Drug & supplement interaction

Fennel + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

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

Tivozanib Hydrochloride falls into 2 drug categories that Fennel can interact with; the most serious is rated moderate. Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fennel and Tivozanib Hydrochloride

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Fennel interacts with whole categories of medication. Tivozanib Hydrochloride falls into 2 of those categories, so it can interact with Fennel in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Fennel interacts with.

Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.

In vitro research suggests that fennel inhibits CYP3A4 enzyme activity. This effect has not been reported in humans.
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 gist for Fotivda (tivozanib). Your body clears this cancer medicine using a liver enzyme called CYP3A4. In test-tube studies, fennel appears to slow that same enzyme down. If that were to happen in real life, tivozanib could build up a bit higher than expected, which might mean more of its usual side effects, things like high blood pressure, fatigue, diarrhea, mouth sores, or hand-foot skin reactions.

I want to keep this in perspective, though. This concern comes only from lab research and has not been seen in people. Everyday fennel in cooking or tea is very unlikely to cause trouble. Concentrated fennel supplements or the essential oil are a different story, so please run those by your oncology team or pharmacist before starting.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
  2. Subehan, Zaidi, S. F., Kadota, S., and Tezuka, Y. Inhibition on human liver cytochrome P450 3A4 by constituents of fennel (Foeniculum vulgare): identification and characterization of a mechanism-based inactivator. J Agric.Food Chem. 12-12-2007;55(25):101 PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Tivozanib Hydrochloride also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.

Animal research suggests that fennel oil has antithrombotic and antiplatelet effects.
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 gist: tivozanib (Fotivda) can already raise your bleeding risk on its own. As a kidney cancer treatment that targets blood vessel growth, it's known to cause problems like nosebleeds, easy bruising, blood in the urine, and in some cases higher blood pressure or more serious bleeds. Fennel, when taken as a concentrated supplement or essential oil, may have mild blood-thinning effects of its own, so stacking the two could in theory add up.

I want to be straight with you, though: this concern comes only from animal and lab studies, not human data, and using fennel as a normal food or spice is very unlikely to matter. To be safe, run any fennel supplements or fennel oil by your oncology pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Tognolini, M., Ballabeni, V., Bertoni, S., Bruni, R., Impicciatore, M., and Barocelli, E. Protective effect of Foeniculum vulgare essential oil and anethole in an experimental model of thrombosis. Pharmacol.Res 2007;56(3):254-260. PubMed
  2. Tognolini, M., Barocelli, E., Ballabeni, V., Bruni, R., Bianchi, A., Chiavarini, M., and Impicciatore, M. Comparative screening of plant essential oils: phenylpropanoid moiety as basic core for antiplatelet activity. Life Sci. 2-23-2006;78(13):1419-1432. PubMed

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

Fennel Also Interacts With Other Medications

Fennel has 739 moderate known drug interactions in our database — the Tivozanib Hydrochloride one above is among them. If you take anything else, check it against the full list below.

Moderate 739 No known interaction 2,091 (incl. Tivozanib Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Fennel

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

From our Q&A

Questions About Fennel or Tivozanib Hydrochloride

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

This page covers Fennel only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tivozanib Hydrochloride page lists 288 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Danshen (major), Grapefruit (major) and Piracetam (major).

By severity: 7 major · 239 moderate · 42 minor.

From our pharmacist’s overview on the Tivozanib Hydrochloride page

“Tivozanib (Fotivda), an oral targeted therapy for advanced kidney cancer, has a supplement list that calls for genuine vigilance. Seven of the 288 ingredients on file are rated major, and those seven deserve your attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Tivozanib Hydrochloride interaction page

One more smart check

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

We hold 2,219 real supplement products containing Fennel, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fennel. Your product may carry other ingredients that interact with Tivozanib Hydrochloride too, on top of Fennel — 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 Fennel and Tivozanib Hydrochloride 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 Fennel
Top 10%

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

29 days ago today
Medication Tivozanib Hydrochloride
Steady interest

#1,836 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 Fennel

What is Fennel?

Fennel
  • Digestive upset and bloating
  • Infant colic
  • Menstrual cramps
  • Cough and respiratory complaints
  • Breast milk support (traditional)

Fennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some small studies suggest possible benefit for certain stomach and menstrual symptoms, but the evidence is limited. It is generally well tolerated in food amounts, but concentrated supplements and the essential oil should be used with caution and after checking with your pharmacist or doctor.

Read the full Fennel monograph & all interactions
Medication

About Tivozanib

What Is Tivozanib Used For?

Brand name: Fotivda

Fotivda (tivozanib) is used to treat adults with advanced renal cell carcinoma (RCC) — a type of kidney cancer — that is relapsed or refractory (has come back or stopped responding to treatment) after two or more prior systemic therapies (cancer treatments given throughout the body).

See full Tivozanib drug information
Keep checking

Other Drugs & Fennel

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

0Major
739Moderate
0Minor
2,090No known interaction
739 Moderate 2,090 No interaction
Moderate

739 interactions

Showing 60 of 739 moderate interactions — see all 739 on the Fennel page.

No interaction 2,090 drugs checked — show the list

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

Showing the 60 most looked-up of 2,090 medications checked with no known interaction — see the full Fennel list.

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

Can you take Fennel with Tivozanib Hydrochloride?
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.
Why are there 2 interactions listed for Fennel and Tivozanib Hydrochloride?
Tivozanib Hydrochloride belongs to more than one drug category, and Fennel interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Fennel and Tivozanib Hydrochloride 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 Tivozanib Hydrochloride and Fennel?

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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.