Drug & supplement interaction

Fenugreek + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

Moderate Interaction
The bottom line Moderate

Fenugreek has a moderate interaction with Tivozanib Hydrochloride. Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.

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

Fenugreek and Tivozanib Hydrochloride

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Fenugreek interacts with.

Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Severity Moderate Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the gist for tivozanib (Fotivda). The concern on file is that some compounds in fenugreek may have a mild blood-thinning, anti-clotting effect. Tivozanib itself can also raise bleeding risk and bump up blood pressure, so the worry is that stacking the two could, in theory, make bleeding or bruising a bit more likely.

I'll be honest with you: this is mostly theoretical, based on lab and animal studies. One human study actually found that fenugreek seed powder didn't change platelet activity at all. Cooking amounts in food are very unlikely to matter. Still, since you're on a cancer therapy, please run any concentrated fenugreek supplement past your oncology team or pharmacist first, and watch for unusual bruising, nosebleeds, or blood in your stool.

References
  1. Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
  2. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty PubMed
  3. Parvizpur, A., Ahmadiani, A., and Kamalinejad, M. Probable role of spinal purinoceptors in the analgesic effect of Trigonella foenum (TFG) leaves extract. J Ethnopharmacol 3-8-2006;104(1-2):108-112. 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

Fenugreek Also Interacts With Other Medications

Fenugreek has 223 moderate, 165 minor known drug interactions in our database — the Tivozanib Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Fenugreek

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

Everything else you take

See Every Supplement That Interacts With Tivozanib Hydrochloride

This page covers Fenugreek 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 Fenugreek as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,385 real supplement products containing Fenugreek, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fenugreek. Your product may carry other ingredients that interact with Tivozanib Hydrochloride too, on top of Fenugreek — 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 Fenugreek 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 Fenugreek
Top 10%

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

29 days ago today
Medication Tivozanib Hydrochloride
Top half

#1,079 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 Fenugreek

What is Fenugreek?

Fenugreek
  • Blood sugar control
  • Boosting breast milk supply
  • High cholesterol
  • Digestive upset
  • Low testosterone or libido

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blood sugar, but overall the evidence is mixed and far from settled. It is generally well tolerated as food, but talk with your pharmacist or doctor before using it as a supplement, especially if you are pregnant.

Read the full Fenugreek 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 (a type of kidney cancer) that is relapsed or refractory — meaning it has come back or stopped responding to treatment — after two or more prior systemic (whole-body) cancer therapies.

See full Tivozanib drug information
Keep checking

Other Drugs & Fenugreek

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

0Major
223Moderate
165Minor
2,441No known interaction
Moderate

223 interactions

Showing 60 of 223 moderate interactions — see all 223 on the Fenugreek page.

Minor

165 interactions

Showing 60 of 165 minor interactions — see all 165 on the Fenugreek page.

No interaction 2,441 drugs checked — show the list

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

Showing the 60 most looked-up of 2,441 medications checked with no known interaction — see the full Fenugreek list.

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

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Pharmacist Counseling Corner

Taking Fenugreek and Tivozanib Hydrochloride Together: Common Questions

Can you take Fenugreek 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.
How serious is the Fenugreek 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 Fenugreek?

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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.