 Trifarotene

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 Trifarotene 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 Trifarotene and European Mistletoe? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Trifarotene

Interactions in our licensed database are recorded against drug classes, not just single drug names. Trifarotene is filed under a single classification — topical drugs. European Mistletoe has documented interactions with 2 drug classes — the most serious being antihypertensive drugs (moderate) and immunosuppressants (moderate) — and none of Trifarotene’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 — Trifarotene isn’t one of them. If you take anything else, check it against the full list below.

Moderate 293 No known interaction 2,537 (incl. Trifarotene)

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 Trifarotene May Share a Side Effect

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.

Itching 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.
“Subcutaneously and intravenously, European mistletoe may cause pruritus, skin rash, and angioedema. When administered subcutaneously, the use of an extended dose-escalation regimen may limit the development of localized reactions in comparison to rapid dose escalation.”

European Mistletoe · Natural Medicines adverse-effect record, reported in pruritus.
6 sources cited

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

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.

93266. Steele ML, Axtner J, Happe A, Kröz M, Matthes H, Schad F. Safety of Intravenous Application of Mistletoe (Viscum album L.) Preparations in Oncology: An Observational Study. Evid Based Complement Alternat Med. 2014;2014:236310.

96476. Bussing A, Stumpf C, Troger W, Schietzel M. Course of mitogen-stimulated T lymphocytes in cancer patients treated with Viscum album extracts. Anticancer Res. 2007 Jul-Aug;27(4C):2903-10.

107285. Baek JH, Jeon Y, Han KW, Jung DH, Kim KO. Effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer: a cohort study. World J Surg Oncol 2021;19(1):178. PubMed

107286. Casetti F, Rafei-Shamsabadi D, Müller S. Grade II-anaphylaxis after subcutaneous injection of mistletoe extract. Contact Dermatitis 2021;85(4):462-5.
Trifarotene

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

Reported for European Mistletoe but not commonly for Trifarotene: liver problems, shortness of breath, an allergic reaction and stomach pain.

Effects for Trifarotene 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

Everything else you take

See Every Supplement That Interacts With Trifarotene

This page covers European Mistletoe only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Trifarotene page lists 3 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Dimethylsulfoxide (dmso) (moderate), Turpentine Oil (moderate) and Alchemilla (minor).

By severity: 2 moderate · 1 minor.

From our pharmacist’s overview on the Trifarotene page

“Trifarotene (Aklief) is a retinoid cream for acne, applied to the skin rather than swallowed, which keeps its supplement interaction list unusually short. Only three ingredients are on file, none rated major, and both moderate entries share one theme, boosting how much of a topical product soaks through the skin.”

Reviewed by 2 · Jul 18, 2026

Open the Trifarotene 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 Trifarotene, 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 Trifarotene 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

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

29 days ago today

Medication Trifarotene

Steady interest

#1,699 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 Trifarotene 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About European Mistletoe

What is 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 Trifarotene Topical

What Is Trifarotene Topical Used For?

Brand name: Aklief

Aklief Cream is used to treat acne vulgaris (common acne) on the face and trunk — including the chest, shoulders, and back. It is approved for patients 9 years of age and older.

See full Trifarotene Topical 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

293 Moderate 2,536 No 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

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

Showing the 60 most looked-up of 2,536 medications checked with no known interaction — see the full European Mistletoe list.

See the full European Mistletoe interactions page

See every supplement checked against Trifarotene, ranked by severity

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.

Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Harvey J, Colin-Jones DG. Mistletoe hepatitis. Br Med J (Clin Res Ed) 1981;282:186-7.
Natl Cancer Inst. Mistletoe (PDQ). CancerNet. www.cancernet.nci.nih.gov/cam/mistletoe.htm#7 (Accessed 30 March 2001).
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.
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
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
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
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
Deliorman D, Calis I, Ergun F. A new acyclic monoterpene glucoside from Viscum album ssp. album. Fitoterapia 2001;72:101-5. PubMed
Finall AI, McIntosh SA, Thompson WD. Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract. BMJ 2006;333:1293-4. PubMed
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
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.
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
Chernyshov, V. P., Heusser, P., Omelchenko, L. I., Chernyshova, L. I., Vodyanik, M. A., Vykhovanets, E. V., Galazyuk, L. V., Pochinok, T. V., Gaiday, N. V., Gumenyuk, M. E., Zelinsky, G. M., Schaefermeyer, H., and Schaefermeyer, G. Immunomodulatory and cl
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
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
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.
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.
Steele ML, Axtner J, Happe A, Kröz M, Matthes H, Schad F. Safety of Intravenous Application of Mistletoe (Viscum album L.) Preparations in Oncology: An Observational Study. Evid Based Complement Alternat Med. 2014;2014:236310.
von Schoen-Angerer T, Wilkens J, Kienle GS, Kiene H, Vagedes J. High-Dose Viscum album Extract Treatment in the Prevention of Recurrent Bladder Cancer: A Retrospective Case Series. Perm J. 2015 Fall;19(4):76-83.
Nazaruk J, Orlikowski P. Phytochemical profile and therapeutic potential of Viscum album L. Nat Prod Res. 2016;30(4):373-85.
Bussing A, Stumpf C, Troger W, Schietzel M. Course of mitogen-stimulated T lymphocytes in cancer patients treated with Viscum album extracts. Anticancer Res. 2007 Jul-Aug;27(4C):2903-10.
Noh D, Park JS, Lee DY. Acute respiratory distress syndrome after Viscum album pleurodesis for primary spontaneous pneumothorax. Koren J THorac Cariodvasc Surg. 2017 Feb;50(1):64-67.
Schad F, Axtner J, Kroz M, Matthes H, Steele ML. Safety of combined treatment with monoclonal antibodies and Viscum album L preparations. Integr Cancer Ther. 2018 Mar;17(1):41-51.
Thronicke A, Steele ML, Grah C, Matthes B, Schad F. Clinical safety of combined therapy of immune checkpoint inhibitors and Viscum album L. therapy in patients with advanced or metastatic cancer. BMC Complement Altern Med. 2017 Dec 13;17(1):534. PubMed
Khan T, Ali S, Qayyum R, Hussain I, Wahid F, Shah AJ. Intestinal and vascular smooth muscle relaxant effect of Viscum album explains its medicinal use in hyperactive gut disorders and hypertension. BMC Complement Altern Med. 2016 Jul 27;16:251. PubMed
Cho SJ, Kim SW, Chang JW. Acute pneumonitis consequent on pleurodesis with Viscum album extract: severe chest images but benign clinical course. Multidiscip Respir Med. 2014 Nov 27;9(1):61. PubMed
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.
Zuzak TJ, Wasmuth A, Bernitzki S, Schwermer M, Längler A. Safety of high-dose intravenous mistletoe therapy in pediatric cancer patients: A case series. Complement Ther Med. 2018;40:198-202. PubMed
Kim JD, Choi JW, Park HO, et al. Chemical pleurodesis with Viscum album L. extract for secondary spontaneous pneumothorax in elderly patients. J Thorac Dis 2020;12(10):5440-5445. PubMed
Baek JH, Jeon Y, Han KW, Jung DH, Kim KO. Effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer: a cohort study. World J Surg Oncol 2021;19(1):178. PubMed
Casetti F, Rafei-Shamsabadi D, Müller S. Grade II-anaphylaxis after subcutaneous injection of mistletoe extract. Contact Dermatitis 2021;85(4):462-5.
Cogo E, Elsayed M, Bhardwaj S, et al. Mistletoe Extracts during the Oncological Perioperative Period: A Systematic Review and Meta-Analysis of Human Randomized Controlled Trials. Curr Oncol 2023;30(9):8196-8219. PubMed

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 Trifarotene Together: Common Questions

Is it safe to take European Mistletoe with Trifarotene?

We do not list a known interaction between European Mistletoe and Trifarotene. 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 Trifarotene have any of the same side effects?

Yes — our sources link each of them separately to one 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 Trifarotene combination checked?

Interactions in our licensed database are recorded against drug classes. Trifarotene is filed under 1 classification, and European Mistletoe has documented interactions with 2 drug classes — none of Trifarotene'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 — Trifarotene 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 Trifarotene interact with any supplements?

Yes. Trifarotene has documented interactions with 3 supplements in our database — European Mistletoe is not one of them. The Trifarotene interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

European Mistletoe monograph Uses, safety profile, and every drug interaction in one place Trifarotene Topical drug information The full plain-English guide to this medication Trifarotene supplement interactions Every supplement checked against Trifarotene, 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 35 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Trifarotene 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.